Unmet social care need

Unmet social care need

Unmet social care need is widespread throughout society

Research suggests complex relationship between unmet need and well-being, posing challenges for social care practice

Unmet need for social care services is widespread and permeates throughout society, but all too often goes unrecognised, research has concluded.

The findings of the project, led by Ipsos MORI’s Dr Margaret Blake in collaboration with NatCen Social Research, and funded by NIHR SSCR, reinforced those of previous studies.

The research combined secondary analysis of data from the English Longitudinal Study of Ageing (ELSA) and Health Survey for England (HSE) with in-depth interviews with older people who have care needs. It found older people judged unmet need around social contact and mobility to be at least as important as meeting everyday needs such as dressing and bathing.

The study also uncovered an unpredictable relationship between unmet need and general well-being. Social care practitioners must rise to the challenge, it concluded, in striking a balance between offering support around basic tasks and recognising and facilitating the independence many people prize highly.

Dr Margaret Blake of Ipsos MORI, who led the study, said: “This research shows that the causes of unmet needs for care and support are wide-ranging, and there is a complex relationship between unmet need and well-being.”

Difficulties of daily living

The research project focused on whether or not needs were being met among people who have difficulties around daily living or mobility.

Data from ELSA and HSE showed that more than half of older people with care needs also had some level of unmet needs – regardless of their age or socio-economic status.

But the in-depth interviews, which involved 24 participants, revealed that even where people did not acknowledge unmet need around basic activities, those without support could find these time-consuming and tiring – an indicator of unmet need. Additionally, where support was said to be available, it was often unreliable or unsustainable over the long-term; for example where loved ones were providing it.

“Thus, unmet needs were often hidden; older people were not generally going hungry or cold or unsafe, but their needs were still not being reliably met,” the study found.

Interviewees also voiced other unmet needs, around a lack of social contact, or being unable to pursue interests or leave the house. Such factors, in particular around loneliness and isolation, had a “huge” impact on the lives of participants reporting them, researchers found.

’Resilience and independence’

The data analysis element of the study revealed few significant predictors of unmet care needs among different individuals over a 10-year period. But people who had started out younger and healthier, lived alone or had recently lost a partner were more likely to develop them.

Potential influencing factors suggested by the study included an unwillingness to seek support, particularly among people who did not feel themselves old enough to be receiving it.

Interviews uncovered a sense of “resilience and independence” among some participants, who felt that managing by themselves helped maintain their sense of identity.

“For some older people, lack of support with activities they find difficult is not necessarily a sign of an unmet need, even though for another person the same lack of support would indicate [unmet need],” researchers concluded.

Diverse experiences

Perhaps influenced by this finding, the two elements of the study drew contrasting pictures around the relationship between unmet need and general well-being.

Analysis of the ELSE/HSE data did not show a link between unmet need and levels of well-being, which were much more influenced by ageing, financial situation and overall levels of care need. Interviews, on the other hand, found unmet need was associated with poor well-being and anxiety in at least some people.

“The difference in findings may relate to that fact that the data analysis looks at the overall picture, whereas the interviews can uncover the diverse experience of individuals,” the study said.

The interviews, unlike the data analysis, also allowed older people to describe their well-being in their own terms – with the most common complaints being around a sense of frustration and lack of purpose. Again, responses underlined the mitigating effect that mobility, and being able to participate in social activities, had on such negative feelings – even where other needs went unmet.

“The in-depth interviews showed that people in similar situations in terms of the support available to them and their level of need could experience them in very different ways, with one relishing their independence and the other feeling they were merely coping and existing, or that they lacked the confidence to use the adaptations they had,” the study concluded.

Among a number of recommendations, researchers highlighted the need for practitioners to consider how certain groups are more vulnerable than others in terms of developing unmet needs. Wider services and social policies, which can enable people to arrange their own care and participate in maintaining activities and relationships, must be considered when identifying needs, they added.

Dr Blake said: “Having timely access to information and advice, being able to plan ahead and save for future care needs, knowing how to access care and support services and retaining independence and social networks all have a role to play in reducing unmet needs for care and maintaining well-being in older age.”

Full summary findings

NIHR SSCR (2019) Predicting Future Unmet Social Care Needs and Examining Links with Well-being, Research Findings 66, NIHR School for Social Care Research, London.

Further information

This study funded by the NIHR School for Social Care Research and led by Dr Margaret Blake at Ipsos MORI.

Sunday, April 28th, 2019

Other news

Dementia Career Development Awards – Call for applications Funding


26 June 2024

Dementia Career Development Awards – Call for applications

NIHR Three Schools' Dementia Research Programme invites applications to support individuals to develop their careers in dementia-related research by 16...

Call for Outline Research Proposals 2024 – Dementia Funding


26 June 2024

Call for Outline Research Proposals 2024 – Dementia

NIHR Three Schools' Dementia Research Programme invites outline research proposals for up to £500,000 by 23 September 2024.

NIHR Three Schools’ Prevention Programme – funding opportunities Funding


21 June 2024

NIHR Three Schools’ Prevention Programme – funding opportunities

NIHR Three Schools' Prevention Research Programme seeking applications for career development awards by 13 September 2024.

Paper: Co-Producing Resources to Raise Awareness of Meals on Wheels Findings


14 June 2024

Paper: Co-Producing Resources to Raise Awareness of Meals on Wheels

Paper from the University of Bristol describes work to co-produce knowledge translation resources with people with lived experience of Meals...

Call for Three NIHR Research Schools’ Mental Health Programme Commissioned Research Funding


3 June 2024

Call for Three NIHR Research Schools’ Mental Health Programme Commissioned Research

The NIHR Three Schools' Mental Health Programme is seeking research proposals focusing on mental health in several areas by 12...

Paper: Care Relationships in Social Care Residential Settings Findings


15 May 2024

Paper: Care Relationships in Social Care Residential Settings

Paper describes findings from a literature review exploring care relationships between support staff and adults with a learning disability in...

Paper: Unpaid carers of people with dementia and ICT Findings


25 April 2024

Paper: Unpaid carers of people with dementia and ICT

Paper from the London School of Economics and Political Science explored the types of information communication technology (ICT) unpaid carers...

Paper: People with learning disabilities renting their own homes Findings


24 February 2024

Paper: People with learning disabilities renting their own homes

Findings from project led by the University of York looking at the rented housing sector for people with learning disabilities.

Supporting older people’s care moves Blog post


23 February 2024

Supporting older people’s care moves

Transitions between care settings: how evidence-based resources can help

Food and drink in later life: the role of homecare Blog post


21 February 2024

Food and drink in later life: the role of homecare

What is the role of homecare in tackling undernourishment in older adults?

Exploring the benefits of music in care homes Blog post


19 December 2023

Exploring the benefits of music in care homes

How care home residents and staff can benefit from music-making

Data-Driven Decision-Making in Homelessness Services Blog post


14 December 2023

Data-Driven Decision-Making in Homelessness Services

How can choice modelling provide better services for people experiencing homelessness?

Funding of £10 million for prevention research News


4 October 2023

Funding of £10 million for prevention research

NIHR Three Research Schools awarded £10 million to deliver programme of prevention research.

‘What’s your 10 minutes of Britney Spears?’ The key to a flourishing life Blog post


4 October 2023

‘What’s your 10 minutes of Britney Spears?’ The key to a flourishing life

Finding the key to a flourishing life: applying a Capability Approach to social care

NIHR announces Research Support Service News


18 July 2023

NIHR announces Research Support Service

New NIHR Research Support Service to provide application support for researchers.

New Catalogue of Social Care Data News


13 April 2023

New Catalogue of Social Care Data

First fully comprehensive catalogue of social care data launched.

Supporting A Charter for Social Work Research in Adult Social Care News


20 February 2023

Supporting A Charter for Social Work Research in Adult Social Care

NIHR SSCR joins with other organisations to support A Charter for Social Work Research in Adult Social Care.