Introduction England has a market-led welfare state with means-tested services. Funding of care is a live issue. Objectives were to compare socio-demographic characteristics and functioning according to sources of help received for disabilities.
Methods Cross-sectional analysis of participants in the fourth round of fieldwork from the English Longitudinal Study of Ageing. Subjects analysed (n=5653) were aged 50 and over, living in the community and reported difficulty with at least one motor skill, activity of daily living, or instrumental activity of daily living.
Results Among the eligible participants 58% received no help (NH), 34% only informal help (IH), 4% paid help but no state help (PH), and 4% state help with or without other sources (SH). The PH and SH groups were older than the other two and less likely to have a partner but the wealthiest were over-represented in the PH group whereas the SH group were most likely to be in the poorest wealth quintile. The SH group scored worst on subjective and objective measures of physical and cognitive functioning whereas the PH group were similar to the IH group. The SH group were most likely to have a mobility aid or an adaptation in their home. The NH group mainly had difficulties with motor skills and performed better cognitively.
Conclusion In the English system small group with substantial problems in functioning receives state help. Another small group pays privately for help, possibly substituting informal help. The sources of help appear to reflect some indicator of need.
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