Perceptions of unmet needs for community social care services in England. A comparison of working carers and the people they care for

Previous UK research has found expressed unmet need for services by unpaid working carers and among disabled and older people. There are, however, suggestions from research that views on unmet needs for services differ between carers and care-recipients. Working carers in the UK say that the care-recipient is sometimes reluctant to accept services and the few international comparative dyad studies that have been carried out find that carers perceive higher unmet need than care-recipients. Recent policy discussions in England have also recognised that there may be differences of opinion. We collected data in 2013 from working carer/care-recipient dyads in England about perceived need for services for the care-recipient, disability, unpaid care hour provision and individual and socio-demographic characteristics. We find that care-recipients as well as their carers perceive high unmet need for services, although carers perceive higher unmet need. For carers, unmet need is associated with the disability of the carer-recipient and being the daughter or son of the care-recipient; for care-recipients it is associated with unpaid care hours, carers' employment status and carers' health. The majority of dyads agree on need for services, and agreement is higher when the working carer provides care for 10 hours or more hours a week. Services for care-recipients may enable working carers to remain in employment so agreement on needs for services supports the implementation of legislation, policy and practice that has a duty to, or aims to, support carer's employment.

[1]  Andy P. Field,et al.  Discovering Statistics Using Ibm Spss Statistics , 2017 .

[2]  D. King,et al.  The Effectiveness of Paid Services in Supporting Unpaid Carers’ Employment in England , 2015, Journal of Social Policy.

[3]  T. Burchardt,et al.  The Coalition's Record on Adult Social Care: Policy, Spending and Outcomes 2010-2015 , 2015 .

[4]  J. Manthorpe,et al.  Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature , 2014, Health & social care in the community.

[5]  L. Bherer,et al.  Depressive symptoms are independently associated with recurrent falls in community-dwelling older adults , 2014, International Psychogeriatrics.

[6]  A. Milne,et al.  The intersection of employment and care: evidence from a UK case study , 2013 .

[7]  Y. Pijnenburg,et al.  The relationship between unmet care needs in young-onset dementia and the course of neuropsychiatric symptoms: a two-year follow-up study , 2013, International Psychogeriatrics.

[8]  D. King,et al.  When is a carer's employment at risk? Longitudinal analysis of unpaid care and employment in midlife in England. , 2013, Health & social care in the community.

[9]  M. Evandrou,et al.  Measuring unmet need for social care amongst older people , 2011, Population trends.

[10]  V. Morrison,et al.  Ethnic variations in the caregiver role: A qualitative study , 2011, Journal of health psychology.

[11]  J. Forder,et al.  The impact of a tightening fiscal situation on social care for older people , 2010 .

[12]  Rose-Marie Dröes,et al.  What do community-dwelling people with dementia need? A survey of those who are known to care and welfare services , 2009, International Psychogeriatrics.

[13]  S. Bleich,et al.  How does satisfaction with the health-care system relate to patient experience? , 2009, Bulletin of the World Health Organization.

[14]  Ian Rees Jones,et al.  `Habitus and Bureaucratic Routines', Cultural and Structural Factors in the Experience of Informal Care , 2008 .

[15]  C. Glendinning,et al.  Combining Work and Care: Carers’ Decision-making in the Context of Competing Policy Pressures , 2007 .

[16]  G. Walter,et al.  Patient and carer perceptions of need and associations with care-giving burden in an integrated adult mental health service , 2006, Social Psychiatry and Psychiatric Epidemiology.

[17]  Bob Woods,et al.  The needs of older people with dementia in residential care , 2006, International journal of geriatric psychiatry.

[18]  C. Jonker,et al.  The Emotional Impact of Psychiatric Symptoms in Dementia on Partner Caregivers: Do Caregiver, Patient, and Situation Characteristics Make a Difference? , 2005, Alzheimer disease and associated disorders.

[19]  L. Eeckhoudt,et al.  The economic value of informal care: a study of informal caregivers' and patients' willingness to pay and willingness to accept for informal care. , 2005, Health economics.

[20]  A. Ek,et al.  Quality of life and burden in parents of outpatients with schizophrenia , 2005, Social psychiatry and psychiatric epidemiology.

[21]  M. Pinquart,et al.  Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis. , 2005, The Gerontologist.

[22]  K. Lyons,et al.  Caregiving as a dyadic process: perspectives from caregiver and receiver. , 2002, The journals of gerontology. Series B, Psychological sciences and social sciences.

[23]  J. Adams Carers of older people with dementia: assessment and the Carers Act. , 2001, Nursing older people.

[24]  M Orrell,et al.  Assessing needs from patient, carer and professional perspectives: the Camberwell Assessment of need for Elderly people in primary care. , 2000, Age and ageing.

[25]  M. Orrell,et al.  Camberwell Assessment of Need for the Elderly (CANE) , 2000, British Journal of Psychiatry.

[26]  M. E. Jackson,et al.  The impact of female caregivers' employment status on patterns of formal and informal eldercare. , 1998, The Gerontologist.

[27]  Joanne Hoven Stohs,et al.  Alternative Ethics in Employed Women's Household Labor , 1994 .

[28]  D. Ward The Caring Relationship—elderly People and Their Families , 1991 .

[29]  Pilar García-Gómez,et al.  Inequity in long-term care use and unmet need: two sides of the same coin. , 2015, Journal of health economics.

[30]  A. Brady,et al.  Hard times, New Directions? The impact of the local government spending cuts in three deprived neighbourhoods of London , 2014 .

[31]  M. Bullinger,et al.  Generic Health-Related Quality-of-Life Assessment in Children and Adolescents , 2012, PharmacoEconomics.

[32]  J. Moriarty The health and social care experiences of black and minority ethnic older people , 2008 .

[33]  Linda Pickard,et al.  The effectiveness and cost-effectiveness of support and services to informal carers of older people: a review of the literature prepared for the Audit Commission , 2004 .

[34]  K. Glaser,et al.  Changing economic and social roles: the experience of four cohorts of mid-life individuals in Britain, 1985-2000. , 2002, Population trends.

[35]  R. Jenkins The needs of older people with , 2000 .

[36]  B. Erens,et al.  The Health Survey for England , 1999 .

[37]  K. Atkin,et al.  Carers perceived : policy and practice in informal care , 1994 .

[38]  N. Zweibel,et al.  Incongruent perceptions of older adult/caregiver dyads. , 1990 .

[39]  J. Finch Family obligations and social change , 1989 .