title: What can local authorities do to improve the social care-related quality of life of older adults living at home? Evidence from the Adult Social Care Survey.
abstract: Local authorities spend considerable resources on social care at home for older adults. Given the expected growth in the population of older adults and budget cuts on local government, it is important to find efficient ways of maintaining and improving the quality of life of older adults. The ageing in place literature suggests that policies in other functions of local authorities may have a significant role to play. This study aims to examine the associations between social care-related quality of life (SCRQoL) in older adults and three potential policy targets for local authorities: (i) accessibility of information and advice, (ii) design of the home and (iii) accessibility of the local area. We used cross-sectional data from the English national Adult Social Care Survey (ASCS) 2010/2011 on service users aged 65 years and older and living at home (N=29,935). To examine the association between SCRQoL, as measured by the ASCOT, and three single-item questions about accessibility of information, design of the home and accessibility of the local area, we estimate linear and quantile regression models. After adjusting for physical and mental health factors and other confounders our findings indicate that SCRQoL is significantly lower for older adults who find it more difficult to find information and advice, for those who report that their home design is inappropriate for their needs and for those who find it more difficult to get around their local area. In addition, these three variables are as strongly associated with SCRQoL as physical and mental health factors. We conclude that in seeking to find ways to maintain and improve the quality of life of social care users living at home, local authorities could look more broadly across their responsibilities. Further research is required to explore the cost-effectiveness of these options compared to standard social care services.
authors.affiliation: Department of General Practice and Elderly Care Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: k.vanleeuwen@vumc.nl.
authors.forename: K M
authors.initials: KM
authors.lastname: van Leeuwen
authors.affiliation: Personal Social Services Research Unit and Quality and Outcomes of Person-centred Care Research Unit, London School of Economics and Political Science, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Malley
authors.affiliation: Department of Health Sciences and EMGO Institute for Health and Care Research, Faculty of Earth & Life Sciences, VU University, Amsterdam, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Bosmans
authors.affiliation: Department of General Practice and Elderly Care Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: A P D
authors.initials: AP
authors.lastname: Jansen
authors.affiliation: Department of Health Sciences and EMGO Institute for Health and Care Research, Faculty of Earth & Life Sciences, VU University, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: R W
authors.initials: RW
authors.lastname: Ostelo
authors.affiliation: Department of General Practice and Elderly Care Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: H E
authors.initials: HE
authors.lastname: van der Horst
authors.affiliation: Personal Social Services Research Unit and Quality and Outcomes of Person-centred Care Research Unit, University of Kent, Canterbury, Kent, UK.
authors.forename: A
authors.initials: A
authors.lastname: Netten
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006699:Home Care Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D008603:Mental Health; D057766:Policy; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Local policy; Older adults; Quality of life; Social care