Unmet care needs are common among community-dwelling older people with memory problems in Finland.

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities (N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

Community-dwelling older adults and their informal carers call for more attention to psychosocial needs - Interview study on unmet care needs in three European countries.

BACKGROUND: Unmet care needs are usually defined in terms of receiving sufficient help in instrumental activities and activities of daily living. Research on unmet needs is mostly based on quantitative data. Older persons' and informal carers' views and experiences have received less attention. METHODS: In this paper, we rely on a definition of unmet needs which includes both unmet needs due to insufficient care and those situations where informal carers experience undue strain. Using theory-driven content analysis, we examine community-dwelling older adults' and their informal carers' experiences of unmet needs: what kind of unmet needs they have, why and in which ways these needs are left unmet and what would they want to do to improve the situation. The data consists of interviews gathered in Austria, Finland and Slovenia. RESULTS: Results of the analysis reveal that unmet needs are largely psychosocial in nature. The predominating task-oriented care systems often do not consider these as care needs. Using methods of qualitative content analysis, we conclude that care users' unmet psychosocial needs are related to lacking a personal relationship with care workers; means to maintain or develop social contacts and pursue activities and interests; and adequate home care services or respite care. Excessive responsibilities are put on informal carers as they top up and fill in the insufficient care. CONCLUSIONS: This study contributes to a broader understanding of unmet care needs: the relational aspects of care and the universal nature of psychosocial care needs should be addressed in care services.

Care Poverty Within the Home Space: Exploring the Emotional Experiences of Unmet Care Needs.

Older adults face inequalities in care. The concept of care poverty has been developed to point out how unmet care needs are not just an individual issue but a phenomenon linked to social and economic disadvantage and societal inequality. In this paper, we approach the question of care poverty by focusing on its intertwinement with emotions and the home space. We analyze how the presence, or more commonly absence, of care shapes interviewees' descriptions of emotional experiences tied to the home space. Our data consists of 12 semi-structured interviews conducted in 2019 and 2020 with customers of outreach work for older adults in Finland. These customers typically face a situation that can be characterized as care poverty: their care needs are not (or have not been) met by either the service system or informal sources. When analyzing the data, we followed the guidelines for thematic analysis proposed by Braun and Clarke. Our analysis shows how care and lack of care transform interviewees' emotional connections with the home space, highlighting particularly three main themes: insecurity, isolation and belongingness. Our analysis reveals how lack of care can transform the home into an unsafe place; a space characterized by isolation, or a space where one sometimes ceases to feel at ease or "like oneself." The emotional experience of home and being adequately cared for is also tied to the sense of (not) belonging to a place. Based on our analysis, we argue that as an experience, care poverty is not just about individual unmet needs and/or a scarcity of resources at the societal level; it should also be understood as deeply relational-born and shaped in interactions (or the lack of interactions) among people, and lived in and through relationships with others. Furthermore, we highlight the importance of a sense of belonging to the feeling of being adequately cared for.

Finnish healthcare professionals' attitudes towards robots: Reflections on a population sample.

AIM: To answer the question: 'How prepared healthcare professionals are to take robots as their assistants in terms of experience and acceptance?' BACKGROUND: The ageing population, increasing care needs and shortage of healthcare professionals pose major challenges in Western societies. Special service robots designed for care tasks have been introduced as one solution to these problems. DESIGN: A correlative design. METHODS: Eurobarometer data (N = 969) and survey data of nurses and other healthcare professionals (N = 3800) were used to assess the relationship between robot acceptance and experiences with robots while controlling for the respondents' age, gender, occupational status and managerial experience. RESULTS: Healthcare professionals had less experience with robots and more negative attitudes towards them than the general population. However, in healthcare, robot assistance was welcomed for certain tasks. These regarded, for example, heavy lifting and logistics. Previous experiences with robots were consistently correlated with robot acceptance.

Users of home-care services in a Nordic welfare state under marketisation: the rich, the poor and the sick.

Stricter access to public services, outsourcing of municipal services and increasing allocation of public funding for the purchase of private services have resulted in a marketisation wave in Finland. In this context of a Nordic welfare state undergoing marketisation, this paper aims to examine the use of Finnish care services among older people and find out who are using these new kinds of private services. How wide is their use and do the users of private care services differ from those who are using public services? How usual is it to mix both public and private care services? The questionnaire survey data set used here was gathered in 2010 among the population aged 75 and over in the cities of Jyväskylä and Tampere (N = 1436). The methods of analysis used include cross-tabulation, chi-square tests and multinomial logistic regression. The findings showed that among those respondents who used care services (n = 681), 50% used only public services, 24% utilised solely private services and the remaining 26% used both kinds of services. Users of solely private services had significantly higher income and education as well as better health than those using public services only. The users of public services had the lowest education and income levels and usually lived in rented housing. The third group, those mixing both public and private services, reported poorer health than others. The results increase concerns about the development towards a two-tier service system, jeopardising universalistic Nordic principles, and also suggest that older people with the highest needs do not receive adequate services without complementing their public provisions with private services.