A triadic approach to health and dependence in aging adults: incongruence in perception

Taking charge of dependent people is a major challenge. Numerous studies focus on the congruence of the dyadic perceptions of the actors. This study looks into the congruence of perceptions concerning dependence (i.e., physical and mental losses that prevent carrying out everyday tasks) and pathologies affecting older people within the triad: the aged person living at home, the informal caregiver, and the in-home professional caregiver.

A face-to-face questionnaire examining dependence and pathologies was administered separately to the three actors of 58 triads. This database has been analyzed mainly with techniques of data mining (MCA and AHC).

The perception of pathologies and dependence are perceivably different depending on the actors. Within a same triad, perceptions of these two points-taken together or individually-turn out to be very dispersed. We bring to light three factors that structure 94% (with Benzécri's correction) of the congruence in perception within triads, and we propose a typology in four clusters of triads on this theme.

The congruence analyses of the triads showed that incongruence in cross-perceptions of older people, formal, and informal caregivers on pathologies and dependence is clearly structured. Four quite distinct clusters have emerged, which could be exploited in the framework of public policies on the management of dependency in the home setting, to effectively alleviate the incongruence in the triads.