Consumers’ Perspectives on Community-based Homecare and Welfare Services

1. Consumers’ Perspectives on Community-based Homecare and Welfare Services PMA van Bilsen, MSc1, JPH Hamers PhD. RN1, W Groot PhD2, C. Spreeuwenberg PhD. MD1 What we have learned The results confirm that elderly people want to remain in their familiar home environment as longas possible, even when they are on a waiting list for residential care. However, the use of welfare services especially set up to promote healthy aging in place was limited. There are indications that the fit between available welfare services and the demand of elderly people for this type of care is not optimal. The results of the second measurement should provide more information about the demand for welfare services in relation to the existing supply. Introduction Preliminary Results Increasingly, elderly people express the wish to remain in their familiar home environment as longas possible with a more varied provision of services. As a result, there is an increase in community-based care defined as locally and regionally organized servicestailored to the needs, beliefs, preferences and values of elderly people. Welfare services like home care alert, personal or group counselling and cultural, social and leisure activities are set up. It is unknown whether these welfare services meet the demands and preferences of elderly people? At baseline, 132 elderly people were subjected to interviews. The mean age was 84 year (sd 5,5). Objectives Users of welfare services compared to non-users Is the available supply of welfare services - especially set up to promote healthy aging at home - in accordance with the demand of elderly people who want to postpone residential care? Demand for residential care • Welfare users have smaller social networks (p<0.05) and are less satisfied with the sufficiency of their income (p<0.01). • Welfare users have a better functional status (p<0.01), are more mobile (p<0.05) and receive more informal care (p<0.01) compared to non-users. • 111 (80%) elderly people want to stay at home as long as possible. 21 (20%) elderly people say that they prefer residential care. Only 15 respondents would actual accept an offer for admission into a home for the elderly. • Elderly people who want to age-in-place feel more vital (p<0.01), experience better subjective wellbeing (p<0.01) and higher quality of life (p<0.01) compared to those who prefer residential care. Compared to women, men want to get admitted more often. Methods A longitudinal study including 2 measurements was started. The sample at baseline consist of 428 elderly people aged 65 and over on a waiting list for residential care. Data were collected using structured interviews. The interviews consisted of questions regarding: quality of live, well-being, autonomy, income, loneliness, functional status, self agency, social network, (in)formal care, welfare use, housing. Discussion The data collection of this study is ongoing and as a result the research question cannot be answered yet. However, the results of the first measurement shows that the use of welfare services at home is still limited. Maybe this is an indication that the fit between available welfare supply and demand is not optimal. In order to understand the demand of elderly people in a better way, the importance of resources like social network and the ability to manage daily activities should be considered (Van Bilsen et al 2005). Use of welfare services Response rate = 44% • 39 (30%) elderly people did not use welfare services and said that they would not use it in the future. • Home care alert and social activities are the most popular services Welfare users (n=93) Van Bilsen, P.M.A., et al (2005) Demand of elderly people for residential care: an exploratory study. Submitted 1 Universiteit Maastricht, Dept. of Health Care Studies, section Nursing Science (www.nursingscience.nl). Corresponding: p.vanbilsen@zw.unimaas.nl 2 Universiteit Maastricht, Dpt. of Health Organisation, Policy and Economics (www.beoz.unimaas.nl)