Social care: need for and receipt of help

Joanne Thompson, Raphael Wittenberg, Catherine Henderson, Robin Darton (2014)

in Health Survey for England 2013 ,

  • This chapter presents information about the need for and receipt of social care among adults aged 65 and over.
  • Participants aged 65 and over were asked whether they needed help with a list of Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). ADLs are activities relating to personal care and mobility about the home, and IADLs are further activities important to living independently..
  • 23% of men and 33% of women aged 65 and over needed help with at least one ADL, and 22% and 35% respectively reported needing help with at least one IADL.
  • Overall, 11% of men and 14% of women aged 65 and over had received help with at least one ADL in the last month, and 15% and 30% respectively had received help with at least one IADL.
  • The need for help increased with age. 13% of men and 21% of women aged 65-69 needed help with ADLs, compared with 46% and 59% respectively aged 85 and over.
  • Both need for help and receipt of help increased with age. There was also variation across tertiles of equivalised household income, with greatest need and highest proportions receiving help in the lowest income tertile.
  • 19% of men and 29% of women aged 65 and over had some unmet need with at least one ADL, and 13% and 16% respectively had some unmet need with at least one IADL.
  • Among people who had received help with ADLs in the last month, most had received this from informal helpers1 only (88% of men and 71% of women), rather than formal helpers only, or a combination of both. The picture was similar for IADLs.
  • Help with ADLs was most frequently provided by a spouse or partner, followed by daughters and sons. Help with IADLs was most frequently given by a spouse or partner for men (47%) and a daughter for women (38%). Friends and neighbours were more likely to have provided help with IADLs than ADLs.
  • The majority of those receiving help with ADLs or IADLs reported having received this kind of help for a year or more (84% of men and 85% of women).
  • Information was collected about the patterns of care provided by formal and informal helpers. Spouses or partners mainly provided help every day, and a substantial proportion provided 20 or more hours a week (33% for men, 30% for women), while 30% and 39% respectively helped for one to nine hours per week. Most informal care was provided during the day time only (63% for men, 73% for women).
  • Patterns of care provided by daughters to their mothers were different, reflecting the fact that many were not living with their parent. They were more likely to provide care once (25%) or 2-3 times per week (22%), to provide care for fewer than ten hours (68%), and mainly to provide day time care only (88%).
  • Older people were asked whether they made use of a range of aids and equipment. An alarm to call for help, a grab rail or stair rail and a bath or shower seat were the most frequently mentioned. Women were more likely than men to use most types of equipment.
  • All adults were asked about accessibility features of their homes, even if they did not currently use them. Among older adults, over bath and walk in showers were the most frequently mentioned features (and are not necessarily related to accessibility). Accessible parking or a drop off point and hand rails were also relatively common.
  • The majority of people aged 65 and over did not currently use any form of mobility aid (80% of men and 69% of women). Walking sticks were the most commonly used overall. Mobility aids were used more as age increased, particularly among women, with 60% of women aged 85 and over using a walking stick, 30% a zimmer frame and 17% a manual wheelchair.