Increasingly, elderly people express the wish to remain i

1
Consumers Perspectives on Community-based
Homecare and Welfare Services PMA van Bilsen,
MSc1, JPH Hamers PhD. RN1, W Groot PhD2, C.
Spreeuwenberg PhD. MD1
What we have learned
The results confirm that elderly people want to
remain in their familiar home environment as long
as possible, even when they are on a waiting list
for residential care. However, the use of welfare
services especially set up to promote healthy
aging in place was limited. There are indications
that the fit between available welfare services
and the demand of elderly people for this type of
care is not optimal. The results of the second
measurement should provide more information about
the demand for welfare services in relation to
the existing supply.
Introduction
Preliminary Results
Increasingly, elderly people express the wish to
remain in their familiar home environment as long
as possible with a more varied provision of
services. As a result, there is an increase in
community-based care defined as locally and
regionally organized services tailored to the
needs, beliefs, preferences and values of elderly
people. Welfare services like home care alert,
personal or group counselling and cultural,
social and leisure activities are set up. It is
unknown whether these welfare services meet the
demands and preferences of elderly people?
At baseline, 132 elderly people were subjected to
interviews. The mean age was 84 year (sd 5,5).
Objectives
Users of welfare services compared to non-users
Is the available supply of welfare services -
especially set up to promote healthy aging at
home - in accordance with the demand of elderly
people who want to postpone residential care?
Demand for residential care

• Welfare users have smaller social networks
  (plt0.05) and are less satisfied with the
  sufficiency of their income (plt0.01).
• Welfare users have a better functional status
  (plt0.01), are more mobile (plt0.05) and receive
  more informal care (plt0.01) compared to
  non-users.

• 111 (80) elderly people want to stay at home as
  long as possible. 21 (20) elderly people say
  that they prefer residential care. Only 15
  respondents would actual accept an offer for
  admission into a home for the elderly.
• Elderly people who want to age-in-place feel
  more vital (plt0.01), experience better subjective
  wellbeing (plt0.01) and higher quality of life
  (plt0.01) compared to those who prefer
  residential care. Compared to women, men want to
  get admitted more often.

Methods
A longitudinal study including 2 measurements was
started. The sample at baseline consist of 428
elderly people aged 65 and over on a waiting list
for residential care. Data were collected using
structured interviews. The interviews consisted
of questions regarding quality of live,
well-being, autonomy, income, loneliness,
functional status, self agency, social network,
(in)formal care, welfare use, housing.
Discussion
The data collection of this study is ongoing and
as a result the research question cannot be
answered yet. However, the results of the first
measurement shows that the use of welfare
services at home is still limited. Maybe this is
an indication that the fit between available
welfare supply and demand is not optimal. In
order to understand the demand of elderly people
in a better way, the importance of resources like
social network and the ability to manage daily
activities should be considered (Van Bilsen et al
2005).
Use of welfare services
Response rate 44

• 39 (30) elderly people did not use welfare
  services and said that they would not use it in
  the future.
• Home care alert and social activities are the
  most popular services

Welfare users (n93)
Van Bilsen, P.M.A., et al (2005) Demand of
elderly people for residential care an
exploratory study. Submitted
1 Universiteit Maastricht, Dept. of Health Care
Studies, section Nursing Science
(www.nursingscience.nl). Corresponding
p.vanbilsen_at_zw.unimaas.nl 2 Universiteit
Maastricht, Dpt. of Health Organisation, Policy
and Economics (www.beoz.unimaas.nl)