To Some Degree: Perspectives on IADL Care Responsibility Linked to Education Level

Attitudes among the general public can influence social policies. A recent study sought to understand how educational attainment relates to attitudes about who should be responsible for the provision and payment of Instrumental Activities of Daily Living (IADL) care for older adults. The results are important because educational status is a marker of socioeconomic status, which is linked to inequalities.

The researcher used a subset of data from the General Social Survey (GSS), a nationally representative survey of US adults. During 2012, a random sample of 1,302 adults age 18 to 89+ was selected to complete an Eldercare module that included questions about whether families or outside institutions should help older adults with IADLs and pay for assistance. Within this module, participants were asked, “Thinking about elderly people who need some help in their everyday lives, such as help with grocery shopping, cleaning the house, doing laundry, who do you think should primarily provide this help?” The researchers divided the response options to analyze groups who said “family” versus groups who said either “government,” “nonprofits,” or “private providers.” The follow-up question was, “And who do you think should primarily cover the costs of this help to these elderly people?” The response options for this question were “older adults themselves/family” and “the government/public.”

The results showed a significant relationship between educational attainment and attitudes about care. Individuals with a bachelor’s degree or higher were almost twice as likely to support families both providing and paying for care, as compared to participants with less than a high school degree. The latter group were almost three times as likely as those with a bachelor’s or graduate degree to support “complete outside IADL care,” or care provided and paid for by outside institutions. These results controlled for demographic and other characteristics that might be expected to influence the results. The researcher said the findings suggest that educational attainment reinforces the prevailing line of thinking in the United States of the family as caregiver, and these attitudes may contribute to social policies that are not aligned with family and caregiving needs.


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Patterson SE. Educational attainment differences in attitudes toward provisions of IADL care for older adults in the US. Journal of Aging & Social Policy, (2020); Feb 3:1-20.



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