The Health Foundation, 90 Long Acre, London, WC2A 9RA, UK; MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, UK.
MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, UK.
Maturitas. 2018 Oct;116:116-122. doi: 10.1016/j.maturitas.2018.08.004. Epub 2018 Aug 6.
We describe sources expected to provide for future care needs among baby-boomers in their late sixties and examine how expectations vary according to earlier health and social experiences. We hypothesised that greater integration in social relationships across adulthood is associated with greater expectation of informal care, and that greater morbidity over a longer time period is associated with greater expectation of formal care.
The MRC National Survey of Health and Development, a population-based birth cohort study set in mainland Britain, provided data on care expectations for 2135 participants aged 68-69. The outcome was who, besides the partner or spouse, is expected to provide for the future care needs, coded as adult children, other relatives, friends/neighbours, paid/professional care, or no one. Adult children were taken as the reference category and the latter two categories were combined as 'formal care' in the multiple regression analysis.
91% had an adult child, of whom 74% expected them to provide care if needed, and 11% expected formal care. The latter rose to 33% of those with no adult children. Geographical distance to adult children (over 25 miles) was strongly correlated with expectations but, independently of this, lack of someone to help in a crisis from midlife onwards and low social contact were associated with expecting formal care. Expectations did not differ by number of chronic conditions, functional limitations or longstanding illness from age 60 + .
Those lacking social relationships in midlife onwards and those living further from adult children are more likely to expect formal help with their future care needs. As personal care needs are projected to rise with population ageing and families are increasingly expected to provide for these needs, initiatives to remove barriers to smaller distances between ageing parents and their children and to support and maintain high-quality family relationships across the life course should be considered.
本研究旨在描述 60 多岁即将步入老年的婴儿潮一代未来的照护需求来源，并探讨这些预期会根据早期的健康和社会经历而有所不同。我们假设，成年后社会关系的整合度越高，对非正式照护的期望就越高，而长期内更高的发病率与对正式照护的期望更高相关。
英国大陆的 MRC 国家健康发展调查是一项基于人群的出生队列研究，为 2135 名年龄在 68-69 岁的参与者提供了照护期望数据。结果是除了伴侣之外，还有谁预计会照顾未来的照护需求，被编码为成年子女、其他亲属、朋友/邻居、付费/专业护理或无人。成年子女被视为参考类别，后两者在多回归分析中合并为“正式护理”。
91%的参与者有成年子女，其中 74%预计如果需要，他们会提供照护，11%预计需要正式护理。对于没有成年子女的人来说，这一比例上升到 33%。与成年子女的地理距离（超过 25 英里）与期望密切相关，但独立于这一点，从中年开始缺乏在危机中帮助的人以及社交联系较少与期望正式护理有关。从 60 岁开始，期望与慢性疾病数量、功能限制或长期患病无关。
从中年开始缺乏社会关系的人和与成年子女居住距离较远的人更有可能期望获得未来照护需求的正式帮助。随着人口老龄化，个人照护需求预计会增加，家庭越来越需要提供这些需求，因此应该考虑采取措施消除父母和子女之间距离较近的障碍，并支持和维持整个生命周期的高质量家庭关系。
