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Increase in informal care has negative impact on wellbeing

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13 January 2025
A long-term study of the impact of the Dutch long-term care reform.

Sociologist Maura Gardeniers examined health, care and well-being following the 2015 care reforms. She shows that these reforms led to changes in how care is organised and perceived, but did not have a major impact on health, well-being and perceived adequacy of care. It does show an increase in the use of informal care, which often has a negative impact on the well-being of both the elderly and their informal carers. This emphasises the need to better support informal carers and put more effort into preventive health care to keep the rising demand for care manageable.

Living longer at home
Gardeniers offers insight into the impact of healthcare reforms. Ageing of the population is one of the biggest challenges of our time. She shows what is important for older people, informal carers, policymakers and care providers. Gardeniers recommends better integration of informal and formal care so that the elderly can live longer at home without overburdening informal carers. Concrete applications include technologies such as care apps and smart alarm systems, as well as fall prevention programmes and neighbourhood initiatives to strengthen informal care networks.

Municipal elderly care
Gardeniers explains, "In 2015, responsibility for long-term elderly care was transferred from the state to the municipalities. Municipalities had to fulfil this responsibility with a budget that was 30 per cent lower than what the State spent on it in previous years. I looked at trends in health, care use, and well-being in the period surrounding this reform and used data from the Longitudinal Aging Study Amsterdam (LASA). LASA has been following several cohorts of older people since the 1990s, collecting data on their health, care, and well-being every three years."

Gardeniers' findings align with current issues such as labour shortages in care and calls for affordable and sustainable solutions. In the future, for instance, AI could help plan care more efficiently. Within a few years, measures such as housing adaptations and better support for informal carers could already have noticeable effects. Her research contributes to the well-being of the elderly and to a society in which everyone can age with dignity.

Gardeniers will receive her PhD at Vrije Universiteit Amsterdam on 30 January.

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