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Ageing, Care Need and Quality of Life The Perspective of Care Givers and People in Need of Care

:	Gabriele Doblhammer, Rembrandt Scholz
:	Gabriele Doblhammer, Rembrandt Scholz
:	Ageing, Care Need and Quality of Life The Perspective of Care Givers and People in Need of Care
:	VS Verlag für Sozialwissenschaften (GWV)
:	9783531923352
:	1
:	CHF 47.60
:

:	Sonstiges
:	English

:	243
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:	PDF

Steadily increasing life expectancy is one of the great achievements of industrialised societies over the last century. Life expectancy has not only been growing among the young and those reaching retirement age, but also, especially in recent decades, among people ages 80 and above. These improvements in life expectancy have led to the emergence of the so-called third age, when people retire, but are still you- ful, healthy and able to participate in society. Nevertheless, closer to the end of life, a fourth age of decrepitude and dependence on others has to be anticipated. - spite the postponement of functional limitations and severe disabilities into higher ages, the debate continues over whether the additional years gained are healthy years, or years with severe care need, particularly among the oldest old, the fastest growing segment of the population. Future improvements in life expectancy and the health status of the elderly will determine the need for care in the future. While different assumptions about these trends based on expert opinion or the extrapolation of past experiences can be made, there will always be a degree of uncertainty about future trends. A third - portant factor driving the extent of future care need is, however, already determined by the history of the past century and is embedded in the age structures of our populations.

Prof. Dr. Gabriele Doblhammer is Professor for Empirical Social Science and Demography at the University of Rostock and Director of the Rostock Center for the Study of Demographic Change.
Dr. Rembrandt Scholz is Research Scientist at the Max Planck Institute for Demographic Research, Rostock.

Part III: Care Givers (S. 203-205)

Perceived Care Giver Burden of Spouses and Children in Flanders: Who’s Feeling more Burdened and Why?

Benedicte De Koker

1. Introduction

The ageing of the population, in combination with other societal evolutions such as the increasing labour market participation of women and the shift towards care ‘in the community’, has led to a growing awareness of the care provided by spouses, relatives, neighbours and friends. It is now widely recognised that informal care constitutes the majority of all care given to elderly people, and that preservation of the informal care capacity is of paramount importance. In accordance with this perspective, scientists as well as policy makers have shown an increasing concern about the well-being of informal carers (Döhner/Kofahl 2005, Kröger 2001, Walker et al. 1995).

Since the 1980’s a bulk of studies have been carried out on the outcomes of informal care giving (Walker et al. 1995). From this research it emerged that giving care to a loved person who is ill or disabled may generate a considerable amount of strain and burden (Braithwaite 1992, Walker et al. 1995). Compared to persons not involved in care giving or population norms, informal carers are reporting more depressive symptoms and higher levels of distress and anxiety (Hirst 2003, Marks et al. 2002, Schulz et al. 1995). While results with regard to physical well-being are less univocal (Hirst 2004, Taylor et al. 1995), a number of studies have found that informal carers tend to have a lower immunity, more physical health complaints and even a higher mortality risk (Schulz/Beach 1999, Vitaliano et al. 2003).

Moreover, evidence exists that care giving is associated with other negative outcomes, like a higher risk of social isolation (Fast et al. 1999, George/Gwyther 1986) and a less favourable financial situation (Fast et al. 1999, Heitmueller/Inglis 2007). The concept of “care giver burden” plays an important role in understanding the outcomes of informal care giving. Although various definitions are apparent in the literature (Braithwaite 1992), the concept generally refers to the care givers’ perception of the impact care giving has on their lives (Stuckey et al. 1996). Because it is based on a personal perception, it is sometimes also referred to as perceived care burden or subjective care burden.

Care giver burden has proved useful in order to understand variation within care giving populations and as a predictor of carerelated outcomes such as the (desire for) institutionalisation of the person in need of care (Stuckey et al. 1996, Stull et al. 1994). Moreover, care giver burden has turned out to be a predictor of the general (psychological) well-being of the care giver (Braithwaite 1996, Chappell/Reid 2002, Lawton et al. 1991, Yates et al. 1999).

	Contents	6
	Preface	8
	Part I: Projections of Care Need and Care Resources	13
	People in Need of Long-term Care: The Present and the Future	14
	1. Introduction	14
	2. In Retrospect: The Development of the Number of People in Need of Long-term Care from 1999 to 2005	14
	2.1 Persons in Need of Long-term Care by Type of Care	14
	2.2 Explanations of Terms Relating to Long-term Care Statistics	16
	2.3 The Development of Persons in Need of Care by Care Level	16
	2.4 Past Developments of the Number of Persons in Care at Länder-level	17
	3. Age-specific Rates of Long-term Care in December 2005	18
	4. Development of the Numbers of People in Need of Care in Germany up to 2030 and in the Länder up to 2020 Status-quo Scenario	20
	4.1 Projection for Germany	20
	Excursus: Declining Long-term Care Rates from 1999 to 2005?	21
	4.2 Projections for the Länder	23
	5. Persons in Need of Care in Germany in 2020 and 2030 Scenario of “Declining Care Rates”	23
	6. References to other Projections	25
	References	27
	Care Need Projections for Germany until 2050	29
	1. Introduction	29
	2. Deterministic Projection	30
	2.1 Methodology and Assumptions	30
	2.2 Results	32
	3. Sensitivity Analysis	35
	4. Conclusion	39
	References	40
	Care Need Projections by Marital Status and Childlessness for Germany 2000-2030 based on the FELICIE Project	42
	1. Introduction	42
	2. Gender Proportions	43
	3. Family Status among German Elderly and Future Developments	45
	4. Childlessness in Germany in the Female Birth Cohorts 1900 to 1968	49
	5. The Prevalence of Care Need and the FELICIE Care Need Projections	50
	6. Summary and Discussion	56
	Literature	58
	Projection of Care Need and Family Resources in Germany	61
	1. Introduction	61
	2. Population Development and the Need for Care	63
	2.1 Population Projection by the DIW Assumptions	63
	2.2 Decline in Population, but Marked Increase in the Share of the Elderly until 2050	63
	2.3 Sharp Increase in the Number of People in Need of Care	65
	3. Changes in Care Giving Potential	66
	3.1 Impact of Changing Living Arrangements of the Elderly	67
	3.2 The Influence of Female Labour Force Participation	68
	3.3 Estimation of Care Giving Potential by 2050	70
	3.4 Ratio of People in Need of Care to Potential Care Givers	72
	4. Influence of Changing Health Status	75
	5. Conclusion	78
	Appendix	79
	References	81
	Cohort Trends in Disability and Future Care Need in Germany	82
	1. Introduction	82
	2. Data and Methods	82
	3. Results	84
	5. Discussion	90
	References	92
	Projections of the Number of People with Dementia in Germany 2002 Through 2047	94
	1. Introduction	94
	2. Dementia in Germany Today	96
	2.1 Prevalence of Dementia	96
	2.2 Projections of Numbers of People with Dementia in Germany	97
	3. Data and Projection Method	99
	4. Results	100
	4.1 Projection of the Number of People with Dementia	100
	4.2 Dementia-Free Life Expectancy at Ages 80-84 in Germany in 2002	104
	4.3 Dementia-Free Life Expectancy at Ages 80-84 in Germany in 2047	104
	5. Discussion	105
	References	108
	Part II: Health Factors and Care Determinants	112
	The Effect of Sex, Obesity and Smoking on Health Transitions: A Statistical Meta-analysis	113
	1. Introduction	113
	2. Methods	114
	2.1 Study Selection	114
	2.2 Measures of Outcome	115
	2.3 Measures of Risk Factors	116
	2.4 Statistical Analysis	116
	3. Results	117
	3.1 Search Results	117
	3.2 Sex	118
	3.3 Obesity	118
	3.4 Smoking	124
	3.5 Effect of Study Characteristics	127
	4. Discussion	127
	4.1 Summary of Main Findings	127
	4.2 Strengths and Limitations of this Study	128
	4.3 Implications for Future Research	129
	5. Acknowledgements	130
	Appendix	131
	Meta-regression Results