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Pan-EuropeanNetwork
1
CoreGroup
EUROFAMCAREEUROFAMCARE
Care-Arrangements against the background of various welfare states
models. First results of the EU-Project EUROFAMCARE
Eva Mnich, Hanneli Döhner
The EUROFAMCARE group: Germany: Döhner H. (project coordinator), Kofahl C., Luedecke D., Mnich E. (Hamburg) and Rothgang H., Becker R. (Bremen); Greece: Mestheneos E. (PI), Triantafillou J. (PI), Prouskas C., Mestheneos K.; Italy: Lamura G. (PI), Balducci C., Melchiorre M.G., Quattrini S., Spazzafumo L.; Poland: Bien B. (PI), Wojszel B., Synak B., Czekanowski P., Bledowski P., Pedich W,; Sweden: Öberg B. (PI), Krevers B., Johansson S.L.; United Kingdom: McKee K. (PI), Barber L., Brown J., Nolan M.
“Services for Supporting Family Carers of Elderly People in Europe: Characteristics, Coverage and Usage”
E U R O F A M C A R EE U R O F A M C A R EE U R O F A M C A R EE U R O F A M C A R E
Pan-EuropeanNetwork
2
CoreGroup
EUROFAMCAREEUROFAMCARE
Six Countries Comparative Study
AGE – European OlderPeople‘s Platform
Brussels
Universityof Hamburg
Italian National Research Centre on AgeingINRCA Ancona
National School for Public Health
SEXTANT Athens
Universityof Bremen
The Medical Academyof Bialystok
&University of Gdansk
Linköping University&
Socialstyrensen Stockholm
Universityof Sheffield
Pan-EuropeanNetwork
3
CoreGroup
EUROFAMCAREEUROFAMCARE
Aims
• EUROFAMCARE will provide a European review of the situation of family carers of elderly people in relation to the existence, familiarity, availability, use and acceptability of supporting services.
• EUROFAMCARE will push a change management process at various policy levels to promote social and health policies towards a partnership approach between family carers, professional providers and cared-for.
Pan-EuropeanNetwork
4
CoreGroup
EUROFAMCAREEUROFAMCARE
Methodology
In depth studies in the 6 countries 6.000 Interviews with family caregivers Elderly in need of support aged over 65 Extent of care/support 4 or more hours per week
Postal or phone interviews (follow-up study) after one year
Postal/phone or face to face interviews with service providers
Background Reports provided by both the 6 core countries and the 17 Pan-European countries
Pan-EuropeanNetwork
5
CoreGroup
EUROFAMCAREEUROFAMCARE
Questions for Data Analysis
Differences of existing service provision on the one hand and on the other hand the knowledge about services and their availability,
The use and non-use of such service provision with fundamental reasons in special interest,
Experience with as well as evaluation of such services with respect to effectiveness and efficiency,
Claimed needs of support, resulting from the individual family situation, which beside others may point out a lack of specific services,
Specific types of family care situation and their relation to specific services, respectively the lack of services.
Pan-EuropeanNetwork
6
CoreGroup
EUROFAMCAREEUROFAMCARE
Organizations of volunteers
Other informal assistants
Service Provider
ElderNeeds > Ressources
Caregiving Relatives(Ressources etc.)
The involved actors
Supply of support
Pan-EuropeanNetwork
7
CoreGroup
EUROFAMCAREEUROFAMCARE
Procedure
Caregiver
- Male / female- Higher / lower educational status-Not gainfully employed / gainfully employed- Cares up to 2 years / more than 2 years- Support / no support during illness- Low burdened / burdened (COPE)- Low / high life quality- Other /same generation
Care-arrangements- rural / urban
- separate / shared household
Cared-for
- Male / female- under / over 80 years- no / cognitive impairments (subjective)- low / high functional impairments (ADL / IADL)- No need / need of financial support
in dichotomous criteria almost 33.000 combinations
Pan-EuropeanNetwork
8
CoreGroup
EUROFAMCAREEUROFAMCARE
Procedure
Family-Carer
Care-arrangement
Cared-for
Reduction on cluster
Country-specific key aspects of care-arrangements
Relevance of support according to care-
arrangements in countries
Relevance of support according to care-
arrangements
Country-specific relevance of
support
Pan-EuropeanNetwork
10
CoreGroup
EUROFAMCAREEUROFAMCARE
1 Female (Carer) 6 No support available
9 Female (Cared-for) 13 Need of financial support (Cared-for)
2 Same generation 7 High strain 10 80 years and older (Cared-for)
14 Shared household
3 Low educational status 8 Life-quality is high 11 Cognitive impairments
15 Rather urban region
4 Gainfully employed 12 Functional impairments
5 Duration of care more than 2 years
Care-arrangement 1
Care-arrangement 2
Prozent von ...
75,432,449,986,676,557,877,231,657,662,780,0 2,5 9,3 98,9 95,90%
25%
50%
75%
100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
62,256,051,390,973,384,585,118,772,172,490,9 3,7 37,1 1,1 93,50%
25%
50%
75%
100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15N=891
N=851
Pan-EuropeanNetwork
11
CoreGroup
EUROFAMCAREEUROFAMCARE
1 Female (Carer) 6 No support available
9 Female (Cared-for) 13 Need of financial support (Cared-for)
2 Same generation 7 Strain is high 10 80 years and older (Cared-for)
14 Shared household
3 Low educational status 8 Life-quality is high 11 Cognitive Impairments
15 Rather urban region
4 Gainfully employed 12 Functional impairments
5 Duration of care more than 2 years
Care-arrangement 3
Care-arrangement 4
Prozent von ...
67,491,535,779,459,630,91,534,873,271,599,3 97,1 48,5 5,9 72,00%
25%
50%
75%
100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
76,192,445,369,744,424,697,153,058,975,274,22,136,089,53,30%
25%
50%
75%
100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
N=824
N=419
Pan-EuropeanNetwork
12
CoreGroup
EUROFAMCAREEUROFAMCARE
55,398,832,645,418,639,176,470,814,919,668,563,410,05,374,10%
25%
50%
75%
100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Female (Carer) 6 No support available
9 Female (Cared-for) 13 Need of financial support (Cared-for))
2 Same generation 7 Strain is high 10 80 years and older (Cared-for)
14 Shared household
3 Low education status 8 Life-quality is high 11 Cognitive impairments
15 Rather urban region
4 Gainfully employed 12 Functional impairments
5 Duration of care more than 2 years
Care-arrangement 5
Care-arrangement 6
Prozent von ...
72,09,029,996,863,976,676,179,926,859,076,1 7,2 16,6 39,6 11,90%
25%
50%
75%
100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15N=775
N=571
Pan-EuropeanNetwork
13
CoreGroup
EUROFAMCAREEUROFAMCARE
1 Female (Carer) 6 No support available
9 Female (Cared-for) 13 Need of financial support (Cared-for)
2 Same generation 7 Strain is high 10 80 years and older (Cared-for)
14 Shared household
3 High education status 8 Life-quality is high 11 Cognitive Impairments
15 Rather urban region
4 Gainfully employed 12 Functional impairments
5 Duration of care more than 2 years
Care-arrangement 7
Percentage of ...
72,70,012,23,716,039,375,670,718,935,750,063,114,79,774,40%
25%
50%
75%
100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
N=1053
Pan-EuropeanNetwork
14
CoreGroup
EUROFAMCAREEUROFAMCARE
Distribution of care-arrangements
15,8%
19,6% 16,5%
15,3%7,8%14,4%
10,6%
Subjective and objective highly strained, not gainfully employed, caring woman without support
Subjective and objective highly strained, gainfully employed Carer
Caring wives/ women with medium strain without support
Caring husbands / men with medium strain without support
Rather subjectively strained, not gainfully employed Carers in separate household with support
Subjectively a. objectively less strained, gainfully employed carers in mutual household with support
Subjectivly a. objectivly less strained, gainfully employed carers in separate household
N=5384
Pan-EuropeanNetwork
15
CoreGroup
EUROFAMCAREEUROFAMCARE
Distribution of care-arrangements in the six countries
N=889 N=792
N=884N=972
N=949 N=898
Pan-EuropeanNetwork
16
CoreGroup
EUROFAMCAREEUROFAMCARE
Dimensionanalysis of important forms of support
Financial-technical support
More money for care Adjustment of housing
Support in planning of future care
Stress coping,
Problemorientation
Visiting self-help groups for family carers Talking about problems
Training of care skills
Spending more time with the family
Support in handling family disputies
Autonomy,
Time souvereignty
Respite from care Attendance to activities beyond care
Activities for the cared-for
Combining care with mit employment
Spending more time with the family
Training and Information
Information about available support possibilities Information about diseases Training of care skills
Pan-EuropeanNetwork
17
CoreGroup
EUROFAMCAREEUROFAMCARE
Overview of focal needs in respective countries categorized in groups of care-arrangements (CA)
Greece Total CA 1 CA 2 CA 3 CA 4 CA 5 CA 6 CA 7
finan.-technical. support + + + + + + (+) + +
Stress coping., Problemorienta. + (+) - -
Relief of strain, time sovereignt. -
Training and Information (+) (+) + (+)
Poland Total CA 1 CA 2 CA 3 CA 4 CA 5 CA 6 CA 7
finan.-technical. support + + + + + + + + + (+)
Stress coping., Problemorienta. (-) (+) - - (-) (-) -
Relief of strain, time sovereignt. (+) - - -
Training and Information - - - - - - - -
Pan-EuropeanNetwork
18
CoreGroup
EUROFAMCAREEUROFAMCARE
Overview of focal needs in respective countries categorized in groups of care-arrangements (CA)
Schweden Total CA 1 CA 2 CA 3 CA 4 CA 5 CA 6 CA 7
finanz.-techn. Unterstützung - - - - - - - - - - - - - -
Stress coping., Problemorienta + + + + + + + (+) +
Relief of strain, time sovereignt. (+) ++
Training and Information
Germany Total CA 1 CA 2 CA 3 CA 4 CA 5 CA 6 CA 7
finanz.-techn. Unterstützung - - - - - - - - - -
Stress coping., Problemorienta (+) - (-) - - -
Relief of strain, time sovereignt. -
Training and Information (-) - -
Pan-EuropeanNetwork
19
CoreGroup
EUROFAMCAREEUROFAMCARE
Overview of focal needs in respective countries categorized in groups of care-arrangements (CA)
Italy Total CA 1 CA 2 CA 3 CA 4 CA 5 CA 6 CA 7
finan.-technical. support + + +
Stress coping., Problemorienta.
Relief of strain, time sovereignt. - - - - - - - - - - (-)
Training and Information + + + + + + + +
England Total CA 1 CA 2 CA 3 CA 4 CA 5 CA 6 CA 7
finan.-technical. support + +
Stress coping., Problemorienta
Relief of strain, time sovereignt. + + + (+)
Training and Information +
Pan-EuropeanNetwork
23
CoreGroup
EUROFAMCAREEUROFAMCARE
Summary
+ -finan./technical(stress coping)*
+(finan./techn.)*
(time autonomy)*
(Information)*
-
+Information
(finan./technical)*
-Time autonomy
+finan./technical
(information)*
(stresscoping)*
-(stress coping)*
+finan./technical
-Information
(time autonomy)**
+Stress coping
-finan./technical
* in special care-arrangements ** concerns caring spouses / partner