2012 Conference Presentation
Aim: Home care for elderly people is seen as the best solution for managing the growing number of elderly people in the population in addition to informal care. The challenge is to find out how to allocate services according to client needs. Purpose of this study is to analyze what kind of the client care need profiles are associated with formal home care and informal care hours.
Methods: The home care client data (n=13502 in 2011) was drawn from the RAI (Resident Assessment Instrument) database kept by National Institute for Health and Welfare (THL). RAI home care assessments of home care clients are conducted by home care staff semi annually and copy of these assessments are sent to THL. Home care clients in the data set represent about 21 % of all regular home care clients in Finland. Based on RAI home care assessment the hours of formal and informal care are collected as well as data for calculating the client care need profiles called Method for Assigning Care Levels (MAPLe, Hirdes et al. 2008). This classification indicates either the needed care level (five levels: low to very high) or 15 sublevels that indicate what kind of care need describes the client. MAPLe is calculated based on Instrumental and Basic Activities of Daily Living, cognition, behavior, and other clinical needs. In the statistical analyses linear regression analyses were used. The dependent variables were formal hours provided during past seven days (n=13502) and among those who had also informal care informal care hours during past 7 days (n=9104).
Results: The average age among home care clients was 80.2 years and among those having also informal care 81.4 years. Amount of women was 71.6% and 73%, respectively. One in ten was a new client. The number of informal hours (15.5 h/week) was higher than formal hours (4.8 h/week). There were significant differences according to client care need profiles adjusted for age and sex both in formal home care and informal care hours. Both formal and informal hours receiving subgroups were those having either little or moderate level functional restrictions and moderate or high level cognitive problems, and those having disturbing behavior, but level of hours was higher among in informal care. New clients (less than 6 months in home care) received less formal hours but more informal care hours.
Conclusions: The results indicate that there are quite big differences in allocating formal and informal care hours according to care needs. Care needs profile information could be useful in allocating services to home care clients and assessing care burden for informal care.