Changes in Home Care Use by Disabled Elderly Persons: 1982-1994

Liu, Korbin; Mantón, Kenneth G.; Aragon, Cynthia

doi:10.1093/geronb/55.4.s245

Cited by 83 publications

(64 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The increase between 1984 and 1994 in the use of paid services among disabled community residents, including those with informal caregivers (Liu, Manton, and Aragon 2000;Spillman and Pezzin 2000), supports the possibility that average costs for the disabled rose. The increase affected all payers.…”

Section: Discussionmentioning

confidence: 91%

“…The increase affected all payers. The percentage of disabled elderly persons with formal caregivers who reported Medicare as a payment source rose from 16 percent in 1982 to more than 25 percent in 1994 (Liu, Manton, and Aragon 2000), and Medicaid programs also greatly increased their spending on community long-term care during this period. Out-of-pocket payments for freestanding home health care agencies also rose dramatically (Braden et al 1998;Letsch et al 1992).…”

Section: Discussionmentioning

confidence: 99%

“…For example, Schoeni and colleagues found that among the noninstitutionalized population aged 70 and older, the disability rate fell between 1982 and 1986 but fluctuated between 1986 and 1996, ending the period essentially unchanged. Other studies found increases in the use of formal long-term care services (Liu, Manton, and Aragon 2000;Spillman and Pezzin 2000) and the level of disability among those receiving help with chronic disabilities, including residents of institutions (Rhoades and Krauss 1999;Sahyoun et al 2001;Spillman and Pezzin 2000). These findings could suggest higher average long-term care costs among the disabled, which could offset savings due to a declining prevalence of disabilities.…”

mentioning

confidence: 92%

See 2 more Smart Citations

Changes in Elderly Disability Rates and the Implications for Health Care Utilization and Cost

2004

View full text Add to dashboard Cite

Recent research indicates declining age-adjusted chronic disability among older Americans, which might moderate health care costs in the coming decades. This study examines the trend's underlying components using data from the 1984-1999 National Long-Term Care Surveys to better understand the reasons for the declines and potential implications for acute and long-term care. The reductions occurred primarily for activities like financial management and shopping. Assistance with personal care activities associated with greater frailty fell less, and independence with assistive devices rose. Institutional residence was stable. More needs to be known about the extent to which these declines reflect environmental improvements allowing greater independence at any level of health, rather than improvements in health, before concluding that the declines will mean lower costs.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 92%

See 1 more Smart Citation

Changes in Elderly Disability Rates and the Implications for Health Care Utilization and Cost

2004

View full text Add to dashboard Cite

show abstract

“…Half the spending increase reflected higher average visits per recipient, but more than a third reflected an increased proportion of beneficiaries using the service (Komisar and Feder 1998). The percent of disabled elderly persons with formal caregivers who reported Medicare as a payment source rose from 16 percent in 1982 to more than a quarter in 1994 (Liu, Manton, and Aragon 2000). Medicaid programs over the same period have also greatly increased spending on community long-term care as an alternative to nursing-home care.…”

Section: Discussionmentioning

confidence: 99%

Potential and Active Family Caregivers: Changing Networks and the ‘Sandwich Generation’

2000

View full text Add to dashboard Cite

A s the Baby Boom generation nears retirement and old age, concerns about how the United States will meet the long-term-care needs of its growing elderly population are intensifying. The Social Security Administration projects that one in five Americans will be aged 65 or older by the year 2030, compared with about 13 percent now. Most of the increase will occur between 2010 and 2030 as the Baby Boom generation turns 65. Whereas the family has long been the primary source of long-term care for the elderly, the steep increase in the elderly population casts doubts on whether it can continue in this role as the number and proportion of older adults increases.In particular, there is concern that demographic trends affecting the number of potential family caregivers and the competing demands for their time threaten their willingness and ability to continue assume most of the responsibility for long-term care. Trends toward delayed childbearing and increased female labor-force participation, for example, suggest a growing "sandwich generation," especially of women, who are caught between the demands of child rearing and elder care while attempting to play a more demanding role in the work force. Reduced availability of family caregivers clearly could affect the economic and physical well-being of the elderly and their families. Public budgets will Recent evidence suggesting a downward trend in the age-adjusted prevalence of disability and functional limitation among the elderly has raised hopes that long-term-care burdens on families and public programs will be less than feared. However, even with a lower disability prevalence, growth in the size of the elderly population could result in a constant or larger absolute number of elderly persons needing assistance, depending on the relative rates of change. Any increase in the level of disability among the disabled also could imply greater burdens on affected families and public programs. Thus, there is a pressing need for information on how disability is changing and how families are responding to those changes.We rely on the 1984 and 1994 National Long Term Care Surveys (NLTCS) to update the estimates of potential and active family caregivers presented by Stone and Kemper (1989) and to examine changes over the decade in informal family caregiving. We use consistent methodology to measure the prevalence of chronic disability among the elderly in each year and the distribution of the disabled elderly by receipt of informal and formal care and by the presence of spouses or children who might provide care. Finally, we examine the characteristics of both potential family caregivers and those who actually provide care and discuss the implications of observed changes.

show abstract

“…This is shown regarding the dependence in ADLs or IADLs (Activities/Instrumental Activities of Daily Living) in Canada (Crowell et al 1996;Shapiro and Tate 1997), the USA (Liu et al 2000;Miller and Weissert 2000), and Sweden (Thorslund et al 1991). Finnish researchers report that difficulties in mobility outdoors are predictors of formal care use (SakariRantala et al 1995).…”

Section: Need Factorsmentioning

confidence: 99%

Are public care and services for older people targeted according to need? Applying the Behavioural Model on longitudinal data of a Swedish urban older population

2006

View full text Add to dashboard Cite

The objectives were to identify factors that predict the use of home help services and transition into institutional care and to study to what extent care services were targeted according to the individuals' needs. A further objective was to study whether people who had moved into institutional care facilities had received home help prior to institutionalisation. A community-dwelling sample (=502) aged 81-100 was twice interviewed and assessed with medical examinations. Their use of public elderly care between 1994/1996 and 2000 was studied using survival analyses. , according to the Andersen Behavioural Model, were the most important predictors for the use of elderly care. Among people living alone, dementia, functional limitations, and depressive symptoms predicted the use of home help services and institutionalisation. Among non-demented cohabiting people, depressive symptoms and dependence in ADLs increased the likelihood of both home help and institutionalisation. Among cohabiting people with dementia, the effect of dementia was difficult to separate from the effects of ADL limitations and depression. were of importance among cohabiting people. A high level of education increased the likelihood of moving into institutional care, and informal extra-residential care increased the likelihood of both outcomes indicating that elderly care resources had not been targeted solely according to need. such as age and gender were of importance only among people living alone. Basically the same factors predicted both the receipt of home help and institutionalisation. Only 4% of people living alone and 5% of those cohabiting moved to institutions without previously receiving home help.

show abstract

Changes in Home Care Use by Disabled Elderly Persons: 1982-1994

Abstract: Use of formal sources of care by community disabled elderly residents increased, likely because of changes in the Medicare home health care benefits in 1989. Increased use of home health care was associated with the concurrent use of informal care.

Cited by 83 publications

References 10 publications

Changes in Elderly Disability Rates and the Implications for Health Care Utilization and Cost

Changes in Elderly Disability Rates and the Implications for Health Care Utilization and Cost

Potential and Active Family Caregivers: Changing Networks and the ‘Sandwich Generation’

Are public care and services for older people targeted according to need? Applying the Behavioural Model on longitudinal data of a Swedish urban older population

Contact Info

Product

Resources

About