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Sustainability of Care for Older People in Ageing Societies

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A special issue of Sustainability (ISSN 2071-1050).

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 33065

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Special Issue Editors

Prof. Dr. Valentina Hlebec

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Guest Editor

Department of Social Informatics and Methodology, University of Ljubljana, Ljubljana, Slovenia
Interests: methodology; research on ageing societies and quality of life of older people; formal and informal care; care systems

Dr. Giovanni Lamura

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Guest Editor

IRCCS INRCA—National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, 60124 Ancona, Italy
Interests: international research on family and long-term care; migrant care work; interdisciplinary research on ageing
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Dr. Marco Socci

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Guest Editor

Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, 60124 Ancona, Italy
Interests: caregiving; active and healthy ageing; intergenerational relationships; reconciliation of paid work with informal care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Care for older people is one of the main areas of interest for both policy and research in our ageing societies. Already within Europe, and even more beyond this continent, a large variability can be observed in terms of approaches and models of care systems adopted at both country and regional levels. In some welfare states, elder care may be performed under the umbrella of a primarily public system of service provision, be prescribed or considered to be the “default” responsibility of family members, or involve a large contribution by private care provider organisations (both for profit and non-profit), with a mix of all of these being the rule. Furthermore, care may be solely provided to older people living at home or delivered in institutional facilities, ranging from health to social and long-term care tasks and services. The COVID-19 pandemic has posed a number of additional challenges to care systems, from the risk of epidemic spreading in institutional care to limiting the provision of services to older people ageing at home and to constraints imposed on informal or family carers, including those having to combine paid work and care responsibilities. This Special Issue focuses on the sustainability of systems of care and care provision and on the quality of care provided to older people. While highlighting the perspective of older people themselves or of their (in)formal carers, it also addresses the social and technological innovations in care provision and their impact on the quality of life of older people and their (in)formal carers. Both qualitative and quantitative—or mixed methods—studies are appreciated, especially those with a comparative approach. We also welcome contributions on the methodological challenges for research carried out in epidemic situations as well as research focusing on policy approaches and the evaluation of implemented measures (e.g., at the macro and the meso level) to enhance the sustainability of care systems. A non-exhaustive list of possible topics that might be submitted includes the following:

Sustainability of informal care in ageing societies;
Relationship between informal and formal elder care;
Developments in home care provision;
Migrant work in home-based care settings;
Integration of health, social, and long-term care services;
Post-pandemic residential care: what should it look like;
Impact of COVID-19 on ageing populations and on care systems;
Economic components of the sustainability of long-term care;
ICT-based solutions supporting informal carers and the provision of innovative care services;
Challenges and supporting measures for combining paid work and informal care;
Role and contribution of young carers in informal care provision.

Prof. Dr. Valentina Hlebec
Dr. Giovanni Lamura
Dr. Marco Socci
Guest Editors

Manuscript Submission Information

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Keywords

ageing
caregiving
care systems
COVID-19
informal carers
long-term care
reconciliation of paid work and informal care
sustainability
technology and care
research on ageing

Published Papers (9 papers)

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Research

18 pages, 602 KiB

Open AccessArticle

Care Task Division in Familialistic Care Regimes: A Comparative Analysis of Gender and Socio-Economic Inequalities in Austria and Slovenia

by Ricardo Rodrigues, Stefania Ilinca, Maša Filipovič Hrast, Andrej Srakar and Valentina Hlebec

Sustainability 2022, 14(15), 9423; https://doi.org/10.3390/su14159423 - 1 Aug 2022

Viewed by 2050

Abstract

Demographic aging has led to an increase in the number of people with multiple needs requiring different types of care delivered by formal and informal carers. The distribution of care tasks between formal and informal carers has a significant impact on the well-being of carers and on how efficiently care is delivered to users. The study has two aims. The first is to explore how task division in care for older people differs between two neighboring countries with different forms of familialism: Slovenia (prescribed familialism) and Austria (supported familialism). The second is to explore how income and gender are associated with task division across these forms of familialism. Multinomial logistic regression is applied to SHARE data (wave 6, 2015) to estimate five different models of task division, based on how personal care and household help are distributed between formal and informal carers. The findings show that the task division is markedly different between Slovenia and Austria, with complementation and supplementation models more frequent in Austria. Despite generous cash benefits and higher service availability in Austria, pro-rich inequalities in the use of formal care only are pervasive here, unlike in Slovenia. Both countries show evidence of pro-poor inequalities in the use of informal care only, while these inequalities are mostly absent from mixed models of task division. Generous cash transfers do not appear to reduce gender inequalities in supported familialism. Supported familialism may not fundamentally improve inequalities when compared with less generous forms of familialism. Full article

(This article belongs to the Special Issue Sustainability of Care for Older People in Ageing Societies)

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23 pages, 11166 KiB

Open AccessArticle

Issues and Needs of Elderly in Community Facilities and Services: A Case Study of Urban Housing Projects in Bangkok, Thailand

by Wiruj Somsopon, Sohee Minsun Kim, Vilas Nitivattananon, Kyoko Kusakabe and Thi Phuoc Lai Nguyen

Sustainability 2022, 14(14), 8388; https://doi.org/10.3390/su14148388 - 8 Jul 2022

Cited by 3 | Viewed by 3353

Abstract

Thailand is projected to become a “super-aged” society in 2050, with more than 35 percent of the population aged 60 or above. The aging population represents enormous challenges in supporting the elderly’s needs in terms of living environment and well-being. Providing community facilities and services that foster healthy aging in urban residential areas ensures that older adults feel comfortable aging in their homes or communities. Therefore, this research study includes a comprehensive assessment of the needs of elderly people that used community facilities and services using a focus group interview, a site investigation, and a questionnaire survey in five urban housing projects in Bangkok. The study reveals that the need for community facilities and services, such as green spaces, safety facilities, and medical services, was prioritized by the majority of elderly respondents, especially those who were ambulant and active. Elderly people’s income and health status, the provision of community facilities and services for the elderly, and the usability and accessibility of community facilities were found to be key factors that affected elderly people’s satisfaction and participation in social activities. As reported in the literature, an elderly-friendly living environment should support social activities in the open spaces of residential areas. It is revealed by the study that green spaces, safety facilities, elderly clubs, medical and long-term care services, and social activity arrangement services were instrumental for elderly people’s social and health status; therefore, these should be considered by housing developers and facility managers. Full article

(This article belongs to the Special Issue Sustainability of Care for Older People in Ageing Societies)

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15 pages, 439 KiB

Open AccessArticle

Healthy and Entrepreneurial Work Environment for Older Employees and Its Impact on Work Engagement during the COVID-19 Pandemic

by Maja Rožman, Polona Tominc and Katja Crnogaj

Sustainability 2022, 14(8), 4545; https://doi.org/10.3390/su14084545 - 11 Apr 2022

Cited by 4 | Viewed by 2016

Abstract

Managing older employees is a major challenge for companies, especially during COVID-19. Therefore, creating a healthy and entrepreneurial work environment as well as an inclusive culture within organizations is crucial for companies to maintain their sustainable advantage. The main objective of this paper is to develop a multidimensional model of a healthy and entrepreneurial work environment for older employees and determine its impact on their work engagement during COVID-19. Structural equation modeling was used for data analysis. The results show that workplace health promotion, entrepreneurial working conditions, and leadership lead to better well-being of older employees. In addition, entrepreneurial working conditions that promote intergenerational synergy lead to higher work engagement of older employees, especially during the COVID-19 pandemic. For the elderly, the entrepreneurial work environment is therefore particularly important, even though entrepreneurship is mostly attributed to younger men. In addition, older employees’ well-being and the promotion of intergenerational synergy have a positive impact on their work engagement. The results will help companies better manage their older employees, shape their workplace, and increase the sustainable benefits of their businesses during and after the COVID-19 crisis. Full article

(This article belongs to the Special Issue Sustainability of Care for Older People in Ageing Societies)

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21 pages, 18063 KiB

Open AccessArticle

A Sustainable, Interactive Elderly Healthcare System for Nursing Homes: An Interdisciplinary Design

by Cunwei Yang, Weiqing Wang, Fengying Li and Degang Yang

Sustainability 2022, 14(7), 4204; https://doi.org/10.3390/su14074204 - 1 Apr 2022

Cited by 13 | Viewed by 3970

Abstract

Population ageing becomes a perplexing conundrum with social and economic development. Many senior citizens are now empty nesters because the younger generation prefer to stay in metropolises for a better life. Therefore, living in a nursing home is a popular choice for the aged. This objective-oriented paper proposes a sustainable elderly healthcare system for nursing homes. The main work is the design and implementation of a new rapid and interactive assistance service. Based on cost-effective fingerprint indoor-positioning technology, the alert message that a person is at risk will be immediately sent to nearby people before professionals arrive. Warning messages are available when nearing marked areas (e.g., slippery floors). The parallel path-finding algorithm plays a significant role in finding nearby people and alerting people who approach specific areas. Furthermore, this system provides application programming interfaces to connect to health devices, such as smart bracelets, watches, and glasses. In general, the system is designed to ensure the safety of the elderly and improve management efficiency, which corresponds to present smart elderly care proposals from governments. Full article

(This article belongs to the Special Issue Sustainability of Care for Older People in Ageing Societies)

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12 pages, 264 KiB

Open AccessArticle

Innovating European Long-Term Care Policies through the Socio-Economic Support of Families: A Lesson from Practices

by Mirian Fernández Salido, Carolina Moreno-Castro, Francesco Belletti, Stecy Yghemonos, Jorge Garcès Ferrer and Georgia Casanova

Sustainability 2022, 14(7), 4097; https://doi.org/10.3390/su14074097 - 30 Mar 2022

Cited by 5 | Viewed by 1779

Abstract

LTC and socio-economic deprivation of families are two relevant issues in international debate. The economic or time investment made by families in caregiving has an impact on the socio-economic status of family members in terms of economic means and social inclusion. This study analyzes the practices that are supported by home LTC, examining their characteristics, identifying their strengths, weaknesses, drivers, and barriers, as well as identifying social innovation aspects. The study provides a qualitative interpretative comparison of 22 practices from eight countries, representing the four LTC care models existing in Europe. Cross-studies aid in the development of sustainable policies. The study highlights the differences and similarities between selected practices. The results indicate the effectiveness of integrative and coordination strategies at the macro, meso, and micro levels for the development of supportive policies for family members with burdens of care. Nevertheless, the results underline the lack of a genuine focus on families’ socio-economic support for providing care. The partial support provided by compensatory cash benefits or unpaid care leave schemes partially addresses the difficulties of familial burden of care. The study recommends that fair economic compensation and social security benefits be incorporated into innovative and sustainable strategies for supporting caregiving in LTC and welfare schemes. Full article

(This article belongs to the Special Issue Sustainability of Care for Older People in Ageing Societies)

18 pages, 1495 KiB

Open AccessArticle

The Working Informal Caregiver Model: A Mixed Methods Approach to Explore Future Informal Caregiving by Working Caregivers

by Eline E. Vos, Henk B. M. Hilderink, Simone R. de Bruin, Allard J. van der Beek and Karin I. Proper

Sustainability 2022, 14(6), 3519; https://doi.org/10.3390/su14063519 - 17 Mar 2022

Cited by 4 | Viewed by 4685

Abstract

A growing number of informal caregivers of older adults combine caregiving with a paid job, raising the question of whether they will be able to meet the increasing demand for informal care. The aims of our study are twofold: first, to describe the development of a model providing insight into the factors that play a role in the availability and provision of informal care by working caregivers of older adults, and second, to investigate which societal developments will impact the factors in the model, and thus the future availability of informal care by workers. A mixed-methods approach was applied to integrate evidence from academic and grey literature, with insights from experts through a Group Model Building exercise and a Delphi study. The resulting Working Informal Caregiver (WIC) model presents a range of individual, social and environmental factors that are related to working caregivers’ ability and their willingness to engage in informal care. Experts foresee that future informal care will be impacted most by the increasing participation of women in the workforce, while changing household structures may diminish opportunities to share care tasks within their households or families. The WIC model can be used to gain better insight into the availability of informal care by workers, now and in the future. Full article

(This article belongs to the Special Issue Sustainability of Care for Older People in Ageing Societies)

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18 pages, 502 KiB

Open AccessArticle

The Burden of Caring for Dependent Older People and the Resultant Risk of Depression in Family Primary Caregivers in Italy

by Cristina Gagliardi, Flavia Piccinini, Giovanni Lamura, Georgia Casanova, Paolo Fabbietti and Marco Socci

Sustainability 2022, 14(6), 3375; https://doi.org/10.3390/su14063375 - 13 Mar 2022

Cited by 8 | Viewed by 3976

Abstract

Long-Term Care (LTC) for older people in need of care is a critical issue affecting the quality of life of family caregivers (as well as older people), encompassing both negative and positive caregiving experiences. Providing support to family caregivers is essential because they play a crucial role in sharing the societal burden of LTC for the growing frail older population. By presenting the results of a survey carried out in 2019–2020 in Central Italy, this study aims to describe the characteristics and estimate by a multivariate logistic model the correlates of depressive symptoms in 369 primary caregivers of dependent older people. Caregivers are mostly women who provide a high amount of care in terms of weekly hours as a result of insufficient assistance from public or private care services. More than half of the sample show depressive symptoms, indicating a fairly serious situation. Perceived burden is a strong predictor of depression. The findings offer suggestions and policy implications. The fragmentation of the care context should be addressed by allocating sufficient funding to expand the supply of public in-kind services and integrate cash-for-care schemes, thus alleviating the burden and mitigating the negative consequences of care on physical and mental health. Full article

(This article belongs to the Special Issue Sustainability of Care for Older People in Ageing Societies)

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21 pages, 452 KiB

Open AccessArticle

Sustainable Social Care: The Potential of Mainstream “Smart” Technologies

by Kate Hamblin

Sustainability 2022, 14(5), 2754; https://doi.org/10.3390/su14052754 - 26 Feb 2022

Cited by 5 | Viewed by 2411

Abstract

Recent proposals for reform in England have presented widely available “smart” mainstream digital devices as a means to address some of the challenges facing adult social care and as alternatives to unsustainable analogue “telecare” systems. Drawing on 40 interviews with experts from local authorities, the care and technology sectors, and people with lived experience of social care services, we explored how mainstream technologies are being used in practice in England and critically examined their potential to contribute to policy priorities of wellbeing and sustainability. Across all expert groups interviewed, examples were cited in which the use of mainstream devices supported the economic sustainability of adult social care and/or enhanced aspects of wellbeing, moving the role of technology in care beyond monitoring and managing risks. However, when viewed through a three-dimensional conceptual lens that includes material, relational and subjective wellbeing, the use of smart devices in practice also created tensions and trade-offs between the dimensions, with implications for sustainability. The various ways mainstream devices are being used in adult social care also raised complexities related to risks, responsibilities, and inequalities and required “wraparound services”, tempering their ability to deliver cost savings. To address these issues, we suggest a person-centred approach to technology across local authorities, with investment in wraparound services and to mediate inequalities associated with the “digital divide”. Full article

(This article belongs to the Special Issue Sustainability of Care for Older People in Ageing Societies)

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17 pages, 690 KiB

Open AccessArticle

The Sustainable Care Model for an Ageing Population in Vietnam: Evidence from a Systematic Review

by Loi Tan Nguyen, Phouthakannha Nantharath and Eungoo Kang

Sustainability 2022, 14(5), 2518; https://doi.org/10.3390/su14052518 - 22 Feb 2022

Cited by 13 | Viewed by 5409

Abstract

Social demographic studies in Vietnam have shown a growing trend of an ageing population. Demographic trends project that one third of the Vietnamese population will be aged 65 years and older by 2050. Vietnam is a country where the majority of the elderly live with their children, with little savings and pension. The purpose of this review was to explore existing literature on models of care for an ageing population and provide evidence to develop a care model that is suitable for the ageing community in Vietnam. A systematic review utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework was carried out. An extensive literature search was performed, with a focus on articles and other materials with relevance to elderly care in Vietnam in terms of socio-economic, demographic, and associated factors based on comprehensive data sources. The review found that there is a lack of evidence of professional practice for caring for the aged in Vietnam. There also is a lack of evidence of government support for the limited community initiatives to support the ageing. There exist no community models of care for the ageing population in Vietnam. From a global perspective, there exist alternative models of care options to support the elderly through various care models, such as living in assisted-care facilities, home care, and other assistance. Inter-professional practice care models and health services were found to be essential for an ageing population. There is limited literature specifically for the care of an ageing population in Vietnam. Most of the available literature on care models for the aged is drawn from developed countries. The review offers insights into the development of care models for the elderly in Vietnam, with the need for inter-professional efforts in practice settings to support the ageing Vietnamese population. The reviewed literature agrees on the developing global challenges due to ageing. Despite the existing literature on care models for the ageing, there is a lack evidence-based care models concerning the current and future needs of elderly care in middle- and lower-income economies like Vietnam. More evidence is required to establish evidence for best care models for the elderly in developing economies. Full article

(This article belongs to the Special Issue Sustainability of Care for Older People in Ageing Societies)

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