Exploring the Preferences of Unpaid Carers of Older Adults Towards Support: Implications for Personalisation

Abstract

Uptake of carers’ services across the UK is relatively low despite evidence of the positive effects of support services. The Carers (Scotland) Act 2016 places duties on local areas to provide personalised support to unpaid carers with eligible needs. However, is it not clear how to best plan local services to meet the diverse support needs, aspirations and preferences of unpaid carers. The preferences of unpaid carers of older people requires particular attention as this group of carers play a vital role enabling many older people to live at home, and are often in need of support themselves.

This thesis uses a discrete choice experiment (DCE) to investigate carers’ preferences for support in Scotland. Applying a realist, interdisciplinary framework, it draws on a literature review, secondary analysis of interview data (n = 62), three focus groups with carers and practitioners, and a DCE survey (n = 112). It examines what matters to carers when choosing between different types of formal support, and investigates the heterogeneity of preferences for respite among different subgroups of carers.

This thesis finds a high stated demand for respite and replacement care services amongst carers of older adults in Scotland. It demonstrates carers particularly value choice surrounding the support provider, and are willing to wait 12 months longer for replacement care provided by a familiar professional carer compared to an unfamiliar paid carer worker in order to take a short break. Reasons for not using support services include a perceived administrative and organisational burden, and lengthy waiting times.

Together, this informs policy and practice in the design of carer support services, both in Scotland and beyond, and highlights the need for further research to understand the impact of accessibility and responsiveness of adult social services in the take-up of short breaks and other personalised forms of carer support.