Informal and paid care for Brazilian older adults (National Health Survey, 2013)

Lima-Costa, Maria Fernanda; Peixoto, Sérgio Viana; Malta, Deborah Carvalho; Szwarcwald, Célia Landmann; Mambrini, Juliana Vaz de Melo

doi:10.1590/S1518-8787.2017051000013

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Articles • Rev. Saúde Pública 51 (suppl 1) • 2017 • https://doi.org/10.1590/S1518-8787.2017051000013 copy

Informal and paid care for Brazilian older adults (National Health Survey, 2013)

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To describe the prevalence and sociodemographic factors associated with informal and paid care for Brazilian older adults with functional limitations.

METHODS

Of the 23,815 participants of the National Health Survey aged 60 or older, 5,978 reported needing help to perform activities of daily living and were included in this analysis. The dependent variable was the source of care, categorized as exclusively informal (unpaid), exclusively formal (paid), mixed or none. The socio-demographic variables were age (60-64, 65-74, ≥ 75 years old), gender and number of residents in the household (1, 2, ≥ 3). The multivariate analysis was based on binomial and multinomial logistic regressions.

RESULTS

Informal care predominated (81.8%), followed by paid (5.8%) or mixed (6.8%) and no care (5.7%). The receipt of care from any source increased gradually with the number of residents in a same household, regardless of age and gender (OR = 4.85 and 9.74 for 2 and ≥ 3, respectively). Age was positively associated with receiving any care while the male gender showed a negative association. The number of residents in the household showed the strongest association with informal care (OR = 10.94 for ≥ 3 residents), compared with paid (OR = 5.48) and mixed (OR = 4.16) care.

CONCLUSIONS

Informal care is the main source of help for community-dwelling older adults with functional limitations. In a context of rapid population aging and decline in family size, the results reinforce the need for policies to support long-term care for older Brazilians.

Aged; Caregivers; Disabled Persons; Activities of Daily Living; Socioeconomic Factors; Health Surveys

Characteristic	Total sample		Without limitation		With limitation^b		p^c

	%^a	95%CI	%^a	95%CI	%^a	95%CI	95%CI
Average age (years)	69.9	69.7–70.1	67.8	67.6–68.0	74.6	74.3–75.0	< 0.001
Age group (years)
60–64	32.2	31.1–33.2	39.0	37.7–40.3	16.4	15.1–17.8	< 0.001
65–74	41.9	40.8–43.0	44.7	43.5–46.0	35.8	33.4–37.3
≥ 75	26.0	25.0–27.0	16.3	15.4–17.3	48.3	46.3–50.3
Gender
Female	56.4	55.6–57.2	47.1	46.1–48.0	64.4	62.8–66.0	< 0.001
Male	43.6	42.8–44.4	52.9	52.0–53.9	35.6	34.0–37.2
Number of residents in the household
1	14.9	14.2–15.7	14.4	13.6–15.3	16.0	14.7–17.4	0.017
2	35.6	34.4–36.8	36.5	35.1–37.9	33.5	31.5–35.6
≥ 3	49.5	48.2–50.8	49.1	47.6–50.6	50.4	48.3–52.5
Needing help to perform at least one activity	-		-		81.2	79.4–82.8
Number of respondents	23,815		16,582		7,233

Source of help	%^a	95%CI
Source of care among those who received or needed it (n = 5,978)^b
Did not receive help though it was needed	5.7	4.8–6.7
Received informal help only	81.8	80.1–83.4
Received paid help only	5.8	4.8–6.8
Received both informal and paid help	6.8	5.7–8.0
Person who helped them to perform at least one of the activities (n = 5,619)^b
Unpaid family member residing in the household	62.0	59.9–64.2
Unpaid family member not residing in the household	35.8	33.7–38.0
Unpaid non-family member	4.9	4.0–6.0
Paid caregiver	3.4	2.7–4.3
Paid family member or domestic worker	10.3	9.0–11.7

Characteristic	No help		Any help (informal or unpaid)		Source of help

					Informal only		Paid only		Informal and paid

	%^b	95%CI^b	%^b	95%CI^b	%^b	95%CI^b	%^b	95%CI^b	%^b	95%CI^b
Age group (years)
60–64	26.2	20.2–33.2	13.5	12.1–15.0	13.9	12.4–15.5	14.5	9.9–20.7	7.8	4.5–13.2
65–74	48.0	40.2–56.0	31.5	29.5–33.6	32.4	30.3–34.7	28.6	22.1–36.2	22.7	16.6–30.4
≥ 75	25.8	10.8–32.8	55.0	52.8–57.1	53.7	51.4–55.9	56.9	48.7–64.7	69.5	61.1–76.8
							p^c < 0.001
Gender
Female	53.8	46.5–61.0	67.0	65.2–68.8	66.9	64.9–68.8	66.8	58.8–73.2	69.2	61.6–38.4
Male	46.2	39.1–53.5	33.0	31.2–34.8	33.1	31.3–35.1	33.2	26.8–40.2	30.8	24.2–38.4
					p^c = 0.006
Number of residents in the household
1	48.3	40.6–56.1	13.9	12.5–15.5	12.7	11.1–14.2	22.5	16.5–29.8	23.2	17.1–30.7
2	28.5	22.3–35.6	32.5	30.2–34.8	32.2	29.8–34.6	27.7	21.5–34.9	40.3	32.4–48.6
≥ 3	23.1	17.4–30.2	53.6	51.2–56.0	55.3	52.8–57.8	49.9	42.1–57.6	36.6	28.9–45.0
							p^c < 0.001
Number of respondents	359				4,890		383		346

Characteristic	Any help (informal or unpaid)		Source of help

			Informal only		Paid only		Informal and paid

	OR^b	95%CI^b	OR^c	95%CI^c	OR^c	95%CI^c	OR^c	95%CI^c
Age in years (vs. 60−64)
65–74	1.51	0.98–2.33	1.52	0.98–2.35	1.22	0.66–2.28	1.83	0.81–4.11
≥ 75	5.18	3.20–8.39	4.88	3.01–7.92	4.65	2.40–9.00	10.68	4.67–24.40
Male (vs. female)	0.53	0.38–0.73	0.53	0.38–0.73	0.55	0.35–0.87	0.50	0.31–0.82
Number of residents in the household (versus 1)
2	4.85	3.13–7.49	5.27	3.39–8.20	2.52	1.36–4.67	3.80	2.06–7.01
≥ 3	9.74	6.24–15.23	10.94	7.00–17.12	5.48	2.92–10.30	4.16	2.21–7.80

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Maria Fernanda Lima-Costa. Centro de Pesquisas René Rachou da Fundação Oswaldo Cruz. Av. Augusto de Lima, 1715. 30190-002 Belo Horizonte, MG, Brasil. E-mail: lima-costa@cpqrr.fiocruz.br