As the number of family carers decreases, older adults with advanced dependency will have to rely on formal long-term care. Most older people prefer home-based care - provided by family members (informal) or by formal caregivers in their own home. However, as dependency increases, informal care is no longer effective. The aim of this study is to identify the key variables influencing preferences for the use of specific forms and financing of long-term care among people aged 65+ in two European capital cities: Warsaw and Madrid. We based the conclusion on the results of a survey using the CAPI method 'A thermosurvey of older adults' experiences and adaptation to urban heat & climate change' (Warsaw: N=808, Madrid: N=864), which was conducted in July-September 2022 among older adults aged 65 and above. The Andersen’s behavioral model of health services use and three hypothetical health situation scenarios: mild, moderate and severe dependency were used to determine preferences for the form and financing of care (informal, home-private, home-public, inpatient-private, inpatient-public). The results of the study showed differences in preferences both between cities and when changing the degree of dependency, as well as differences in the factors determining these preferences. However, some similarities in preferences can be found in both cities. Older people most prefer to be cared for in their own home, but as the level of dependency increases, the preference for informal care decreases in favour of formal care financed by private or public funds.
Małgorzata Wrotek, University of Warsaw, Poland