Litwin Howard, Attias-Donfut Claudine
Israel Gerontological Data Center, Hebrew University, Jerusalem, Israel.
Ageing Soc. 2009 Jan;29(1):71-91. doi: 10.1017/S0144686X08007666.
This study examined whether formal care services delivered to frail older people's homes in France and Israel substitute for or complement informal support. The two countries have comparable family welfare systems but many historical, cultural and religious differences. Data for the respondents aged 75 or more years at the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed. Regressions were examined of three patterns of care from outside the household: informal support only, formal support only and both formal and informal care, with the predictor variables including whether informal help was provided by a family member living in the household. The results revealed that about one-half of the respondents received no help at all (France 51%, Israel 55%), about one-tenth received care from a household member (France 8%, Israel 10%), and one-third were helped by informal carers from outside the household (France 34%, Israel 33%). More French respondents (35%) received formal care services at home than Israelis (27%). Most predictors of the care patterns were similar in the two countries. The analysis showed that complementarity is a common outcome of the co-existence of formal and informal care, and that mixed provision occurs more frequently in situations of greater need. It is also shown that spouse care-givers had less formal home-care supports than either co-resident children or other family care-givers. Even so, spouses, children and other family care-givers all had considerable support from formal home-delivered care.
本研究调查了法国和以色列向体弱老年人家庭提供的正规护理服务是替代还是补充了非正规支持。这两个国家有着类似的家庭福利体系，但在历史、文化和宗教方面存在诸多差异。对欧洲健康、老龄化与退休调查（SHARE）首轮调查中年龄在75岁及以上的受访者数据进行了分析。研究了来自家庭外部的三种护理模式的回归情况：仅非正规支持、仅正规支持以及正规和非正规护理都有，预测变量包括是否由居住在家庭中的家庭成员提供非正规帮助。结果显示，约一半的受访者完全没有得到帮助（法国为51%，以色列为55%），约十分之一的受访者得到了家庭成员的护理（法国为8%，以色列为10%），三分之一的受访者得到了家庭外部非正规护理人员的帮助（法国为34%，以色列为33%）。在家中接受正规护理服务的法国受访者（35%）比以色列受访者（27%）更多。两国护理模式的大多数预测因素相似。分析表明，互补性是正规和非正规护理并存的常见结果，而且在需求更大的情况下，混合提供护理的情况更频繁出现。研究还表明，配偶护理人员得到的家庭正规护理支持比同住子女或其他家庭护理人员少。即便如此，配偶、子女和其他家庭护理人员都从家庭提供的正规护理中获得了相当多的支持。
