Living Arrangements and Care Receipt Among Older People - SFI

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and 3) later ages at leaving the parental home among the younger generation, a result of
longer periods of education, later marriage and a later stable working career.
3.3 Trends in the living arrangements of elderly people in Britain and Italy
Figure 1 shows trends over 30 years (i.e., 1970-2000) in living alone in Britain and Italy.
In both countries there has been a slowdown in the trend toward solitary living. Table 1
shows in greater detail the household composition of men and women aged 65 years and
over in Britain. In this table data from the General Household Survey (GHS) shows that
the proportions of men living alone have stagnated in the 1990s, whereas the proportions
living with a spouse have increased. In addition, the proportion of older individuals
living with children or in ‘other’ types of households has declined. Trends for women are
similar to those for men. Stagnation in the trend of older people living alone is also
observed in Sweden and the Netherlands (the latter country has experienced a
considerable decline) (FAMSUP DataBase).
Even though most European countries have experienced considerable rises in the
proportion of older people living alone significant differences across countries remain
with lower proportions of elderly individuals living in multigenerational households in
Northern Europe when compared with their Southern European counterparts (Figure 2).
3.4 Trends in the proportion of older people in communal establishments
The proportion of older people resident in communal establishments, although low
compared to other Northern European countries, has been fluctuating in Britain, for
demographic reasons and as a result of government policy changes. At the 2001 Census
4.1 per cent of people aged 65 and over were resident in communal establishments, a
smaller proportion compared to the 5.1 per cent found in the 1991 Census. A similar
decline occurred among people age 85 and older, with 18.1 per cent in 2001, against 23.4
per cent found in 1991 (Figure 3). Women are more likely to live in institutions in old
age: among women 65 and older, 5.4 per cent were resident in communal establishments,
against just 2.4 per cent of men in the same age group. The differences are even more
striking among very old people: 20.9 per cent of women older than 85, against 11.3 per
cent of men, were living in communal establishments. An important factor for the higher
presence of women in communal establishment is the different marital status
composition: women are more likely to be widowed and so without a spouse to care for
them. Another important factor is the higher level of disability reported by women at any
given older age. Declines in institutionalisation among older people have also occurred
in the Netherlands and Sweden (FAMSUP DataBase). In Britain this follows an
expansion in the use and provision of institutional care during the 1980s, an unintended
consequence of policy changes which increased financial help available for those moving
to residential and nursing homes. The policy response to this expansion was new
legislation implemented in 1993 which was intended to reaffirm the objective of allowing
older people to remain in their own homes as long as possible. Sweden, the Netherlands
and a number of other countries also now have explicit policy objectives to reduce
institutional care use. Is the observed decline in institutionalisation a result of policy
changes aimed a reducing the availability of institutional care or a result of the greater
proportion of individuals with a surviving spouse in old age?