Predictors of long-term care use - informal home care recipients versus private and public facilities residents in Poland.

BACKGROUND: The population aging, together with the shrinking caring potential of families, is a major challenge for social policy in the coming years. The aim of the study is to identify the factors that determine not only the use of long-term care (LTC) but also the selection of individual types of such care in Poland. METHODS: Using unique data collected from inpatient LTC facilities in Poland and the Survey on Health, Ageing and Retirement in Europe (SHARE) database, we estimate logistic regressions explaining the choice of LTC solution. RESULTS: Our results suggest that social inequalities play a role in choosing the type of LTC. Better educated people choose private institutions, while people without support network use more often social residential homes. The impact of multimorbidity on choosing different types of inpatient facilities is limited, thus the number of ADL limitations remains a better indicator of long term care utilization. CONCLUSIONS: The study confirms that social inequalities influence decisions about the choice of LTC. However, multi-morbidity is a predictor of using LTC to a limited extent. The differences in LTC selection determinants between women and men are noticeable.

Social and private activity after retirement-substitutes or complements.

BACKGROUND: Commonly observed low activity of older adults harms their well-being. We perceive the retirement as a new opening that could be utilized to fulfill previously neglected needs and involve in new activities. They can be a remedy for losing the sense of life while changing the social role and getting older. This study explores trends in activity over retirement. In particular, it verifies if different post-retirement activities: 1) formal social engagement; 2) informal help given outside the household; 3) solitary leisure or self-development activities, and 4) sociable leisure or self-development activities are mutually exclusive or supportive of each other. METHODS: We use the data from 4 and 6th wave of Survey of Health, Ageing and Retirement in Europe, taking into consideration 2757 respondents who participated in both waves. We analyze trends in activity over retirement and verify the hypotheses regarding the relationships between engaging into different types of activities and between the activity and development of personal social networks. We conduct the descriptive analysis and utilize the Generalized Structural Equation Model. RESULTS: Most people do not change their involvement in different activities after retirement. Among those who change, the average trend is upward. We find support that different types of activities undertaken after retirement do not crowd out each other. On the contrary, being active in one sphere goes hand in hand with activity in another. We give evidence for presence of social network mechanisms that enhance such understood complementarity. Maintaining social relationships correlates with engagement in socially-oriented activities and privately-oriented sociable pastimes. Being active, with exception of solitary forms of recreation, creates an opportunity to foster relations with other people and, thanks to their encouragement, to engage in new activities. CONCLUSIONS: The small change in activity after retirement signifies the need to encourage non-work activity during earlier stages of life. As different types of post-retirement activities are complementary, the most active group of older adults would be the most open for social engagement and volunteering, however the least active group needs the biggest support to involve in any activities.

Non-Financial Support Provided to Parents in Stepfamilies: Empirical Examination of Europeans 50.

The aging of the population, coupled with increasing divorce and remarriage rates, are changing the structure of potential non-financial support for older parents. The purpose of this study was to examine support provided to parents aged 50+ in stepfamilies and to determine if the difference existed between help provided by natural children and stepchildren. The primary objective was to investigate whether blood ties were a significant determinant of the support if the quality of the relationship between the parent and a natural child or a stepchild was taken into account. The secondary objective was to answer the question to what extent the reciprocal exchange motive of support was observed in stepfamilies. The probability of non-financial support from children and stepchildren was estimated based on the sixth wave of the SHARE (Survey on Health, Ageing, and Retirement in Europe) database for European countries. Children in stepfamilies provided less non-financial help to parents than those in intact families. Stepchildren were less likely to be in stepparents' social networks, and stepparents provided less help with childcare for grandchildren than they did to their biological children. Relationship closeness and looking after grandchildren increased the probability of non-financial support to older parents, regardless of whether the donor was a natural child or a stepchild.

Impact of Physical Activity by Older People on Long-Term Care Cost Projections in Poland.

In this study, we investigate whether higher physical activity of older people dampens increases in public expenditure, particularly the costs of long-term care. In our estimations, we refer to the projections of long-term care costs in Poland, published by the European Commission. Using the Survey of Health, Ageing and Retirement in Europe (SHARE) database, we calculate disability rates based on physical activity performed. Our results suggest that disability rates are significantly lower for older people who are physically active, and the promotion of physical activity in Polish society may significantly reduce future budgetary burden connected with population aging.

Physical Activity and Healthcare Costs: Projections for Poland in the Context of an Ageing Population.

BACKGROUND: The proportion of older people in many countries, including Poland, is expected to increase, which will lead to a rise in healthcare costs. OBJECTIVES: This study aims to analyse the impact of older adults' physical activity on public spending on healthcare in Poland over the long term. METHOD: To include the physical activity factor needed for our long-term projections, we modified the macro-simulation model used by the European Commission in Poland. We used the Survey of Health, Ageing and Retirement in Europe database to calculate the number of healthcare users depending on their level of physical activity. We used three measures of healthcare users: people with chronic diseases, people who were in hospital or visited a doctor more than once in the previous year, and people who subjectively evaluated their health as fair or poor. RESULTS: We found that a higher level of physical activity in older adults is associated with lower public expenditure on healthcare for all measures adopted. However, the magnitude of this effect differed depending on the measure used, with gains ranging from 0.4 to 1.2% of gross domestic product per year by the end of the projection horizon. CONCLUSION: Our findings provide a strong argument for social policy in Poland to intensify the promotion of physical activity in society to decrease future healthcare costs of older adults.