APLICACIÓN DE UN MODEW NUMERICO DE FLUJOS DE ESCOMBROS Y LODO EN UNA QUEBRADA EN EL PERU 17

Surveys of informal home care provision are often undertaken from the perspective of carers: enumerating carers and determining their input to caring and the demands upon them. Surveys of the recipients of care tend to restrict them by some other characteristic such as disability definition. In this analysis, the NDS and NISALD surveys are a rich source of data on informal care receipt by persons with disability or ADL difficulty. However, for the Republic of Ireland, it is evident from the 2009 Carers' Module of the Quarterly National Household Survey (QNHS), which unusually relates caregivers to care recipients, that this definition limits the estimates of recipients of informal care aged 65 and over and understates the need for informal support among a wider population without defined disability. The NDS-based informal home care utilisation data which form the basis for projected utilisation in the Republic are restricted to persons with ADL difficulty who receive all-day or daily care. Evidence from the 2009 QNHS forms the basis for estimated and projected utilisation of any informal care by all persons aged 65 and over. The Northern Ireland utilisation estimate and projection are based on NISALD and are for persons with disability receiving any form of informal care. Estimated and projected utilisation rates in Table 10.5 are not therefore comparable.

Table 10.5 Informal home care utilisation data and projections comparison, differing definitions

Republic of Ireland Northern Ireland

2006 2021 Preferred projection/ range 2006 2021 Preferred projection/ range Republic of Ireland definitions:

Numbers aged 65+ with ADL difficulty receive all day/daily informal home care

41,018 64,500 - -

% aged 65+ who have ADL difficulty & receive all day/daily informal home care

8.8% 8.1% - -

% aged 65+ who receive any

informal home care 28% 26% - -

Northern Ireland definition Numbers aged 65+ with disability receiving any informal home care

42,821 53,827

% aged 65+ who have disability & receive any informal home care

- - 17.9% 16.1%

% aged 65+ living alone 25.9% 25.9% 33%* -

Female labour force

participation rate (15-64 RoI; 16-64 NI)

53.1% - 61.7% -

Part-time workers as percentage of women in the labour force

34.5% 39%**

Male life expectancy at birth

(years) 76.8 - 76.2 -

Female life expectancy at

birth (years) 81.6 - 81.2 -

Difference between M and F

life expectancy (years) 4.8 - 5.0 -

Notes: Republic of Ireland: Household composition for 2006 sourced from Census of Population (2006); 2021 forecast sourced from Morgenroth (2009). Female labour force participation rate and life expectancies sourced from Central Statistics Office Database (accessed 1st

December 2011). Part-time female employment rate from ILO Percentage of population receiving all day, daily or some informal home care estimated in Chapter 5; projections developed in Chapter 8. Northern Ireland: Female participation rates in Northern Ireland are for women aged 16-64; *Percentage aged 65 and over living alone is the 2001 figure from Northern Ireland Census 2001 (NISRA). **Part-time female employment rate from ILO for UK in 2006. Information sourced from NISRA, Department of Finance and Personnel, ‘Women in Northern Ireland’ (2011) (accessed 1st

December 2011). Percentages of population receiving any informal home care are estimated in Chapter 6; projections developed in Chapter 9.

These estimates must, furthermore, be qualified by the evidence from a community-based survey of people aged 65 and over in the Republic of Ireland and Northern Ireland conducted in 2003 which found much higher proportions of older people receiving some form of informal care. McGee et al (2008) found that 49% of people aged 65 and over in the Republic

and 48% in Northern Ireland had received some form of informal care in the preceding year. Within this grouping receiving informal care, care from non-resident relatives was the most common source of help (27% RoI and 30% NI). Spouses or partners provided informal care to 18% (21% RoI and 14% NI) but the proportion of spouses giving continuous care was higher in NI at 60% compared to 41% in RoI. Care was given by another relative in the same household to 16% (20% in RoI and 11% in NI). The results of the McGee et al (2008) study suggest that the estimates in this study may underestimate overall informal care utilisation and generate correspondingly understated projections. The projections for intense informal care utilisation by people with ADL difficulty for the Republic and any informal care utilisation by people with disability for Northern Ireland, while a good basis for assessing need for care- giving for people with disability, should be considered an under-estimate of the care needs of the wider population of older people.

Table 10.5 also compares some socio-demographic characteristics which would influence the supply of informal care. The literature review in Chapter 2 discussed the wide evidence that the setting in which care is received and whether it is informal or formal is influenced by such factors as the marital status of the older person requiring care, their household composition and the availability of adult children. Living alone at older ages is a significant predictor of formal LTC need because intense care needs can generally only be met informally by co- resident carers. There is evidence from 2001 that 33% of the Northern Ireland population was living alone, which compares to 26% of the population in the Republic in 2006. This is compatible with the higher proportion of older people in Northern Ireland and with the greater difference in life expectancies between men and women in Northern Ireland, which would give rise to a higher rate of widowhood than in the Republic. Such factors reduce numbers of potential co-resident carers and would be expected to give rise to greater need for and utilisation of formal home care and residential care. Northern Ireland also had a higher female labour force participation rate than the Republic in 2006. Even though this may be partially offset by a higher part-time working rate (if NI rates are as in the UK on average), the potential supply of care by adult daughters of their parents would be less in NI than the Republic. The very high participation rates by younger women in the Republic combined with their emigration patterns may change this comparative picture over the projection period, however. In summary, it would appear that although on the evidence of McGee et al (2008) overall Northern Ireland rates of informal caring may be comparable to those in the Republic, these informal carers are drawn from a relatively smaller pool of potential care-givers.

The two disability surveys conducted North and South in 2006 offer a snapshot view of two populations with disability and their sources of care under every heading. These surveys were the sources of pie diagrams showing the proportions of care received under different headings in Chapters 5 and 6. These diagrams are not directly comparable because the definition of formal home care provision in the NDS includes any provider of carer, home help or personal attendant services, so that in the analysis for the Republic in Chapter 5, this category includes privately purchased care, which is excluded in the NISALD definition employed in Chapter 6. A striking difference that does emerge from the two surveys is that a much higher proportion of people aged 65 and over with ADL difficulty and living in the community receives no help in the Republic at 14% compared to 2% in Northern Ireland. The unmet need for care in a

much higher proportion of people with identified ADL difficulty in the Republic of Ireland than in Northern Ireland suggests that NI has a more effective care system.