Use of Informal Support As a Predictor of Home- and Community-Based Services Utilization

Overview

Journal J Gerontol B Psychol Sci Soc Sci

Specialties Geriatrics
Psychology
Social Sciences

Date 2020 Apr 9

PMID 32266395

Citations 4

Authors

Kristen N Robinson

Heather L Menne

Raphael Gaeta

Affiliations

Soon will be listed here.

Abstract

Objectives: Home- and community-based services (HCBS) help older adults remain living safely in their homes by delaying or preventing the need for institutionalization. This analysis is guided by the Andersen Behavioral Model of Health Services Use to examine the association between informal support and use of HCBS.

Method: Health and Retirement Study data from 2011 and 2012 are used in the bivariate analyses and multivariate logistic regression models to examine differences in HCBS utilization among extremely vulnerable older adults who have informal caregivers and those who do not.

Results: For extremely vulnerable older adults who report difficulties with any instrumental or basic activities of daily living, use of HCBS is not strongly associated with access to informal caregivers. However, for this same population of extremely vulnerable older adults, those who live alone have roughly 3 times the odds of using any HCBS compared to those who do not live alone.

Discussion: Among already vulnerable older adults, this study revealed that living alone is an important enabling factor of the Andersen Behavioral Model as applied in HCBS research. Further investigation is needed to see if more resources should be allocated to senior centers and local providers to identify vulnerable older adults who live alone and may have unmet needs.

Citing Articles

The relationship between Medicaid policy and realized access to home- and community-based services.

Konetzka R, Ellis E, Ghazali N, Wang S Home Health Care Serv Q. 2024; 43(2):154-172.

PMID: 38185122 PMC: 10978281. DOI: 10.1080/01621424.2023.2300672.

The relationship between home and community-based healthcare services utilization and depressive symptoms in older adults in rural China: a moderated mediation model.

Huang Z, Xu T, Zhang R, Zhang X, Wang S, Zhang J BMC Public Health. 2023; 23(1):1014.

PMID: 37254084 PMC: 10227957. DOI: 10.1186/s12889-023-15590-2.

Perspectives on the popularization of smart senior care to meet the demands of older adults living alone in communities of Southwest China: A qualitative study.

Kong D, Liu S, Hong Y, Chen K, Luo Y Front Public Health. 2023; 11:1094745.

PMID: 36908438 PMC: 9998995. DOI: 10.3389/fpubh.2023.1094745.

Why do older adults living alone in cities cease seeking assistance? A qualitative study in China.

Du Q, Gong N, Hu Q, Chen G, Xie J, Luo L BMC Geriatr. 2022; 22(1):540.

PMID: 35768784 PMC: 9241305. DOI: 10.1186/s12877-022-03217-x.

References

Chen Y, Berkowitz B . Older adults' home- and community-based care service use and residential transitions: a longitudinal study. BMC Geriatr. 2012; 12:44. PMC: 3444350. DOI: 10.1186/1471-2318-12-44. View

Herrera A, George R, Angel J, Markides K, Torres-Gil F . Variation in Older Americans Act caregiver service use, unmet hours of care, and independence among Hispanics, African Americans, and Whites. Home Health Care Serv Q. 2013; 32(1):35-56. PMC: 3583214. DOI: 10.1080/01621424.2012.755143. View

Andersen R . Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995; 36(1):1-10. View

Andersen R . National health surveys and the behavioral model of health services use. Med Care. 2008; 46(7):647-53. DOI: 10.1097/MLR.0b013e31817a835d. View

Lehning A, Kim M, Dunkle R . Facilitators of home and community-based service use by urban African American elders. J Aging Health. 2013; 25(3):439-58. DOI: 10.1177/0898264312474038. View

Casado B, van Vulpen K, Davis S . Unmet needs for home and community-based services among frail older Americans and their caregivers. J Aging Health. 2010; 23(3):529-53. DOI: 10.1177/0898264310387132. View

Sonnega A, Faul J, Ofstedal M, Langa K, Phillips J, Weir D . Cohort Profile: the Health and Retirement Study (HRS). Int J Epidemiol. 2014; 43(2):576-85. PMC: 3997380. DOI: 10.1093/ije/dyu067. View

Robison J, Shugrue N, Fortinsky R, Gruman C . Long-term supports and services planning for the future: implications from a statewide survey of Baby Boomers and older adults. Gerontologist. 2013; 54(2):297-313. DOI: 10.1093/geront/gnt094. View

Greenwood N, Habibi R, Smith R, Manthorpe J . Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature. Health Soc Care Community. 2014; 23(1):64-78. PMC: 4283974. DOI: 10.1111/hsc.12116. View

10.

Cai Q, Salmon J, Rodgers M . Factors associated with long-stay nursing home admissions among the U.S. elderly population: comparison of logistic regression and the Cox proportional hazards model with policy implications for social work. Soc Work Health Care. 2009; 48(2):154-68. DOI: 10.1080/00981380802580588. View

11.

Gaugler J, Duval S, Anderson K, Kane R . Predicting nursing home admission in the U.S: a meta-analysis. BMC Geriatr. 2007; 7:13. PMC: 1914346. DOI: 10.1186/1471-2318-7-13. View

12.

Desai M, Lentzner H, Weeks J . Unmet need for personal assistance with activities of daily living among older adults. Gerontologist. 2001; 41(1):82-8. DOI: 10.1093/geront/41.1.82. View

13.

Wallace S, Levy-Storms L, Kington R, Andersen R . The persistence of race and ethnicity in the use of long-term care. J Gerontol B Psychol Sci Soc Sci. 1998; 53(2):S104-12. DOI: 10.1093/geronb/53b.2.s104. View

14.

Sonnega A, Robinson K, Levy H . Home and community-based service and other senior service use: Prevalence and characteristics in a national sample. Home Health Care Serv Q. 2016; 36(1):16-28. PMC: 5540243. DOI: 10.1080/01621424.2016.1268552. View

15.

Lindquist L, Ramirez-Zohfeld V, Forcucci C, Sunkara P, Cameron K . Overcoming Reluctance to Accept Home-Based Support from an Older Adult Perspective. J Am Geriatr Soc. 2018; 66(9):1796-1799. DOI: 10.1111/jgs.15526. View

16.

Shaw J, Farid M, Noel-Miller C, Joseph N, Houser A, Asch S . Social Isolation and Medicare Spending: Among Older Adults, Objective Social Isolation Increases Expenditures while Loneliness Does Not. J Aging Health. 2018; 29(7):1119-1143. PMC: 5847278. DOI: 10.1177/0898264317703559. View

17.

Friedman E, Shih R, Langa K, Hurd M . US Prevalence And Predictors Of Informal Caregiving For Dementia. Health Aff (Millwood). 2015; 34(10):1637-41. PMC: 4872631. DOI: 10.1377/hlthaff.2015.0510. View

18.

Ewen H, Washington T, Emerson K, Carswell A, Smith M . Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services. Int J Environ Res Public Health. 2017; 14(3). PMC: 5369165. DOI: 10.3390/ijerph14030330. View

19.

Kaye H, Harrington C, LaPlante M . Long-term care: who gets it, who provides it, who pays, and how much?. Health Aff (Millwood). 2010; 29(1):11-21. DOI: 10.1377/hlthaff.2009.0535. View