Older adults may feel tension and powerlessness towards social care services

Sao Jose J, Nyqvist F, Barros R, et al.  Older persons’ experiences and perspectives of receiving social care: A systematic review of the qualitative literature  Health and Social Care in the Community. 2016; 24(1): 1-11.

Review question

What are the experiences of individuals over the age of 65 when they need to receive social care? What are the negative and positive aspects of these experiences? What are the factors which influence the experiences?

Background

The amount of information on the perspectives of older adults related to receiving social care is limited. As a result, there are opportunities for improvement when considering the alignment between social care theory, empirical research, professional practice and social policy, and the wants and needs of older adults. It is challenging to develop policies to improve senior care without understanding the experiences of those receiving care.

This systematic review aims to identify, appraise, synthesize and discuss relevant evidence highlighting the experiences and perspectives of older persons while receiving social care.

How the review was done

A detailed search of a number of electronic databases for studies published from 1990 to 2014 was conducted. Studies that focused on adults aged 65 and up living in community settings in countries of the European Union and receiving social care were included in the review.

A total of 140 studies were identified in searches, and 30 were included in the review after assessments for eligibility.

This review was partially funded by the Portuguese Foundation for Science and Technology.

What the researchers found

The review found that older adults who begin asking for and needing care can have feelings of tension and powerlessness due to unfamiliarity with formal health and social care services. With regards to informal care from family and friends, the older population included in the reviewed studies often worried that they were a burden to informal caregivers. This presents a challenge for older individuals to balance the sense of comfort and guilt when requesting support.

Included studies highlight some negative aspects of receiving care from an older adult perspective, such as the loss of independence, autonomy, confidence and social identity.

In response to these challenges, older individuals cope with the transition to receiving care by maintaining the activities and relationships they had before care to preserve a sense of self, letting go of the emotions associated with such changes, and upholding the expectation of receiving quality social care when and if care is required.

Conclusion

This review highlighted the experiences of older adults while receiving social care. It is evident that the process of receiving care is accompanied by personal challenges for older individuals, such as a lack of autonomy. Although the studies included for review do highlight coping mechanisms for older individuals to address the challenges associated with social care, they do not provide strategies for assisting older adults to manage the losses during this transition. Further investigation is recommended in this area.

The study is limited to northern countries of the European Union and fails to include the impact of cultural perspectives on receiving social care. The methods of qualitative interviewing between studies included in this review also lacked consensus.