Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer's Disease Patients: Evidence From the Up-Tech Study

J Gerontol B Psychol Sci Soc Sci. 2016 May;71(3):514-25. doi: 10.1093/geronb/gbv045. Epub 2015 Aug 21.

Abstract

Background: The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs.

Method: We analyzed baseline data from 438 older people with moderate Alzheimer's disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables-education, social class, and the availability of a care allowance-and three outcomes-employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers).

Results: The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW.

Discussion: Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems.

Keywords: Alzheimer’s disease; Care allowance; Family caregiver; Migrant care worker; Socioeconomic factors; Up-Tech.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / economics*
  • Alzheimer Disease / therapy*
  • Caregivers / economics
  • Caregivers / supply & distribution
  • Educational Status
  • Employment / economics*
  • Employment / statistics & numerical data*
  • Female
  • Financing, Government* / economics
  • Financing, Government* / statistics & numerical data
  • Financing, Personal / economics*
  • Financing, Personal / standards*
  • Home Care Services / statistics & numerical data*
  • Humans
  • Italy
  • Long-Term Care*
  • Male
  • Middle Aged
  • Socioeconomic Factors*
  • Transients and Migrants / statistics & numerical data*