Patterns of care and support in old age

Abstract: This study describes the situation for community living older people, 65 years of age and older in Iceland, analyzing their needs for care and services and how these needs are met. The study analyzes the relationship between the main providers of help and care, the formal caregivers and the informal carers. The study further depicts what kinds of care and support older informal caregivers provide and receive themselves and analyze what factors are related to providing care alone or in combination with other caregivers, informal and formal. The study also analyzes the relationship and mutual support between grandparents and grandchildren and whether there are gender differences in intergenerational relations and support. As little research has been conducted on informal care in Iceland, it is important to show the importance of the informal carers in the care paradigm. Two Icelandic studies were used for the descriptions and analysis. The main data source is the ICEOLD survey (Icelandic older people), based on a random representative national sample of 700 non-institutionalized persons in ages 65 – 79 years and 700 persons aged 80+. The final sample consists of 1,189 older persons to which an introduction letter was sent. They were contacted by phone a few days later and 782 persons, 341 men and 441 women, agreed to participate, giving a response rate of 66%. A study carried out among college students in Iceland, The Grammar School study, was also used to retrieve information on intergenerational relations between grandparents and grandchildren.The study indicates that older people in Iceland are receiving help and care from both informal and formal carers but informal help provided by family members seems to play a major role in supporting older people in their home. The great majority of the respondents with Instrumental Activities of Daily Living (IADL) limitations and Personal Activities of Daily Living (PADL) limitations received either informal or formal help but not both. The care and help provided is more often help with domestic tasks than with personal care. However, when the need increases the formal system steps in. It is not clear whether the informal care is a substitute for the formal one. As the formal help provided is rather sparse, it is suggested that when the need for personal care increases, the older person moves into a nursing home instead of increasing the formal care in the home. Women more often than men are the sole carers, and daughters are more important carers for older people than sons are.Older informal caregivers were alone in their caregiving in almost half of the cases and women more often than men. One third provided help with several tasks, such as help with errands and surveillance or keeping company in addition to ADL help. Older caregivers provide care even when they need help themselves.The results indicate that grandparents and grandchildren exchange more emotional than practical support. The emotional support provided and received by the generations is of great value. Gender influences the contact frequency between the generations, as women more often cultivate ties between grandparents and grandchildren.