Formal and informal long-term care in the community: interlocking or incoherent systems?

摘要

Help with activities of daily living for people in the community is provided through formal servicesud(public and private) and informal (often unpaid) care. This paper investigates how these systemsudinterlock and who is at risk of unmet need. It begins by mapping differences between OECDudcountries in the balance between formal and informal care, before giving a detailed breakdown forudthe UK. New analysis of UK Family Resources Survey data for 2012/13 and 2013/14 suggests highudlevels of unmet need. We investigate who receives formal and informal care, and who receivesudneither, among the working-age and older populations. We find that while informal care fills someudgaps left by the lack of availability of formal services (and vice versa), not all older or working-ageuddisabled people are protected in these ways. Adults living alone and those with high but not theudhighest levels of difficulty are most likely to have unmet need. Means-tested public entitlementsudameliorate but do not remove the increased risk among people in low-income households. Theudpaper concludes that public policy needs to integrate its support for formal and informal modes ofudcare, with particular attention to those groups most at risk of unmet need.