Bianca Suanet

Informal and formal home-care use among older adults in Europe: can cross-national differences be explained by societal context and composition?

ABSTRACT Cross-national comparisons employed welfare state classifications to explain differences in care use in the European older population. Yet these classifications do not cover all care-related societal characteristics and limit our understanding of which specific societal characteristics are most important. Using the Survey of Health, Ageing and Retirement (second wave, 2006–07), the effect of societal determinants relating to culture, welfare state context and socio-economic and demographic composition on informal and formal care use of older adults in 11 European countries was studied. Multinomial multi-level regression analyses showed that, in addition to individual determinants, societal determinants are salient for understanding care use. In countries with fewer home-based services, less residential care, more informal care support and women working full time, older adults are more likely to receive informal care only. Older adults are more likely to receive only formal home care or a combination of formal and informal care in countries with more extensive welfare state arrangements (i.e. more home-based services, higher pension generosity), whereas the odds of receiving a combination of informal and formal care are also larger in countries that specify a legal obligation to care for parents. We tentatively conclude that the incorporation of societal determinants rather than commonly used welfare state classifications results in more understanding of the societal conditions that determine older adults’ care use.

Nonkin in Older Adults’ Personal Networks: More Important Among Later Cohorts?

OBJECTIVES Research on age-related changes in personal networks has found compelling evidence for socioemotional selectivity theory and exchange theory holding that older adults experience a decline in less emotionally close nonkin relations as they age. However, recent societal developments are likely to have increased the salience of nonkin relations. We hypothesize that age-related decline in the proportion of nonkin in personal networks has been delayed or is slower in late birth cohorts of older adults compared with earlier cohorts. METHOD Seven observations by the Longitudinal Aging Study Amsterdam covering a time span of 17 years since 1992 were analyzed using multilevel regression analysis. The sample had 12,949 person-year observations from 3,516 respondents born between 1908 and 1937. RESULTS Age-related decline in the proportion of nonkin is absent for cohorts born after 1922 and large for cohorts born in 1922 and before. Mediating variables for health and other resources did not explain cohort differences in age-related change. DISCUSSION The salience of nonkin relationships is likely to have increased due to societal changes, resulting in absence or delay of decline in later cohorts. The findings raise the need for a reevaluation of old age and the creation of new theoretical perspectives.

Adverse effects of frailty on social functioning in older adults: Results from the Longitudinal Aging Study Amsterdam

OBJECTIVES The aim of this study was to examine the association between physical frailty and social functioning among older adults, cross-sectionally and prospectively over 3 years. STUDY DESIGN The study sample consisted of 1115 older adults aged 65 and over from two waves of the Longitudinal Aging Study Amsterdam, a population based study. MAIN OUTCOME MEASURES Frailty was measured at T1 (2005/2006) using the criteria of the frailty phenotype, which includes weight loss, weak grip strength, exhaustion, slow gait speed and low physical activity. Social functioning was assessed at T1 and T2 (2008/2009) and included social network size, instrumental support, emotional support, and loneliness. RESULTS Cross-sectional linear regression analyses adjusted for covariates (age, sex, educational level and number of chronic diseases) showed that pre-frail and frail older adults had a smaller network size and higher levels of loneliness compared to their non-frail peers. Longitudinal linear regression analyses adjusted for covariates and baseline social functioning showed that frailty was associated with an increase in loneliness over 3 years. However, the network size and levels of social support of frail older adults did not further decline over time. CONCLUSIONS Frailty is associated with poor social functioning, and with an increase in loneliness over time. The social vulnerability of physical frail older adults should be taken into account in the care provision for frail older adults.

Trends in the informal and formal home-care use of older adults in the Netherlands between 1992 and 2012

ABSTRACT This study investigates trends in, and the interdependence of, the use of informal and formal home care of community-dwelling older people over the last two decades in the context of governmental reform of long-term care services and modernisation of informal relationships. Seven observations of the Longitudinal Aging Study Amsterdam covering the time span between 1992 and 2012 were analysed using multi-level logistic regression analysis. The sample entailed 9,585 observations from 3,574 respondents, aged between 65 and 85 years and living independently at each time of measurement. Measures included formal and informal care use, health, physical and cognitive limitations, socio-demographics, partner status, social network, privately paid help and sense of mastery. Results showed that between 1992 and 2012, formal home-care use increased slightly while there was a large decrease in the use of informal care. Multivariate multi-level logistic regression analyses showed a substitution effect between formal and informal care use which decreased over time. Analyses also showed improved cognitive functioning, increased partner availability and social network size, as well as increased use of privately paid care over time. Nevertheless, these positive trends did not explain the large decrease in informal care use. The results regarding informal care use suggest a societal trend of weakened informal solidarity, reflecting increased individualisation and increased availability of formal home care. The decreased substitution effect suggests that, in agreement with current reforms of long-term care, complementary or supplementary forms of care use may be more common in the near future.

Cohort Differences in Received Social Support in Later Life: The Role of Network Type

Objectives The objective is to assess cohort differences in received emotional and instrumental support in relation to network types. The main guiding hypothesis is that due to increased salience of non-kin with recent social change, those in friend-focused and diverse network types receive more support in later birth cohorts than earlier birth cohorts. Method Data from the Longitudinal Aging Study Amsterdam are employed. We investigate cohort differences in total received emotional and instrumental support in a series of linear regression models comparing birth cohorts aged 55-64, 65-74, 75-84, and 85-94 across three time periods (1992, 2002, and 2012). Results Four network types (friend, family, restricted, and diverse) are identified. Friend-focused networks are more common in later birth cohorts, restrictive networks less common. Those in friend-focused networks in later cohorts report receiving more emotional and instrumental support. No differences in received support are evident upon diverse networks. Discussion The increased salience of non-kin is reflected in an increase in received emotional and instrumental support in friend-focused networks in later birth cohorts. The preponderance of non-kin in networks should not be perceived as a deficit model for social relationships as restrictive networks are declining across birth cohorts.

Transnational aging among older Turkish and Moroccan migrants in the Netherlands: Determinants of transnational behavior and transnational belonging

Abstract This study investigates how resources and constraints (location of family, gender, income, cultural distance to society of settlement, and health) impact the experience of two interrelated dimensions of transnational aging: transnational behavior and transnational belonging. We specify transnational behavior by visitation of the country of origin and transnational belonging by emotional attachment to the country of origin and consideration of return migration. Data come from the Longitudinal Aging Study Amsterdam with interviews held between 2013 and 2014 with 264 Turkish migrants and 205 Moroccan migrants, aged 55–66. Regression analyses reveal that transnational belonging and behavior are explained by different factors. Family-in-laws’ location and gender only play a role in explaining transnational belonging, while cultural distance and self-rated health affect both dimensions, and subjective income only impacts transnational behavior. Results from the stratified analysis show that for Turkish migrants, family location, cultural distance, and health are important in considering return migration, whereas for Moroccan migrants, only cultural distance plays a role. We conclude that the distinction between transnational belonging and behavior is useful in understanding transnational aging and that our resources and constraints approach extends our view on older migrants.

Sibling Position and Marriage Timing in the Netherlands, 1840-1922: A Comparison across Social Classes, Local Contexts, and Time

Research on the effects of sibling position on marriage timing has produced ambivalent findings, suggesting that birth order effects were contingent on social, local, and historical contexts. Based on a large database of marriage certificates from five Dutch provinces between 1840 and 1922, we examine the influence of birth order on marriage timing. Our main conclusion is that sibling position became less important for marriage timing during the nineteenth century. This trend can be considered part of the transition from the West-European marriage pattern to a marriage pattern characterized by more universal marriage in which personal preferences became more significant.

National and transnational belonging among Turkish and Moroccan older migrants in the Netherlands: protective against loneliness?

This research investigates how a sense of belonging functions as protective mechanism against loneliness. Inspired by the work of Berry (1980) on acculturation strategies (i.e. integration, assimilation, separation and marginalization), we distinguish migrants who feel a relatively strong or weak sense of belonging to larger society and those who feel a strong or weak belonging to the “own group.” We expect that more national belonging contributes to less loneliness. We add a transnational perspective by arguing that feelings of belonging to the own group can take place in the country of settlement, but can also be transnational, i.e. a feeling of belonging to the country of origin. Transnational belonging can protect against loneliness, as it acknowledges the importance of place attachment. Using data from the Longitudinal Aging Study Amsterdam on older migrants aged 55–66, we employ latent class analysis and find five national belonging clusters, interpretable in terms of Berry’s acculturation strategies. Further analyses reveal mixed evidence: some aspects of transnational belonging vary with belonging to the own group, but other aspects point to a third dimension of belonging. Regression analysis shows that those marginalized are loneliest and that a transnational sense of belonging contributes to more loneliness. We conclude that Berry’s (1980) typology is useful for interpreting older migrants’ national belonging and that a transnational sense of belonging is apparent among older migrants, but needs to be explored further.

Social network type and informal care use in later life: A comparison of three Dutch birth cohorts aged 75-84

ABSTRACT Recent societal changes have increased the salience of non-kin relationships. It can be questioned whether network types that are more strongly non-kin-based give more informal care nowadays. We study how informal care use differs according to network type for three birth cohorts. Data from the Longitudinal Aging Study Amsterdam (LASA) on older adults aged 75–84 years, interviewed in 1992, 2002 and 2012, respectively (total sample size N = 2,151, analytical sample having functional limitations N = 926). We found four network types: restricted, family-focused with a partner, family-focused without a partner and wider community-focused diverse networks. Wider community-focused diverse networks are more common in the late birth cohort, whereas restricted networks and family-focused networks without a partner are less common. Logistic regression analyses reveal that those in a family-focused network with a partner use informal care more often than those in the other three network types, and insignificant interaction terms show that this does not differ by birth cohort. Irrespective of their network type, those in the late birth cohort use informal care less often. However, after controlling for need, predisposing and context factors, this cohort-difference is no longer significant. We conclude that despite large-scale societal changes, wider community-focused diverse networks do not provide more informal care than before and that among the functionally impaired, the odds of receiving informal care does not decline across birth cohorts.

Unmarried older people: Are they socially better off today?

Objectives Previous studies have shown that unmarried older adults are generally at disadvantage in personal networks and social well-being compared to the married. It can be questioned whether their situation has improved in contemporary society, as amongst others the stigma of divorce and being never-married has declined. We hypothesize differential developments in networks and well-being according to marital status (married, widowed, divorced and never-married) across birth cohorts. Method Data are from the 1993 and 2013 observations of the Longitudinal Aging Study Amsterdam on Dutch people aged 55-69 (N = 2,894) and 70-84 years (N = 2,317). We employ general linear modelling of network size and diversity, received emotional and instrumental support, emotional and social loneliness, and depressive symptoms. Results The widowed are better off socially in 2013 than in 1993. Similar to the divorced they have a larger network, and similar to the never-married they receive more emotional support and are less emotional lonely. We find some gender-differences in these developments. Discussion Societal change has not radically altered networks and well-being of unmarried older people. The widowed seem to benefit most, possibly because they are better able to retain relationships after widowhood.