Use of care

Use of care


LASA033 / LASA233
LASA603 / LASA703

Contact: Marjolein Broese van Groenou

Background
Services from long term care (e.g. residential care, home care) are, within the Dutch system of long term care, available for persons with a specific level of need. There are three types of facilities and services, for which an approved indication on medical grounds are required, but the legislation and allocation of these services has changed considerably during the LASA period. Until January 2007 there was one institute that assessed the needs for appliances, social services and care (RIO). Since January 2007 a distinction is made between facilities for disabled persons (WVG-voorzieningen: Wet Voorzieningen Gehandicapten), social services and household care (Wmo: Wet Maatschappelijke Ondersteuning) and personal care (by professionals, AWBZ: Algemene Wet Bijzondere Ziektekosten, indication by CIZ). Since 2007 persons who have an indication for (AWBZ) professional care, can choose for a personal financial budget (PGB) from which they can hire a professional caregiver themselves. In 2015 the AWBZ was transformed into the Chronic Care Act (Wlz), covering residential care, and the Care Insurance Act (Zwv), covering personal care and nursing care for community-dwelling persons. The coverage of the Social Support Act was extended and since then covered transport, walking devices, household care and guidance.

Measurement instruments in LASA
In LASA, questions concerning care use have been asked in the main study. The concept of care refers to actual care received and potential care use in case of sickness. In all waves use of care concerned assistance with household tasks as well as personal care. The care can be provided by either formal services (from public and private funds) and/or informal caregivers (spouse, family, neighbours, friends, volunteers). Besides type of care and source of care, the intensity of care has been asked as well as the perceived sufficiency of care. In the H and I wave, several additional questions have been asked. First, questions were added about received help with nursing, transport and administrative tasks. Second, the total number of helpers was asked for informal caregivers per type and formal caregivers providing care in a team. Third, intensity and gender was recorded for each of the other caregivers (not in I wave). Fourth, questions about perceived control of the care were asked as well whether the care was paid out of a personal budget (PersoonsGebonden Budget). In the 3B, MB and I wave, use of care concerned assistance with domestic tasks, personal care as well as nursing care. The care can be provided by either formal services (from public and private funds) and/or informal caregivers (spouse, family, neighbours, friends, volunteers). Besides type of care and source of care, the intensity of care has been asked as well as the perceived satisfaction with care. Also perceived control of the care was investigated.

Need for (more) care
In addition to the question about perceived sufficiency of care, starting from wave F, questions were asked about the need for care. In wave F this involved a question regarding the need for more home care and if answered affirmative whether they applied for home care at the official sites, whether they received additional home care, or why they did not apply or did not receive home care respectively. At the G-wave it only involved one question (need more homecare, yes/no?). At the H- and B3-wave, if the respondent reported to be not satisfied with the care received, questions were asked about what help they need: more hours of help, another type of help, or help from other informal or formal helpers. At the I-wave six different questions were asked regarding unmet needs: whether one was in need of more help with personal care, household care, nursing care and guidance, and whether one was in need of care regarding mental complaints or physical complaints.

In the telephone interviews the same questions were asked of the respondent and, if the respondent could not be interviewed, the proxy. In the C, D, E, F and G wave, the respondent/proxy was asked if the respondent received help with domestic care as well as personal care, and from which source. During the H and I wave, the same questions were asked for received help with nursing, transport and administrative tasks.

 

Side studies

In addition to the main study, three additional side studies have been conducted on care. The first is on the use of care in the last phase of life. Relatives of deceased respondents were selected and asked to report about the health and use of care in the final months of life of the LASA-respondent. If this relative had performed informal care in the final phase of life, he or she received an additional questionnaire and was approached for qualitative interviews. Details of the data collection in this side study are reported elsewhere [1].

The second side study concerned the family context of caregiving to older adults. In this study a selection of older parents were interviewed about the care giving activities of their spouse and children. Spouses and children were also approached for questioning and reported about care activities twice with an interval of about one year and a half. Details of this data-collection are available elsewhere [2].

The third side study concerned perceived control in health care. In this study a selection of older parents was interviewed about perceived control in health care and perceived quality in life. Details of this data-collection are available elsewhere [3].

In this report only the data available from the main study are described. The use of other professional health care services are also included in LASA-main study, but are documented elsewhere (see: Contact with Health and Social Services, Hospital Admission, Contact with Medical Specialists).

Questionnaires
LASAB033 / LASAC033 / LASAD033 / LASAE033 / LAS2B033 / LASAF033 / LASAG033 / LASAH033 / LAS3B033 / LASMB033 / LASAI033
(main interview, in Dutch)

LASAC603 / LASAD603 / LASAE603 / LASAF603 / LASAG603 / LASAH603 / LASAI603
(telephone interview with PROXY, in Dutch)
LASAD703 / LASAE703 / LASAF703 / LASAG703 / LASAH703 / LASAI703
(telephone interview with RESP, in Dutch)

In wave C the same questionnaire was used for both respondent and proxy, see LASAC603

Variable information
LASAB033 / LASAC033 / LASAD033 / LASAE033 / LAS2B033 / LASAF033 / LASAG033 / LASAH033 / LAS3B033 / LASMB033 / LASAI033;
LASAH233 (scale scores)
(pdf)

LASAC603 / LASAD603 / LASAE603 / LASAF603 / LASAG603 / LASAH603 / LASAI603
(pdf)

LASAD703 / LASAE703 / LASAF703 / LASAG703 / LASAH703 / LASAI703
(pdf)

Availability of information per wave1:

 

B

C

D

E

 
2B*

F

G

H



3B*

MB*

I

Use of Personal care
- by R
- by spouse
- in case of      illness

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Use of Personal care
- by R
- Tel_resp/
Tel_proxy
Tel_resp
Tel_proxy
Tel_resp
Tel_proxy
- Tel_resp
Tel_proxy
Tel_resp
Tel_proxy
Te_resp
Te_proxy
- - Tel_resp
Tel_proxy

Use of Household care
- by R
- in case of   illness

Ma

Ma

Ma

Ma

Ma

Ma

Ma

 

Ma

Ma

Ma

Ma

Use of Household care
- by R
- Tel_resp/
Tel_proxy
Tel_resp
Tel_proxy
Tel_resp
Tel_proxy
- Tel_resp
Tel_proxy
Tel_resp
Tel_proxy
Tel_resp
Tel_proxy
- - Tel_resp
Tel_proxy

Care evaluation

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Ma

Use of nursing care
- by R

-

-

-

-

-

-

-

Ma
Tel_resp
Tel_proxy

Ma

Ma

Ma
Tel_resp
Tel_proxy

Use of transportation care
- by R

-

-

-

-

-

-

-

Ma
Tel_resp
Tel_proxy

-

-

Ma
Tel_resp
Tel_proxy

Use of administrative care
- by R

-

- - - - - -

Ma
Tel_resp
Tel_proxy

-

-

Ma
Tel_resp
Tel_proxy

Personal budget

-

-

-

-

-

-

-

Ma

-

-

-

Perceived control

-

-

-

-

-

-

-

Ma

Ma

Ma

Ma

Satisfaction Ma Ma Ma Ma Ma Ma Ma Ma Ma Ma Ma
Need for Care - - - - - Ma Ma Ma Ma Ma Ma

Aggregated variables care network (LASAH233)

-

-

-

-

-

-

-

Ma

-

-

-

1 More information about the LASA data collection waves is available on:
http://www.lasa-vu.nl/data/lasa/sampleLASAdatacollection.html

* 2B=baseline second cohort;
  3B=baseline third cohort;
  MB=migrants: baseline first cohort

Ma=data collected in main interview;
Tel_resp=data collected in telephone interview with respondent;
Tel_proxy=data collected in telephone interview with proxy

Previous use in LASA
In LASA the focus has been on the general use of informal and formal care. Informal care is then defined by the use of help from at least one type of informal caregiver (partner, other type of resident, child, other relative, neighbor or friend) with either household activities and/or personal care. Formal care is defined as by the use of help from at least one type of formal caregivers (home care and/or residential caregiver) with either household activities and/or personal care. In addition, help received from volunteers and help received from privately paid helpers, are distinguished. Variation in use of care has generally been examined using the Behavioral Model of use of Care (Andersen & Newman 2005), which typifies individual determinants of use of care in terms of need, disposition and external factors. Many publications are reports written on request of the ministry of Health, Welfare and Sports, and/or in collaboration with the National Institute for Social Research (SCP). The use of formal and informal care has been studied with regard to

  1. Differences by socio-economic status
  2. Differences relating to health and mental functioning
  3. Composition of the social network
  4. Transitions in use of care, including residential care
  5. Historic developments in use of care

Publications on care use

  1. Boer, A. de, Ouddijk, D. & Broese Van Groenou, M.I. (2011). Wonen en zorg. In C. van Campen (Ed.), Kwetsbare ouderen (pp. 149-164). Den Haag: Sociaal en Cultureel Planbureau.
  2. Broese van Groenou, M.I. (2000). Minder gezond, dus meer zorg? Een onderzoek naar de sociaal-economische verschillen in zorggebruik bij ouderen. In D.J.H. Deeg, R.J. Bosscher, M.I. Broese van Groenou, L. Horn & C. Jonker (Eds.), Ouder worden in Nederland. Tien jaar Longitudinal Aging Study Amsterdam (pp. 147-154). Amsterdam: Thela Thesis.
  3. Broese van Groenou, M.I., van der Pas, S., & Deeg, D.J.H. (2000). Zorg voor ouderen: Verwachtingen en werkelijkheid. Geron, 2, 3, 24-29.
  4. Broese van Groenou, M., K. Glaser, C. Tomassini & T. Jacobs (2006) Socio-economic status differences in older people’s use of informal and formal help: a comparison of four European countries, Ageing & Society, 26, 5, 745-766.
  5. Broese van Groenou, M.I and D.J.H. Deeg (2007) Gebruik van thuiszorg en welzijnsvoorzieningen door 55-plussers tussen 1992 en 2006. Een onderzoek naar individuele en historische ontwikkelingen. Onderzoek uitgevoerd in opdracht van ministerie VWS.
  6. Broese van Groenou, M.I. & van Tilburg, T.G. (2007). Het zorgpotentieel in de netwerken van ouderen. In A. de Boer (Ed.), Toekomstverkenning Informele Zorg (pp. 45-64). Den Haag: Sociaal & Cultureel Planbureau.
  7. Campen, C. van, Broese van Groenou, M.I., Deeg, D.J.H. & Iedema, J. (2013). Met zorg ouder worden. Zorgtrajecten van ouderen in tien jaar. Den Haag: Sociaal Cultureel Planbureau.
  8. Campen, C. van, Iedeman, J., Broese van Groenou, M.I. & Deeg, D.J.H. (2017). Langer zelfstandig. Ouder worden met hulpbronnen, ondersteuning en zorg. Den Haag: SCP
  9. Deeg, D.J.H., & Broese van Groenou, M.I. (2007). Zorggebruik door ouderen na opname in het ziekenhuis: Ontwikkelingen in 1992-2002. Tijdschrift voor Gezondheidswetenschappen, 85, 174-182.
  10. Geerlings, S.W. & Deeg, D.J.H. (2004). Veranderingen in zorggebruik. In M.M.Y. de Klerk (Ed.), Zorg en wonen voor kwetsbare ouderen. Rapportage Ouderen 2004 (pp. 65-79). Den Haag: SCP.
  11. Geerlings, S.W., Broese van Groenou, M.I., & Deeg, D.J.H. (2004). Determinanten van  veranderingen in zorggebruik. In M.M.Y. de Klerk (Ed.), Zorg en wonen voor kwetsbare ouderen. Rapportage Ouderen 2004 (pp. 81-111). Den Haag: SCP.
  12. Geerlings, S.W., Pot, A.M., Twisk, J.W.R., & Deeg, D.J.H. (2005). Predicting transitions in the use of informal and professional care by older adults. Ageing & Society, 25, 111-130.
  13. Jacobs, M.T., Aartsen, M.J., Deeg, D.J.H. & Broese Van Groenou, M.I. (2016). Diversity in older adults’ care networks: the added value of individual beliefs and social network proximity. Journals of Gerontology. Series B: Psychological Sciences and Social Sciences. doi: 10.1093/geronb/gbw012
  14. Portrait, F. (2000). Long-term care services for the Dutch elderly: An investigation into the process of utilization. PhD Dissertation, VU University Amsterdam.
  15. Pot, A.M., Deeg, D.J.H., Twisk, J.W.R., Beekman, A.T.F., & Zarit, S.H. (2005). The longitudinal relationship between the use of long-term care and depressive symptoms in older adults. Gerontologist, 45, 359-369.
  16. Pot, A.M., Portrait, F.R.M., Visser, G., Puts, M.T.E., Broese van Groenou, M.I., Deeg, D.J.H. (2009). Utilization of acute and long-term care in the last year of life: comparison with survivors in a population-based study. BMC Health Services Research, 9, 139 (online only, DOI: 10.1186/1472-6963-9-139)
  17. Swinkels, J. (2013). Trends in formal and informal care use in the Netherlands between 1992 and 2012. Master Thesis Sociology, VU University, Amsterdam.
  18. Swinkels, J.C., Suanet, B., Deeg, D.J.H. & Broese Van Groenou, M.I. (2016). Trends in the informal and formal home-care use of older adults in the Netherlands between 1992 and 2012. Ageing and Society, 36 (9), 1870-1890. doi: 10.1017/S0144686X1500077X
  19. VWS. (2001). Zorg nabij. Notitie over mantelzorgondersteuning. Den Haag: VWS.

Reports for the Ministry of Health, Welfare and Sports

  • Thomese, F., Sluik, J. & Huisman, M. (2015). Zorgtransities en verschillen in kwaliteit van leven bij ouderen. LASA-report 2015 voor het ministerie van VWS. Amsterdam: LASA, VU/VUmc.
  • Huisman, M., Claasens, L, en Deeg, D.J.H. (2014). Ervaren regie bij Nederlandse ouderen en de samenhang ervan met zorggebruik, demografische factoren en persoonlijkheid. VWS-rapport 2014. Amsterdam: LASA VU/VUmc.
  • Plaisier, I., Broese van Groenou, M.I. & Deeg, D.J.H. (2012). Kwetsbare ouderen: zorg of geen zorg? LASA-report 2011 voor het ministerie van VWS. Amsterdam: LASA, VU/VUmc.
  • Plaisier, I., van Tilburg, T.G., Deeg, D.J.H. (2011). Mogelijkheden voor preventie van AWBZ-gebruik: netwerken van zelfstandig wonende ouderen [Opportunities for prevention of publicly paid care: social networks of independently living older adults]. LASA-report 2010.
  • Thomese, F. & Tolkacheva, N. (2013). Verhuizing naar (semi)residentiële woonvormen. [Moving into (semi)residential care]. LASA-report 2013.
  • Van Vliet, M.G., Broese van Groenou, M.I. en Deeg, D.J.H. (2010). Extramurale zorgzwaartepakketten. Rapport in opdracht van het ministerie van VWS. Amsterdam: LASA.

Side studies on use of care

1. Use of care at the end of life

    • Klinkenberg, M., Visser, G., Broese van Groenou, M.I., Van der Wal, G., Deeg, D.J.H., & Willems, D.L. (2005). The last 3 months of life: care, transitions and the place of death of older people. Health and Social Care in the Community, 13, 420-430.

 

2. Family Caregivers

3. Perceived control of care