ICAS slides Nicinska & Kalbarczyk

MotivationData

Transition matricesEconometric resultsConcluding remarks

Daily Life Limitations and Reception of Care in theLast Year of Life

Ma lgorzata Kalbarczyk-Steclik, Anna Nicinska

University of Warsaw

[email protected], [email protected]

November 9, 2013

Ma lgorzata Kalbarczyk-Steclik, Anna Nicinska The last year of life: Daily life limitations and care

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Overview

1 MotivationResearch problemBasic factsResearch questions

2 DataTwo types of SHARE interviewsResearch sample

3 Transition matrices

4 Econometric resultsADL and IADL limitations numberCare providers

5 Concluding remarks


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Research problemBasic factsResearch questions

Intergenerational solidarity

The last year of life substantially differs from the previous years oflife.Private intergenerational transfers of money and care in Europe: ingeneral the 50+ are net givers [Albertini et al, 2007].

Does this general observation hold for the last year of life?Is intergenerational solidarity sufficient?


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ADL and IADL limitations dynamics

Distribution of the number of limitations significantly differsbetween the last and the previous year of life.

ADL and IADL: dressing, walking, bathing, eating, getting in bed,using the toilet, preparing a meal, shopping, telephoning, takingmedication.


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Care providers in the last and the previous year of life

Care by Year of lifePrevious Last

Family only 62.82 53.96Non-family only 9.81 15.72Family and non-family 27.37 30.32

Proportion of care receivers 55.18 95.84N of individuals 980 1706

Table 1 : Care providers in the previous and the last year of life.


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The last year of life vs the previous one

ADL and IADL

What are the ADLs and IADLs in the last and in the previous yearsof life?

Care

Who and from who receives care in the last and previous years oflife?


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Two types of SHARE interviewsResearch sample

Survey on Health, Ageing and Retirement in Europe

SHARE is a biannual panelsurvey on individuals aged50+ in 19 Europeancountries. In consists of 3types of interviews:

Regular interviews

Exit interviews

Life history interviews

As of today, 4 waves of datacollection have been released.


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Regular interviews

Regular interviews are conducted in each wave of data collectionexcept from wave 3.

They collect information on the current situation of respondents’physical and mental health, medical care, economic activity,income, and consumption.


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Exit interviews

Exit interviews are conducted with the deceased respondents’proxies. Proxies are usually family members or other individualsclose to respondents.

Exit interviews concern the last 12 months of the deceasedrespondents’ lives. They provide exact dates of the deceasedrespondents’ deaths.


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Research sample

We use the data from the exit interviews matched with the latestregular interview preceding respondent’s death.


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Limitations with ADL and IADL

Limitations number Last year of lifePrevious year of life 0 1-5 6-10 Total

0 49.18 27.99 22.83 1001-5 22.41 35.21 42.38 1006-10 5.94 18.13 75.94 100

Total 34.90 28.71 36.40 100

Table 2 : Transition of ADL and IADL limitations number between theprevious and the last year of life.


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Care providers

Care providers Last year of lifePrevious year of life Fam. Non-fam. Fam. & non-fam. Total

Family only 60.13 9.38 30.49 100Non-family only 30.43 44.93 24.64 100Family & non-family 48.06 15.53 36.41 100

Total 54.03 14.38 31.59 100

Table 3 : Transition of care providers between the previous and the lastyear of life.


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ADL and IADL limitations numberCare providers

Ordered logit model for functional status (ADL and IADLlimitations)

Last year Previous yearOdds ratio Std. err. Odds ratio Std. err.

Female 1.31∗∗∗ 0.11 1.43∗∗∗ 0.19Age 1.07∗∗∗ 0.007 1.05∗∗∗ 0.004RegionCentral 1.05 0.11 1.4 0.22South 1.24∗∗ 0.12 1.78∗∗∗ 0.24Married 0.91 0.08 0.93 0.12N of obs. 2207 1290

Table 4 : Significance level: *** p < 0.01 ** p < 0.05 * p < 0.1


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Ordered logit model for functional status (ADL and IADLlimitations)


Heart attack 0.40∗∗∗ 0.06 1.42∗ 0.27Stroke 0.74∗ 0.12 2.20∗∗∗ 0.45Other cardio. 0.77∗ 0.11 1.96∗∗∗ 0.41Respiratory dis. 1.04 0.2 1.94∗∗ 0.54Digestive sys. dis. 0.72 0.23 0.86 0.35Severe inf. dis. 0.74 0.15 2.87∗∗∗ 0.92Accident 0.22∗∗∗ 0.07 0.55 0.34Other 1.18 0.14 2.85∗∗∗ 0.5

Table 5 : Significance level: *** p < 0.01 ** p < 0.05 * p < 0.1Ma lgorzata Kalbarczyk-Steclik, Anna Nicinska The last year of life: Daily life limitations and care

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Multinomial logit for sources of support - Non-kin only


Female 1.28 0.25 0.41∗ 0.16Age 1.03∗∗∗ 0.01 0.95∗∗∗ 0.02RegionCentral 0.57∗∗∗ 0.12 0.53 0.23South 0.13∗∗∗ 0.03 0.30∗∗∗ 0.12Married 0.23∗∗∗ 0.05 0.78 0.40N of obs. 1366 583



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Multinomial logit for sources of support - Non-kin only


Heart attack 1.07 0.38 0.78 0.40Stroke 1.45 0.53 0.52 0.33Other cardio. 1.80∗ 0.57 0.46 0.29Respiratory dis. 2.40∗∗ 1.02 1.13 0.78Digestive sys. dis. 3.69∗∗ 2.05 1.60 2.60Severe inf. dis. 1.28 0.53 0.53 0.46Accident 9.76∗∗∗ 8.02 3.48 4.92Other 1.74∗∗ 0.45 0.81 0.43



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Multinomial logit for sources of support - Family andNon-kin


Female 1.33∗∗ 0.18 0.76 0.17Age 1.02∗∗ 0.01 0.98∗ 0.01RegionCentral 0.76∗ 0.12 0.69 0.18South 0.25∗∗∗ 0.04 0.43∗∗∗ 0.10Married 0.76∗ 0.11 0.35∗∗∗ 0.08N of obs. 1366 583



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Multinomial logit for sources of support - Family andNon-kin


Heart attack 0.89 0.22 1.56 0.51Stroke 1.74∗∗ 0.43 1.11 0.39Other cardio. 1.16 0.27 0.70 0.26Respiratory dis. 1.47 0.48 0.91 0.47Digestive sys. dis. 1.19 0.53 1.31 1.36Severe inf. dis. 1.24 0.40 0.81 0.39Accident 2.51 1.79 2.20 1.95Other 1.29 0.24 1.74∗ 0.53

Table 9 : Significance level: *** p < 0.01 ** p < 0.05 * p < 0.1Ma lgorzata Kalbarczyk-Steclik, Anna Nicinska The last year of life: Daily life limitations and care

MotivationData


substantial increase between previous and last year in ADLand IADL limitations number

largest increases in ADL and IADL limitations for people dyingon cancer

95% of care receives in last year and 50% in previous year

care is provided by family only most often in the SouthEurope and for married individuals

care provided by non-kin is more often for individuals whodied due to respiratory disease, disease of the digestive systemor other cardiovascular related illness or accident

who provided care depends on age differently in previous andlast year


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References

Albertini M., Kohli M., Vogel C. (2007)

Intergenerational transfers of time and money in European families:common patterns different regimes?

Journal of European Social Policy 17(4), 319 – 334.

Covinsky K. E, Eng C., Lui L.-Y. Sands L., Yaffe K. (2003)

The last 2 years of life: functional trajectories of frail older people

Journal of American Geriatric Society 51, 492 – 498.

Hank K., Jurges H. (2010)

The last year of life in Europe: regional variations in functional status andsources of suppor

Ageing and Society 30(6), 1041 – 1054.


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Thank you


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