Does informal care compensate formal care during COVID-19? Cross-sectional study of service utilization among community-dwelling people living with dementia in the post-pandemic period 

Presenter: Cheng Shi (The University of Hong Kong)

Abstract for the International workshop on COVID-19 and Long-Term Care systems: What have we learnt and what policies do we need to strengthen LTC systems?

Video of the presentation (see 38:40):

Cheng Shi: LTC-COVID Webinar 6 – 7 December 2021

Abstract 

Objective: This study aims to examine the impact of COVID-19 on service use pattern of formal-informal care for people with dementia during the post-pandemic period. 

Methods: We included 481 dyads of community-dwelling residents living with dementia and their family carer in Hong Kong and captured informal care hours of multiple carers. A two-part model with logistic regression and generalised linear model was employed for analysing the relationship between formal and informal care service use. 

Results: Participants reported, since the COVID-19 outbreak, decreased service utilisation in healthcare (n=69; 14.4%) and social care (n=38; 7.9%). Among those who reported a decrease, service use decreased by 48.9% for healthcare and 70.5% for social care, on average. 18.7% participants (n=86) reported an increase in informal care, with an average increase rate of 53.4%. The two-part model showed that participants who reported decreased formal care service use had a higher likelihood of increased informal care, after controlling for sociodemographics, comorbidities, cognitive ability, functional status, having a dementia diagnosis and number of informal carers (healthcare: OR=3.1, p=0.002; social care: OR=7.1, p=0.000). Increased informal care hours were associated with the number of family carers and the functional status of the person with dementia.  

Conclusions: Changes in service use pattern of formal care during COVID-19 is related to that of informal care. Informal care may be invoked as a compensatory mechanism for the reduced formal care, while increased informal care hours may be dependent on the availability of family carers and care needs. In the post-pandemic period, long-term care policy should consider the impact of COVID-19 on formal-informal care relationship.  

Authors and affiliations 

  • Dr Cheng Shi*, Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China 
  • Dr Jacky CP Choy, Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China 
  • Ms Kayla KY Wong, Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China 
  • Dr Terry YS Lum, Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China 
  • Dr Gloria HY Wong, Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China 

(* Presenting author) 

For more information about the Tools to Inform Policy: Chinese communities’ Action in Response to Dementia (TIP-CARD) project:

Web: https://www.tip-card.hku.hk/ 

Twitter: @tip_card 

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