OBJECTIVES: Frail older individuals are more susceptible to falls and might require formal, long-term care. Despite this, they may not qualify for public financial assistance since eligibility criteria for public allowances are often based on disability criteria such as physical limitations. This study investigates how unmet formal care needs affect the risk of falls in frail older adults.

METHODS: Six regular waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) collected between 2004 and 2020. We estimate Two-Way Fixed Effects panel data models using falls in wave t as the dependent variable and former unmet needs for formal care (in wave t-1) as the primary independent variable on an unbalanced panel of frail individuals (N=2,622; NT=9,622 ). Our results are robust to selection bias and consistent across all sensitivity and heterogeneous analyses.

RESULTS: Our findings demonstrate that for a given frail individual, having unmet formal care needs for Activities of Daily Living (ADL) leads to a 18-percentage point (pp.) increase in the risk of falls. Those results are statistically significant at the 5% level. Moreover, the impact of unmet needs for formal care on falls varies between men and women. For a frail woman facing unmet needs, the risk of falling increases by 20.5 pp. compared to a woman who receives help. Results for men are statistically non-significant. We also find that former unmet needs for formal care have no impact on falls when children co-reside with frail parents, unlike those who live without children.

CONCLUSIONS: Our results suggest that addressing frail elders’ unmet needs for formal care could significantly prevent future falls and associated costs for the health system. Public policies should prioritize prevention programs for these individuals, which could result in healthcare cost savings.