Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer's Disease Patients: Evidence from the Up-Tech Study

Francesco Barbabella, Carlos Chiatti, Joseph M Rimland, Maria Gabriella Melchiorre, Giovanni Lamura, Fabrizia Lattanzio, Diletta Baldassarri, Luigina Bitti, Aurora Carosi, Maila Sabbatini, Elisabetta Paolasini, Tania Fiori, Cinzia Fronzi, Simona Giacchetta, Valeria Giacomini, Laura Giovagnoli, Giuli Lattanzi, Anna Maria Manca, Valeria Pigini, Marina PignottiMaria Chiara Proietti, Antonia Quarticelli, Martina Rovedi, Letizia Tasso, Valentina Valeri, Andrea Antonioli, Mariella Barabucci, Mara Bassani, Paola Bollettini, M. Cristina Bruttapasta, Carla Buccolini, Rosa Carangella, Franca Carboni, Daniela Ceccolini, Patrizia D'Incecco, Mariangela Di Felice, Lara Dini, Giordano Gioia, Giuseppe Di Prima, Giancarlo Giusepponi, Cesarina Lanciotti, Alessia Loffreda, Oriana Luciani, Laura Mariani, Francesco Mastrorilli, Roberto Moroni, Izabela Piatkowska, Roberta Rucoli, Giampaola Scoccia, Nives Teodori, Up-Tech Research Group

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs. Method: We analyzed baseline data from 438 older people with moderate Alzheimer's disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables - education, social class, and the availability of a care allowance - and three outcomes - employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers). Results: The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW. Discussion: Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems.

Original languageEnglish
Pages (from-to)514-525
Number of pages12
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Volume71
Issue number3
DOIs
Publication statusPublished - 2016 May 1
Externally publishedYes

Free keywords

  • Alzheimer's disease
  • Care allowance
  • Family caregiver
  • Migrant care worker
  • Socioeconomic factors
  • Up-Tech

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