Informal caregiving for frail older people at home and in long-term care institutions: who are the key supporters?

This paper describes the extent of the informal caregiving unit for older p eople who are physically or mentally frail living in private households or resident in long-term care institutions using cross-sectional analysis of s urvey data. A total of 1444 people aged 65 years or more registered with a general practitioner (GP) in four areas in England and, consenting to the s tudy, were screened for mental or physical frailty. Of 1127 older subjects living at home 7% reported receiving no informal support, 15% had a paid su pporter only and 78% nominated a key informal supporter who helped with def ined activities of daily living of whom 650 (74%) were interviewed. Only 13 % nominated more than one informal supporter. Key supporters were spouses ( 38%), daughters (30%), sons (9%), daughters-in-law (4%), other relatives (1 1%) and friends and neighbours (8%). Of 317 frail older people resident in long-term care institutions 175 (55%) received a main visitor at least once a week of whom 132 (75%) were interviewed. Main visitors were spouses (11% ), daughters (36%), sons (23%), daughters-in-law (2%), other relatives (24% ) and friends (4%). Qureshi & Walker's (1989) hierarchical, decision-making model for selecting informal caregivers was applied to the data and correc tly identified 85% of key informal supporters and 79% of main visitors inte rviewed. This large-scale comprehensive survey of informal care for frail o lder people supports earlier small-scale localized studies highlighting the key role of spouses and daughters in the provision of informal support. Fa milies of frail older people provide the support to maintain people at home .