Elder Care and Living Arrangements in Three Western Nations
Douglas A. Wolf, Principal Investigator
National Institute on Aging Grant No. R01-AG14402-02
Specific Aims
This project is a study of the living and long-term care arrangements adopted by the older populations of Germany, the United Kingdom and the United States. The motivation for the study is the combination of demographic change and changing public policy environments in the three countries, suggesting adjustments to both living and care patterns in response to those changes. The project will produce both within- and across-country analyses of living and care arrangements, with particular emphasis on the use of panel data sets to develop multivariate models.
Thus, the specific aims of the project are:
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to develop panel-data models of household composition among older people in the United States, Germany, and the United Kingdom; and
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to develop panel-data models of community-based long-term care service use, including services provided by formal organizations, close family members, and other informal sources, in those three countries.
Preliminary Results
Most of the work to date has used data from the British Household Panel Study (BHPS). Using the BHPS we have produced preliminary estimates of a 5-equation panel-data model. Three of the equations pertain to service use: Meals on Wheels, nursing services, and homemaker services. Another equation depicts death, and the final equation depicts attrition (sample loss) for other reasons (one of which, we suspect, is unrecorded transitions into nursing facilities). This is a complex model, one that incorporates an explicit representation of “unmeasured heterogeneity,” that is, a composite factor representing time-invariant but unmeasured factors that can, in theory, influence all five of the outcomes.
The initial results from this model were presented at a poster session of the November 1999 meeting of the Gerontological Society of America (D. Wolf, E. Grundy, and J. Laditka, “The Dynamics of Formal Care in the United Kingdom”). A more extensive set of results were presented at the March 2000 meeting of the Population Association of America (D. Wolf, E. Grundy, and J. Laditka, “A Model for Panel Data with Categorical Responses, Unmeasured Heterogeneity, and Selective Nonresponse”). The preliminary results indicate that childless elderly are significantly more likely to use the Meals on Wheels and homemaker services (but not nursing services), holding constant age, sex, marital status, education, income, housing wealth, and ADL limitations. This work will continue as we further refine the methodology.
This project also supports Wolf’s collaboration with Ulrike Schneider of the University of Hannover in a project on the costs of elder care in Germany (Schneider’s participation in that project is funded by Germany’s TRANSCOOP program). The TRANSCOOP project complements and extends the work carried out in the R01 project. Schneider and Wolf also presented preliminary estimates of the costs of providing informal care in a poster presented at the November 1999 GSA meeting (U. Schneider and D. Wolf, “The Costs of Informal Care in Germany”). Wolf and Schneider are continuing to refine and extend that work.
