Domestic help needed by older people

Most people in advanced age have someone to provide extra help with daily activities, especially domestic help with housework, washing, shopping and managing money.

That was the conclusion of a report into older peoples need for extra help in advanced age from the long-term LILACS NZ study - a longitudinal study of advanced ageing, called 'Life and Living in Advanced Age: a Cohort Study in New Zealand - Te Puāwaitanga O Ngā Tapuwae Kia Ora Tonu' (LiLACS NZ).

The study uses a population-based sample of Māori (aged 80 to 90 years) and non-Māori (aged 85 years), living in the Bay of Plenty.

"More than 80 percent of people in advanced age had someone to provide extra help with daily activities when they needed it," says study leader, Professor Ngaire Kerse from the University of Auckland. "Domestic activities were the most common activities that people received informal help with."

The study looked at the source of help and whether assistance was used for mobility (walking around outside, getting in and out of a car, crossing roads, using public transport), kitchen activities (making a hot drink, doing the washing up, making a snack), and domestic activities (managing money, housework, washing, shopping).

Thirty-seven percent of people received help with domestic activities, seven percent received help with mobility and four percent received help with kitchen activities.

The report describes access to extra help with daily activities when it is needed by sex, ethnic group and socio-economic deprivation. It did not include those people in residential care.

Significantly fewer men (76 percent) than women (84 percent) reported having someone available to provide extra help with daily activities when they needed it.

A small proportion of Māori (seven percent) and non-Māori (four percent) said they had no-one to provide extra help with daily activities. There was no difference in availability of help with daily activities by socio-economic deprivation.

The source of help also varied depending on living arrangement - people in advanced age living alone or with a variety of other people including their spouse/partner; their adult children or other relatives.

Significantly more women (51 percent of Māori women and 65 percent of non-Māori women) lived alone than men (26 percent of Māori men and 33 percent of non-Māori men).

Thirty-eight percent of those who lived alone reported that a non-relative was their main source of extra help with daily activities compared with nine percent of those who did not live alone.

Professional caregivers were the main source of help for 16 percent of people who lived alone, while 56 percent of Māori men, 60 percent of Māori women and 58 percent of non-Māori women listed their son or daughter as the most helpful person.

For non-Māori men who lived alone, the majority (64 percent) listed 'Other' as the person who gave the most help with daily activities and, of these, one third listed a professional caregiver.

Among those living with their spouse only, the most helpful person with daily activities was their spouse – 91 percent of Māori men and 62 percent of Māori women in this living situation reported that their spouse was the person who provided the most help with daily activities.

For non-Māori, 65 percent of men and 67 percent of women in this living situation reported that their spouse was the most helpful person.

Some people in advanced age had an unmet need for help with daily activities, Fourteen percent said that they could have used more help than they received; that is, they had an unmet need for extra help with daily activities when they needed it.

Overall, 21 percent of Māori and 11 percent of non-Māori reported that they could have used more help with daily activities than they received. There was no significant difference between ethnic groups when adjusted for age and sex. Unmet need was reported by the same proportion of those who lived alone and those who lived with other people.

• The source of these data is Life and Living in Advanced Age: a Cohort Study in New Zealand—Te Puāwaitanga O Ngā Tapuwae Kia Ora Tonu (LiLACS NZ). Data were gathered in face-to-face, standardised interviews with Māori aged 80-90 years old and non-Māori aged 85 years old at home, plusnursing assessments of physical function and cardiorespiratory health.
• The LiLACS NZ sample lives within the boundaries of the Bay of Plenty and Lakes District Health Boards, excluding the Taupo region of Lakes DHB. The participants were first interviewed and assessed in 2010 (the 'first wave' of data collection). This is a longitudinal study with annual data collection, subject to mortality and participant retention.