Elderly prefer in-home care by family; family don’t

A new American study suggests that you shouldn't assume a home care professional can provide better care for your parent than you can.

Study co-author, Steven Stern, a University of Virginia economics professor, found that elder parents are more likely to describe themselves as “happy” when they are receiving informal in-home care from an adult child or spouse than when they receive formal in-home care from a nurse, home health aide or other home care professional.

Appearing in the International Economic Review, the study examined data covering about 3,500 households with at least one member age 70 or older who participated in the 1993 wave of a nationally representative, longitudinal survey called the Assets and Health Dynamics Among the Oldest Old.
 
The survey, which was conducted by the University of Michigan, was designed to study older Americans in terms of health, family characteristics (including demographic details of one's spouse and/or children), income and wealth, but it did not include any direct measure of health quality.

Consequently, self-reported “happiness” was used as a proxy, Professor Stern noted.
 
Of the 3,500 respondents, 22% received some sort of in-home care, 90% of which was informal, performed by family or friends, compared with 18% formal, meaning care was provided by home care staff. Eight percent received both.
 
“A big part of looking at happiness isn't the care per se, but the fact that the kid is involved in it,” explaining why he felt self-reported happiness was more common among those receiving informal in-home care from a child or spouse.
 
Many children of elderly parents did not share that insight about how parental happiness during long-term care may hinge more on sharing time with loved ones rather than the medical proficiency of a relative stranger.
 
“The kids who are more educated perceive their own caregiving as not particularly high-quality. They think that formal care is going to be more high-quality.”
 
That attitude may reflect belief in the whole concept of professionalism, the notion that a professional, by definition, will be more skilled at a given task than a non-professional.
 
Such assumptions have huge financial implications as Baby Boomers age and swell the ranks of those needing long-term care. Billions of dollars are at stake, both for society and for family nest eggs, in decisions about whether in-home elder care will be provided informally or formally, according to the study findings.