Chair: Marjolein Broese van Groenou:

Population ageing, retrenching welfare states, increasing cultural diversity and extending working lives are just a few of the developments that western societies are currently facing. These developments have large consequences for the provision and receipt of informal care, the care provided by the social network to those in need. This symposium addresses the global challenges to care, and provides new original empirical evidence regarding outcomes of providing and receiving informal care in different long term care contexts. First, Karen Glaser provides an overview of global challenges to family care and discusses to what extent social disparities exist in intergenerational care and support. Next, Martina Brandt takes a cross-national perspective and zooms in on how spousal caregiving affects wellbeing in different long-term care contexts. In the third paper Marjolein Broese van Groenou focuses on the receipt of informal care within the changing long term care context in the Netherlands, showing how patterns of informal and formal care affect the perceived quality of life of home-dwelling older adults. Together the three papers provide new perspectives on the growing importance of informal care in our societies and how disparities and adverse outcomes may be prevented. Norah Keating (University of Alberta, Canada) will address these issues and more in her discussion of our papers. None of the papers used financial support from commercial parties.

S1.6.1 Global challenges to family care

Karen Glaser

Kings College, London, UK

Background: Families are undergoing rapid transformations that are affecting intergenerational care and support around the Globe. While families have proved remarkably adaptable in the face of such change, the ability of families to provide care and support is at risk. We review key evidence on demographic and social trends and policy changes that are occurring around the world which may be leading to greater reliance on families – and whether this is disproportionately affecting the most disadvantaged. Methods: We examine both macro-level (e.g. from the United Nations, and the International Labour Force Organisation) and micro-level data from two key studies:  Wellbeing, Health, Retirement and the Lifecourse (e.g. British Retirement Survey, British Household Panel Survey/UKHLS, English Longitudinal Study of Ageing) and Grandparents in Europe (IPUMS-International and ONS Longitudinal Study).  The latter studies have used a variety of techniques including multivariate modelling and latent class analysis. Results: Evidence suggests that care demands are likely to increase given projected rises in complex multi-morbidities and challenging health conditions such as dementia, but social changes such as women’s increasing engagement in paid work and migration are influencing care and support within families. Moreover, changes in family behaviour are not distributed uniformly across social groups.  Conclusions: Evidence to date has raised concerns that the need for family assistance among all generations of the already disadvantaged may increase, potentially exacerbating social disparities in intergenerational care and support.

S1.6.2 Long-term care provision and the well-being of spousal caregivers: an analysis of

138 European regions

Melanie Wagner¹, Martina Brandt²

¹ Munich Center for the Economics of Aging (MEA), Max Planck Institute for Social Law and Social Policy, Germany, ² TU Dortmund, Germany

Background: The individual burden of caring for one’s relatives not only depends on care characteristics but is also related to contextual factors. The objective of this study is to determine whether regional formal long-term care provision is linked to the well-being of spousal caregivers introducing the concept of “control” as central pathway to explain this link. Methods: We applied multilevel analysis using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) from over 29,000 Europeans and 1,800 spousal caregivers located in 138 regions in eleven countries to analyze the effects of regional contexts on caregiver well-being. The provision of formal care in a region was measured by the number of long-term care beds in nursing and residential homes among the older population. Results: We found that spousal caregivers’ well-being, measured in terms of life satisfaction, loneliness, and depression, was positively linked to the regional availability of formal care, which is partly due to higher perceived control in regions with more formal care provision. Conclusions: Our results suggest that formal care supply is essential not only for care recipients but also for caregivers: perceived alternatives to the private care arrangement go along with greater well-being of informal caregivers.

S1.6.3 Do patterns of care affect the quality of care and quality of life among Dutch

older adults?

Marjolein Broese van Groenou

VU University, Amsterdam, the Netherlands

Background: The reform of long term care increases the need for informal care and the abilities to arrange care oneself. Yet, it is not known how this impacts the perceived quality of care and quality of life of the care recipient. This study examines to what degree quality of life of community-dwelling older adults is associated with the composition of the care network, the intensity of care provided and the perceived quality of care.  Method: Multivariate regression analyses were conducted using 607 respondents of the 2016 wave of the Longitudinal Aging Study Amsterdam, who received help with at least one of five tasks. Results: Multivariate analyses show that, adjusted for background variables and health status, a larger and more diverse care network lowered the perceived control over care and increased depressive symptoms. Interaction-effects show that the receipt of formal care in particular adds to depressive symptoms among older adults who highly value to stay in control of care themselves. Also, receiving care from  children reduces loneliness, in particular among those who report to be lacking control of care.  Conclusion: Results suggest a gap between preferred and realized patterns of care impacts on quality of life of older care recipients. This calls for better working linkages between formal and informal caregivers in order to increase the quality of life of those ageing in place.