Fresh insights into how Ireland’s system of caring affects older adults

Posted on: 07 December 2020

Family caring plays a positive and essential role in Ireland’s health system, but new TILDA research highlights the social, financial, physical and emotional demands it places on carers.

Researchers at the Irish Longitudinal Study on Ageing (TILDA) at Trinity College have conducted a key analysis of the role of family care and home supports for older adults in Ireland.

The report offers fresh insight into how Ireland’s system of caring affects older adults receiving care, the positive experiences of being a carer, as well as the pressures placed on older adults acting as carers. It estimates the proportion of older adults who report difficulty with at least one activity of daily living, and who receive help from family, and examines if this support has changed over time. The report also estimates the number of older adults living in Ireland who received state-funded or privately funded home support, and the rates of unmet need among those who require help with care provision.

 

The role of caring in a growing ageing population

Populations are ageing rapidly worldwide, thanks to a combination of advances in healthcare, nutrition and lifestyle changes. According to the WHO, the number of people aged 60 years and over is projected to more than double, from 962 million (2017) to 2.1 billion by 2050. With this changing demographic structure comes an inevitable rise in the number of older people who will be dependent on appropriate forms of care. Caring for family members is essential in our society, yet this role can put social, financial and emotional pressures on carers, and negatively impact their physical, emotional and mental health.

This new report analyses data from Waves 1-5 of the TILDA study (2009 – 2018) to examine the roles of family care and state-provided services in supporting Ireland’s older adults.

What are the key findings of the report?

  • One in eight adults aged over 50 (13%) report a functional limitation. This is a combination of limitations in instrumental activities of daily living (IADL – difficulty cooking, cleaning, and grocery shopping) and basic functional activities (ADL – difficulty with dressing, eating and bathing).
  • The percentage of those who received help (family caring and home support)

increased from 45% receiving help with ADL and IADL limitations in Wave 1, to 60% in Wave 5.

  • The majority of that help was provided by family carers (70%), with 30% receiving

either state-provided or private home support in Wave 5 (2018).

  • For both men and women with functional limitations, the main helper their main carer is their spouse (47%) while 24% of care was provided by paid carers.
  • Of those older adults with basic functional limitations who received no help, one in five (18%) reported that they needed help all the time but received none.
  • The majority (65%) of participants who had received help with their functional

limitations report that the help met their needs all the time.

  • The older population continues to contribute substantially to the informal care of their family and friends. In Wave 5, 7% of women and 5% of men reported they had cared for someone in the past week (68,500 people) aged 58 and over.
  • To enable family caring to continue, state-provided home support must also be

available to facilitate and support carers to retain their work and leisure in addition to their care responsibilities.

 

Dr Christine Mc Garrigle, Trinity College, Lead Researcher on the report, said:

TILDA’s report shows that a large majority of older adults with functional limitations receive a combination of family care, with state or private care. Family carers often act as advocates and coordinators of care, tasked with taking on the challenges of caregiving often without assistance, and can sometimes face an added emotional, mental, and financial burden in this role. As the number of older people living well into their later years increases, the demand for appropriate investment to support and strengthen a multi-faceted care system is growing. State-provided home support can facilitate and support carers with their caregiving. What is needed is appropriate planning to ensure those who receive care will benefit and equip family caregivers with suitable support.

 

Professor Rose Anne Kenny, Principal Investigator of TILDA and Lead Researcher, said:

This research shows that older adults contribute substantially to informal care of family and friends. Data from our latest wave, for example, shows that a significant number of adults aged 58 and over – 68,500 people nationally – identify themselves as caregivers. Family carers allow for a significant decrease in expenditure on state-provided home care, and institutional care for older people, while greatly encouraging and benefiting those who are cared for at home by loved ones. We also know that family caring is wholly associated with positive health outcomes, but this greatly depends on the intensity of care that is provided.  Greater support is needed to enable family carers to continue in this role for as long as possible. This report provides important information for policy and health planners as they prepare and plan a progressive care system to support Ireland’s older population.

Stephen Donnelly, TD, Minister for Health, welcomed the report and said:

We are all aware of the enormous contribution and sacrifice made by family carers. They are the backbone of care provision in this country and I am glad to see this proven through this report. Supporting people who care for others is a key commitment of this Government. Additional funding was secured in Budget 2021 to advance the National Carers’ Strategy, with a focus on providing more carer-supports across the country. There is also work ongoing to develop a statutory scheme for the financing and regulation of home-support services. This TILDA report, which provides valuable evidence of the vital role that family carers have in the provision of care to our older adults, will help to inform us in these initiatives to allow us to best support family carers.

 

To read the full report entitled Receipt of care and caring in community-dwelling adults aged 50 years and over in Ireland’ please visit https://doi.org/10.38018/TildaRe.2020-09

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Ciara O’Shea, Media Relations Officer | coshea9@tcd.ie | +353 1 896 4337