Spousal characteristics and unmet care needs: A longitudinal national study of adults aged 50 and over in England

This paper investigates unmet needs among dyads of people aged 50 and over in England. Understanding the extent and patterns of unmet needs for long-term care across different social groups is critical for understanding care-related experiences and inequalities and planning the long-term care system. Although spouses are a main source of care support, little is known about how spouses' characteristics relate to one's experience of unmet care needs. This study adopts a dyadic perspective, investigating the association between unmet care needs and spouses' characteristics, including socioeconomic status, health status and the quality of spousal relationships. Drawing on data from the English Longitudinal Study of Ageing (ELSA) (N = 3439), we matched the information of individuals who have care needs to the characteristics of their spouses and used random effects modelling to account for the longitudinal nature of the data. The results show that having a spouse with poorer functional abilities was associated with a higher risk of experiencing objective and subjective unmet needs. Men were more likely to experience objective unmet care needs if their spouses engaged in paid work, but this is not the case for women. Women faced a lower risk of subjective and objective unmet needs when having a closer relationship with their spouse, whereas this pattern was not observed among men. The findings highlight the importance of considering the interpersonal care relationships and gendered dynamics of caregiving, providing insights into designing gender-sensitive intervention programmes to better support people in care needs and their families.