Essays on the provision of long term care to older adults in Scotland

Abstract

This thesis presents three empirical analyses on different aspects of the provision of long term care (LTC), in the paid and unpaid settings, to older adults in Scotland. It contributes to the academic literature by deepening our understanding in three interrelated areas.Firstly, it explores variation in the provision of Free Personal Care (FPC) across Scottish local authorities, in order to establish whether or not FPC provision matches the need of the population. The analysis suggests that there are significant differences in FPC provision, even after accounting for personal care need. This raises equity concerns, suggesting that older Scots might be more or less likely to receive FPC, depending on which local authority they reside. Secondly, it investigates the interaction between paid care and unpaid care, to understand how unpaid carers influence older people’s use of FPC. In particular, it aims to establish whether or not unpaid carers substitute or complement FPC. The paper finds that individuals who have an unpaid carer receive around one hour and a quarter more FPC each week. This raises concerns for the pressure unpaid carers might have on FPC resources and for individuals without unpaid carers, who might not be getting the formal help that they need. Lastly, it focuses on unpaid carers themselves and explores whether or not providing care has an impact on their Standard of Living (SoL). Specifically, it estimates the monetary amount an unpaid carer would need to be compensated by in order to reach the same SoL as a non-carer. In doing so, it offers evidence for the extent to which the current Carers Allowance is sufficient in compensating them for the material impact of their care giving duties. The results suggest that unpaid carers have a significantly lower SoL compared to non-carers and demonstrate that the Carers Allowance falls considerably short of compensating unpaid carers for the loss in SoL they experience due to caring.