Can family caregiving substitute for nursing home care?

Charles, Kerwin Kofi; Sevak, Purvi

doi:10.1016/j.jhealeco.2005.05.001

Cited by 215 publications

(173 citation statements)

References 17 publications

(21 reference statements)

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“…Over a two-year recall period, a 10% increase in informal care leads to a 0.87 percentage point reduction in the likelihood of home health care use (to 7.43% from a mean of 8.3%) and a two-night reduction in nights in a nursing home (to 23 nights from a mean of 25) across the full sample. The estimates of Charles and Sevak (2005) suggest that receipt of informal care reduces the probability of any nursing home use by 39-49 percentage points. Bolin et al (2008) found that informal and formal home care are substitutes, though this effect is less strong in the Central European States.…”

Section: A Accessibility and Availability Of Carementioning

confidence: 99%

What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands

et al. 2015

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Section: A Accessibility and Availability Of Carementioning

confidence: 99%

What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands

et al. 2015

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“…In addition, "enabling" refers to whether the individual has a regular source of care to meet his or her long-term care needs. Examples of regular sources of care include availability of informal care provided by family or friends (Charles & Sevak, 2005), or formal care provided through HCBS. HCBS attendant care addresses disability in ADL, a strong determinant of longterm care use.…”

Section: E4mentioning

confidence: 99%

Volume of Home- and Community-Based Services and Time to Nursing-Home Placement

Sands

Thomas

et al. 2012

MMRR

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Objective: The purpose of this study was to determine whether the volume of Home-and CommunityBased Services (HCBS) that target Activities of Daily Living disabilities, such as attendant care, homemaking services, and home-delivered meals, increases recipients' risk of transitioning from longterm care provided through HCBS to long-term care provided in a nursing home.Data Sources: Data are from the Indiana Medicaid enrollment, claims, and Insite databases. Insite is the software system that was developed for collecting and reporting data for In-Home Service Programs.Study Design: Enrollees in Indiana Medicaid's Aged and Disabled Waiver program were followed forward from time of enrollment to assess the association between the volume of attendant care, homemaking services, home-delivered meals, and related covariates, and the risk for nursing-home placement. An extension of the Cox proportional hazard model was computed to determine the cumulative hazard of nursing-home placement in the presence of death as a competing risk. Principal Findings:Of the 1354 Medicaid HCBS recipients followed in this study, 17% did not receive any attendant care, homemaking services, or home-delivered meals. Among recipients who survived through 24 months after enrollment, one in five transitioned from HCBS to a nursing-home. Risk for nursing-home placement was significantly lower for each five-hour increment in personal care (HR=0.95, 95% CI=0.92-0.98) and homemaking services (HR=0.87, 95% CI=0.77-0.99). Conclusions:Future policies and practices that are focused on optimizing long-term care outcomes should consider that a greater volume of HCBS for an individual is associated with reduced risk of nursing-home placement.

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“…Death of the care recipient serves as a sorting variable that allows us to compare health effects of caregivers who are still caregiving, caregivers who have stopped caregiving, and non-caregivers who have also experienced the death of a parent. To examine the effects of the initial selection into caregiving, we use sibling characteristics as instrumental variables, as has been done in the current literature focusing on the cross-section (Ettner 1995;Stern 1995;Heidemann & Stern 1999;Engers & Stern 2002;Holmes & Van Houtven 2002;Van Houtven & Norton 2004;Charles & Sevak 2005;Heitmuller 2007). By controlling for selection in and out of caregiving, this ensures that any observed health effects are not simply bereavement effects but can be attributed to caregiving, and will help ensure that our estimates are free of endogeneity bias or compounding factors.…”

Section: Introductionmentioning

confidence: 99%

Caring for Mom and Neglecting Yourself? The Health Effects of Caring for an Elderly Parent

Coe

Houtven

2008

SSRN Journal

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We examine the physical and mental health effects of providing care to an elderly mother on the adult child caregiver. We address the endogeneity of the selection in and out of caregiving using an instrumental variable approach, and carefully control for baseline health and work status of the adult child using fixed effects and Arellano-Bond estimation techniques. Continued caregiving over time increases depressive symptoms for married women and married men. In addition, the increase in depressive symptoms is persistent for married men. Depressive symptoms for single men and women are not affected by continued caregiving. There is a small protective effect on the likelihood (10%) of having any heart conditions among married women who continue caregiving.Robustness checks confirm that the increase in depressive symptoms and decrease in likelihood of heart conditions can be directly attributable to caregiving behavior, and not due to a direct effect of the death of the mother. The initial onset of caregiving, by contrast, has no immediate effects on physical or mental health for any subgroup of caregivers.3

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Can family caregiving substitute for nursing home care?

Cited by 215 publications

References 17 publications

What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands

What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands

Volume of Home- and Community-Based Services and Time to Nursing-Home Placement

Caring for Mom and Neglecting Yourself? The Health Effects of Caring for an Elderly Parent

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