Informal and formal care of older people in Iceland

Background: Even if older people in the Nordic countries living in their homes usually have good access to formal help, the family plays an important role. Few studies have looked at the distribution of informal and formal care and the interplay between these spheres. The aim of this study is to shed light on the distribution of care and to analyse the patterns of care depending on the degree of limitations, the gender of the recipient and whether she/he is cohabitating or not. Method and sample: The Icelandic survey 'Icelandic Older People' (ICEOLD) is a random nationally representative survey among persons 65+ living in their homes. Of those who participated (n = 782), 341 were men and 441 were women, giving a response rate of 66%. Findings: About 60% of the people investigated in the survey had limitations with instrumental activities of daily living (IADL), and 10% of people had limitations with personal activities of daily living (PADL). The majority of the respondents with IADL or PADL limitations received either informal or formal help, but not both. When the IADL limitations increase, the informal care increases for men, but not for women, and the formal care increases for women, but decreases for men. Cohabiting men are much likelier to receive informal IADL help and less likely to receive formal help than men not cohabiting. Among women, corresponding differences are much smaller and not significant. When there is no spouse, the daughters help more than the sons and they help their mothers more than they help their fathers. Conclusion: More persons receive informal care than formal care, which shows the importance of the family. There is a gender difference in receiving care. Cohabitation is important for receiving informal care, especially for men.