Unmet Need for Assistance with Activities of Daily Life Among Older Adults in Brazil

Overview

Journal Rev Saude Publica

Specialty Public Health

Date 2018 Aug 2

PMID 30066812

Citations 7

Authors

Tania Bof de Andrade

Fabiola Bof de Andrade

Affiliations

Soon will be listed here.

Abstract

Objective: To estimate the proportion of unmet need for personal assistance for basic and instrumental activities of daily life and to evaluate socioeconomic inequalities related to the unmet need among community-dwelling Brazilian older adults.

Methods: This was a cross-sectional study with data from the last National Health Survey in Brazil. Unmet need was considered as the presence of at least one unmet need for basic or instrumental activities of daily life among individuals reporting the need for assistance. Logistic regression models were used to assess the correlates and probabilities of unmet need.

Results: The proportion of unmet need was 18% and 7.1% for basic and instrumental activities of daily life, respectively. Unmet need was significantly related to living arrangements and socioeconomic status. Individuals in the first quintile of wealth status had about 50% higher probability of having an unmet need. A family member was the most prevalent type of caregiver.

Conclusions: Long-term care policy is needed to reduce the proportion of unmet need, especially among socioeconomically disadvantaged groups. Future studies should address the availability, training, and remuneration of caregivers, as those are an indispensable labor force in an aging society.

Citing Articles

Predicting unmet activities of daily living needs among the oldest old with disabilities in China: a machine learning approach.

Wang K, Zhao J, Hu J, Liang D, Luo Y Front Public Health. 2023; 11:1257818.

PMID: 37771828 PMC: 10523409. DOI: 10.3389/fpubh.2023.1257818.

A systematic review and meta-analysis of unmet needs for healthcare and long-term care among older people.

Rahman M, Rosenberg M, Flores G, Parsell N, Akter S, Alam M Health Econ Rev. 2022; 12(1):60.

PMID: 36482044 PMC: 9733388. DOI: 10.1186/s13561-022-00398-4.

Community Support for Persons with Disabilities in Low- and Middle-Income Countries: A Scoping Review.

Hunt X, Bradshaw M, Vogel S, Encalada A, Eksteen S, Schneider M Int J Environ Res Public Health. 2022; 19(14).

PMID: 35886121 PMC: 9319493. DOI: 10.3390/ijerph19148269.

Population with Long-Term Care Needs in Six Latin American Countries: Estimation of Older Adults Who Need Help Performing ADLs.

Matus-Lopez M, Chaverri-Carvajal A Int J Environ Res Public Health. 2021; 18(15).

PMID: 34360226 PMC: 8345476. DOI: 10.3390/ijerph18157935.

Gender difference in unmet need for assistance with activities of daily living among disabled seniors in China : a cross-sectional study.

Chen N, Li X, Deng M, Wang C, Zhou C BMJ Open. 2021; 11(6):e044807.

PMID: 34083335 PMC: 8174515. DOI: 10.1136/bmjopen-2020-044807.

References

Desai M, Lentzner H, Weeks J . Unmet need for personal assistance with activities of daily living among older adults. Gerontologist. 2001; 41(1):82-8. DOI: 10.1093/geront/41.1.82. View

Knodel J, Teerawichitchainan B, Pothisiri W . Caring for Thai Older Persons With Long-Term Care Needs. J Aging Health. 2018; 30(10):1516-1535. DOI: 10.1177/0898264318798205. View

Katz S, Ford A, Moskowitz R, Jackson B, JAFFE M . STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963; 185:914-9. DOI: 10.1001/jama.1963.03060120024016. View

Victora C, Huttly S, Fuchs S, Olinto M . The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol. 1997; 26(1):224-7. DOI: 10.1093/ije/26.1.224. View

Quail J, Wolfson C, Lippman A . Unmet need for assistance to perform activities of daily living and psychological distress in community-dwelling elderly women. Can J Aging. 2011; 30(4):591-602. DOI: 10.1017/S0714980811000493. View

Newcomer R, Kang T, Laplante M, Kaye S . Living quarters and unmet need for personal care assistance among adults with disabilities. J Gerontol B Psychol Sci Soc Sci. 2005; 60(4):S205-13. DOI: 10.1093/geronb/60.4.s205. View

Kingston A, Collerton J, Davies K, Bond J, Robinson L, Jagger C . Losing the ability in activities of daily living in the oldest old: a hierarchic disability scale from the Newcastle 85+ study. PLoS One. 2012; 7(2):e31665. PMC: 3280316. DOI: 10.1371/journal.pone.0031665. View

Lima J, Allen S . Targeting risk for unmet need: not enough help versus no help at all. J Gerontol B Psychol Sci Soc Sci. 2001; 56(5):S302-10. DOI: 10.1093/geronb/56.5.s302. View

Wilkinson-Meyers L, Brown P, McLean C, Kerse N . Met and unmet need for personal assistance among community-dwelling New Zealanders 75 years and over. Health Soc Care Community. 2013; 22(3):317-27. DOI: 10.1111/hsc.12087. View

10.

Xu H, Covinsky K, Stallard E, Thomas 3rd J, Sands L . Insufficient help for activity of daily living disabilities and risk of all-cause hospitalization. J Am Geriatr Soc. 2012; 60(5):927-33. PMC: 4162318. DOI: 10.1111/j.1532-5415.2012.03926.x. View

11.

DePalma G, Xu H, Covinsky K, Craig B, Stallard E, Thomas 3rd J . Hospital readmission among older adults who return home with unmet need for ADL disability. Gerontologist. 2012; 53(3):454-61. PMC: 3635854. DOI: 10.1093/geront/gns103. View

12.

de Oliveira Duarte Y, Lebrao M, Lima F . [The contribution of living arrangements in the provision of care for elderly persons with functional impairments in São Paulo, Brazil]. Rev Panam Salud Publica. 2005; 17(5-6):370-8. DOI: 10.1590/s1020-49892005000500009. View

13.

Verbrugge L, Jette A . The disablement process. Soc Sci Med. 1994; 38(1):1-14. DOI: 10.1016/0277-9536(94)90294-1. View

14.

LaPlante M, Kaye H, Kang T, Harrington C . Unmet need for personal assistance services: estimating the shortfall in hours of help and adverse consequences. J Gerontol B Psychol Sci Soc Sci. 2004; 59(2):S98-S108. DOI: 10.1093/geronb/59.2.s98. View

15.

Lawton M, Brody E . Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3):179-86. View

16.

Harwood R, Sayer A, Hirschfeld M . Current and future worldwide prevalence of dependency, its relationship to total population, and dependency ratios. Bull World Health Organ. 2004; 82(4):251-8. PMC: 2585969. View

17.

Lima-Costa M, Peixoto S, Malta D, Szwarcwald C, Mambrini J . Informal and paid care for Brazilian older adults (National Health Survey, 2013). Rev Saude Publica. 2017; 51(suppl 1):6s. PMC: 5676367. DOI: 10.1590/S1518-8787.2017051000013. View

18.

Szwarcwald C, Malta D, Pereira C, Vieira M, Conde W, Souza Junior P . [National Health Survey in Brazil: design and methodology of application]. Cien Saude Colet. 2014; 19(2):333-42. DOI: 10.1590/1413-81232014192.14072012. View

19.

Sands L, Wang Y, McCabe G, Jennings K, Eng C, Covinsky K . Rates of acute care admissions for frail older people living with met versus unmet activity of daily living needs. J Am Geriatr Soc. 2006; 54(2):339-44. DOI: 10.1111/j.1532-5415.2005.00590.x. View

20.

Mitra M, Bogen K, Long-Bellil L, Heaphy D . Unmet needs for home and community-based services among persons with disabilities in Massachusetts. Disabil Health J. 2011; 4(4):219-28. DOI: 10.1016/j.dhjo.2011.08.003. View