Use of care

Use of care

LASA filenames:
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,  I and J-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 (only in the H wave). Fourth, questions about perceived control of the care were asked. In the 3B and MB wave, only the questions regarding assistance with household tasks, personal care as well as nursing care, the perceived sufficiency of the care received and the perceived control over care are asked.

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. From the H-wave onward, the same questions were  added to the interview for received help with nursing, transport and administrative tasks.

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. From the I-wave onward, 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.

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 in 2000. 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 (2001) 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 (2013) 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 / LASAJ033 / LASAK033
(main interview, in Dutch)

LASAC603 / LASAD603 / LASAE603 / LASAF603 / LASAG603 / LASAH603 / LASAI603 / LASAJ603 / LASAK603
(telephone interview with PROXY, in Dutch)
LASAC703 / LASAD703 / LASAE703 / LASAF703 / LASAG703 / LASAH703 / LASAI703 / LASAJ703 / LASAK703
(telephone interview with RESP, in Dutch)


Variable information
LASAB033 / LASAC033 / LASAD033 / LASAE033 / LAS2B033 / LASAF033 / LASAG033 / LASAH033 / LAS3B033 / LASMB033 / LASAI033 / LASAJ033 / LASAK033;
LASAH233 (scale scores)
(pdf);
LASAC603 / LASAD603 / LASAE603 / LASAF603 / LASAG603 / LASAH603 / LASAI603 / LASAJ603 / LASAK603
(pdf);
LASAC703 / LASAD703 / LASAE703 / LASAF703 / LASAG703 / LASAH703 / LASAI703 / LASAJ703 / LASAK703
(pdf)

Availability of information per wave ¹

BCDE
2B*		FGH

3B*		MB*IJK
Use of Personal care
– by R
– by spouse
– in case of illness		MaMaMaMaMaMaMaMaMaMaMaMaMa
Use of Personal care
– by R		-
-		Tr
Tp		Tr
Tp		Tr
Tp		-
-
Tr
Tp		Tr
Tp		Tr
Tp		-
-		-
-		Tr
Tp		Tr
Tp		Tr
Tp
Use of Household care
– by R
– in case of illness		MaMaMaMaMaMaMaMaMaMaMaMaMa
Use of Household care
– by R		-
-		Tr
Tp		Tr
Tp		Tr
Tp		-
-		Tr
Tp		Tr
Tp		Tr
Tp		-
-		-
-		Tr
Tp		Tr
Tp		Tr
Tp
Care evaluationMaMaMaMaMaMaMaMaMaMaMaMaMa
Use of nursing care
– by R		-
-
-		-
-
-		-
-
-		-
-
-		-
-
-		-
-
-		-
-
-		Ma
Tr
Tp		Ma
-
-		Ma
-
-		Ma
Tr
Tp		Ma
Tr
Tp		Ma
Tr
Tp
Use of transportation care
– by R		-
-
-		-
-
-		-
-
-		-
-
-		-
-
-		-
-
-		-
-
-		Ma
Tr
Tp		Ma
-
-		Ma
-
-		Ma
Tr
Tp		Ma
Tr
Tp		Ma
Tr
Tp
Use of administrative care
– by R		-
-
-		-
-
-		-
-
-		-
-
-		-
-
-		-
-
-		-
-
-		Ma
Tr
Tp		Ma
-
-		Ma
-
-		Ma
Tr
Tp		Ma
Tr
Tp		Ma
Tr
Tp
Personal budget-------Ma-----
Perceived control-------MaMaMaMaMaMa
SatisfactionMaMaMaMaMaMaMaMaMaMaMaMaMa
Need for Care-----MaMaMaMaMaMaMaMa
Aggregated variables
care network
(LASAH233)		-------Ma-----
Aggregated variables
care network
(LASAH233)		-------Ma-----
BCDE
2B*		FGH

3B*		MB*IJK

¹ More information about the LASA data collection waves is available here

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

Ma=data collected in main interview;
Tr=data collected in telephone interview with respondent;
Tp=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 Sport, and/or in collaboration with the National Institute for Social Research (SCP). The use of care has been studied with regard to:

  1. Trends in differences by socio-economic status and gender (cohort comparisons)
  2. Differences relating to health and mental functioning
  3. Composition of the care network and associations with well-being
  4. Transitions in use of care, including residential care (longitudinal comparisons)


Use of the care variables in research: A syntax
In many of the studies on care in LASA (see the list op publications below), three important binary variables are constructed for the use of help with household activities and/or the use of help with personal care: use of informal care, use of formal care and use of privately paid care. These variables can also be combined in one variable showing whether mixes of care types are used. Here are the links to the syntax for the construction of these variables, including a merger of the information from the main interview and the interview by phone or by proxy:
– Syntax Care Use wave B (pdf)
– Syntax Care Use wave C (pdf)
– Syntax Care Use wave D (pdf)
– Syntax Care Use wave E (pdf)
– Syntax Care Use wave F (pdf)
– Syntax Care Use wave G (pdf)
– Syntax Care Use wave H (pdf)
– Syntax Care Use wave I (pdf)
– Syntax Care Use wave J (pdf)†

† The syntax is designed for the construction of these variables on the J-wave, but can easily be adjusted to be applied to other waves. One remark has to be made: the variable names in the 603 and 703 files may vary by wave (see also the files with variable information).

Publications on care use

Articles in academic English peer reviewed journals

  1. Aaltonen, M., Raitanen, J., Comijs, H.C., Broese van Groenou, M.I. (2020). Trends in the use of care among people aged 65-85 with cognitive impairment in the Netherlands. Ageing & Society, 40, 43-72.
  2. Alders, P., Comijs, H.C., Deeg, D.J.H. (2017). Changes in admission to long-term care institutions in the Netherlands: comparing two cohorts over the period 1996-1999 and 2006-2009. European Journal of Ageing, 14, 123-131.
  3. Alders, P., Deeg, D.J.H., Schut, F.T. (2019). Who will become my co-residents? The role of attractiveness of institutional care in the changing demand for long-term care institutions.  Archives of Gerontology and Geriatrics, 81, 91-97.
  4. Boumans, J., Deeg, D.J.H. (2011). Changes in the quality of life of older people living at home: does type of care play a role? Tijdschrift voor Gerontologie en Geriatrie, 42, 170-183.
  5. Broese Van Groenou, M. (2020). Associations between care network types and psychological well-being among Dutch older adults. International Journal of Care and Caring, 1, online first. https://doi.org/10.1332/239788220X15833754379590
  6. 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.
  7. Broese van Groenou, M.I., Jacobs, M.T., Zwart-Olde, I., Deeg, D.J.H. (2016). Mixed care networks of community-dwelling older adults with physical health impairments in the Netherlands. Health & Social Care in the Community, 24, 1, 95-104.
  8. Da Roit, B., Thomése, G.C.F. (2016). Is more local home care more (un)equal? Socioeconomic inequalities in the access to home care in Dutch municipalities before and after the implementation of the Social Support Act (WMO) in 2007. Mens en maatschappij, 91, 4, 381-403.
  9. 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.
  10. Hoogendijk, E.O., Deeg, D.J.H., Poppelaars, J.L., Van der Horst, M.H.L., Broese van Groenou, M.I., Comijs, H.C., Pasman, H.R.W., Van Schoor , N.M., Suanet, B.A., Thomése, G.C.F., Van Tilburg, T.G., Visser, M., Huisman, M. (2016). The Longitudinal Aging Study Amsterdam: cohort update 2016 and major findings. European Journal of Epidemiology, 31, 927-945.
  11. 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
  12. Jacobs, M. T., van Tilburg, T. G., Groenewegen, P., & Broese Van Groenou, M. I. (2016). Linkages between informal and formal caregivers in home-care networks of frail older adults. Ageing and Society, 36(8), 1604-1624.
  13. Portrait, F.R.M., Lindeboom, M., Deeg, D.J.H. (2000). The use of long-term care services by the Dutch elderly. Health Economics, 9, 513-531.
  14. 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.
  15. 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)
  16. Puts, M.T.E., Lips, P.T.A., Ribbe, M.W., Deeg, D.J.H. (2005). The effect of frailty on residential/nursing home admission in the Netherlands independent of chronic diseases and functional limitations. European Journal of Ageing, 2, 264-274.
  17. Suanet, B., Broese Van Groenou, M. I., & van Tilburg, T. G. (2019). Social network type and informal care use in later life: A comparison of three Dutch birth cohorts aged 75-84. Ageing and Society, 39(4), 749-770.
  18. Swinkels, J. (2013). Trends in formal and informal care use in the Netherlands between 1992 and 2012. Master Thesis Sociology, VU University, Amsterdam.
  19. 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
  20. Wouterse, B., Huisman, M., Meijboom, B.R., Deeg, D.J.H., Polder, J.J. (2013). Modeling the relationship between health and health care expenditures using a latent Markov model. Journal of Health Economics, 32, 423-439.


Publications in Dutch

  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. (2004). Sociaal-economische verschillen in de hulpverlening van kinderen aan hun oude ouders. Sociale Wetenschappen, 47, 4, 49-64.
  4. Broese van Groenou, M.I. (2005). Delen in de zorg: de rol van broers en zussen in de zorg van kinderen voor hun ouders. In A. de Boer (Ed.), Kijk op Informele Zorg (pp. 61-74). Den Haag: SCP.
  5. Broese van Groenou, M.I. (2011). Samen zorgen voor ouderen. Tijdschrift voor Gerontologie en Geriatrie, 42, 156-158.
  6. Broese van Groenou, M.I., van der Pas, S., & Deeg, D.J.H. (2000). Zorg voor ouderen: Verwachtingen en werkelijkheid. Gerõn, 2, 3, 24-29.
  7. 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
  8. 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.
  9. 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
  10. Colder, L., Broese van Groenou, M.I. (2019). LASA: Sociaaleconomische ongelijkheid in informele zorg. Gerõn, Tijdschrift over ouder worden & samenleving, 21, 3.
  11. 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.
  12. Deeg, D.J.H., Smits, C.H.M. (1995). Even ziek maar minder hulp?: Factoren die invloed hebben op het zorggebruik van oudere vrouwen [Equally ill but less assistance?: Factors influencing use of care in older women]. In C.H.M. Smits, M.J.F.J. Vernooij-Dassen(Eds.), De toekomst van vrouwen. Oudere vrouwen in onderzoek, beleid en praktijk [The future of women: Older women in research, policy, and practice] (pp. 49-57). Amsterdam: VU-Uitgeverij.
  13. 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.
  14. 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.
  15. Jacobs, M. T., Broese Van Groenou, M. I., & Deeg, D. J. H. (2014). Overleg tussen mantelzorgers en formele hulpverleners van thuiswonende ouderen [Discussion between informal and formal caregivers of community-dwelling older adults]. Tijdschrift voor Gerontologie en Geriatrie, 45(2), 69-81.
  16. Knipscheer, C.P.M., Broese van Groenou, M.I. (2004). Determinanten van zorgbelasting bij partners en kinderen van hulpbehoevende ouderen met fysieke gezondheidsproblemen. Tijdschrift voor Gerontologie en Geriatrie, 35, 96-106.
  17. Schuijt-Lucassen, N.Y., & Broese van Groenou, M.I. (2006). Verschillen in zorggebruik door ouderen naar inkomen: De rol van gezondheid, sociale context, voorkeur en persoonlijkheid [Income inequality in the use of professional home care by older adults: The impact of health, social context, care preference and personality]. Tijdschrift voor Gezondheidswetenschappen, 84, 4-11.


Dissertations

  1. Jacobs, M.T. (2016). Connecting to care. The interrelationships between informal and formal caregivers in care networks of community-dwelling older adults. PhD Dissertation, VU University Amsterdam.
  2. Portrait, F. (2000).Long-term care services for the Dutch elderly: An investigation into the process of utilization. PhD Dissertation, VU University Amsterdam.
  3. Tolkacheva, N. (2011). Sharing the care of older parents. PhD Dissertation, VU University Amsterdam


Reports for the Ministry of Health, Welfare and Sport
Reports are available here.

  • Van Tilburg, T. & Suanet, B. (2019).  Reisduur van netwerkleden van kwetsbare ouderen: Implicaties voor professionele zorg, eenzaamheid en depressie.
  • Broese van Groenou, M.I. & Bijnsdorp, F. (2017). Zorgnetwerk, kwaliteit van zorg en kwaliteit van leven.
  • Broese van Groenou, M.I. & Deeg, D.J.H. (2016). Gezond, sociaal actief en zelfstandig ouder worden.
  • Thomese, F., Sluik, J. & Huisman, M. (2015). Zorgtransities en verschillen in kwaliteit van leven bij ouderen.
  • Tolkacheva, N. & Thomese, F. (2014). Sociale en emotionele factoren bij verhuizingen van ouderen naar een zorginstelling of een aangepaste woonvorm.
  • 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.
  • Thomese, F. & Tolkacheva, N. (2013).Verhuizing naar (semi)residentiële woonvormen.
  • Pasman, H.R.W., Onwuteaka‐Philipsen, B.D. & Deeg, D.J.H. (2012). De laatste levensmaanden van ouderen in Nederland.
  • Plaisier, I., Broese van Groenou, M.I. & Deeg, D.J.H. (2012). Kwetsbare ouderen: zorg of geen zorg?
  • Plaisier, I., van Tilburg, T.G., Deeg, D.J.H. (2011). Mogelijkheden voor preventie van AWBZ-gebruik: netwerken van zelfstandig wonende ouderen.
  • Van Vliet, M.G., Broese van Groenou, M.I. en Deeg, D.J.H. (2010). Extramurale zorgzwaartepakketten. 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.


Side studies on use of care

1. End of Life Care for all publications on end-of-life-care

2. Family Caregivers

3. Perceived control of care


Date of last update: April 21, 2020