24. Improved Measures and Methodologies. Past models of formal and informal care have focused on either the individual or macro level. As such, they have tended to ignore the role of supply-side and demand-side characteristics at the regional level or the individual-level availability of care needs and potential supports. By explicitly linking these two levels of data for two different time points, it is 3ossible to investigate how regional characteristics affect the extent and type of supports received by the individuals within them. The proposed pilot research will link individual and regional level data on formal and informal care systems in Sweden, a country which serves as an excellent starting 3oint for understanding health disparities and ethnocultural variation in care. The project aims first to identify regional demographic and formal care characteristics that are associated with formal and informal supports to older adults and rates of unmet need.
A second aim i s to determine whether longitudinal changes in demographic characteristics and availability of formal services have differentially affected women, the oldest old, those with little available kin support, and those with greatest functional impairment. Multilevel models will be used to address the study aims by linking statistics for 212 of Sweden's 289 municipalities with nationally representative individual data from these municipalities in 1994 (N = 1379) and 2000 (N = 1466). Levels of home help services have decreased in Sweden over this period while the older population in Sweden grows increasingly old and frail. This provides an ideal opportunity to examine how municipal level changes in home help services and demographic characteristics have affected the balance of ADL assistance that frail older Swedes receive from formal and informal sources and any resulting changes in rates of unmet need for assistance. Better understanding of the relation between formal and informal care systems has important implications for planning and design of services, and for finding more effective ways to support and sustain older adults and their families within the community.
| Davey, Adam; Malmberg, Bo; Sundström, Gerdt (2014) Aging in Sweden: local variation, local control. Gerontologist 54:525-32 |
| Davey, Adam; Femia, Elia E; Zarit, Steven H et al. (2005) Life on the edge: patterns of formal and informal help to older adults in the United States and Sweden. J Gerontol B Psychol Sci Soc Sci 60:S281-8 |
