Unmet Need for Personal Assistance With Activities of Daily Living Among Older Adults

Abstract

Purpose: This study examined the prevalence, correlates, and negative consequences of unmet need for personal assistance with activities of daily living (ADLs) among older adults. Design and Methods: The authors analyzed crosssectional data from the 1994 National Health Interview Survey's Supplement on Aging. Data were weighted to be representative of the noninstitutionalized population aged 70 years and older. Results: Overall, 20.7% of those needing help to perform 1 or more ADLs (an estimated 629,000 persons) reported receiving inadequate assistance; for individual ADLs, the prevalence of unmet need ranged from 10.2% (eating) to 20.1% (transferring). The likelihood of having 1 or more unmet needs was associated with lower household income, multiple ADL difficulties, and living alone. Nearly half of those with unmet needs reported experiencing a negative consequence (e.g., unable to eat when hungry) as a result of their unmet need. Implications: Greater, targeted efforts are needed to reduce the prevalence and consequences of unmet need for ADL assistance in elderly persons.

Inequity in long-term care use and unmet need: Two sides of the same coin

“…In many cases, the definition of unmet need is determined by the database available for analysis, rather than pre-positioning of the authors of the work. Thus, it is not surprising that a wide variability is observed in the literature in the percentage of people with unmet needs, depending on the type of population analyzed and the concept of unmet need used (Desai, Lentzner, and Weeks, 2001;Komisar, Feder, and Kasper, 2005;Muramatsu and Campbell, 2002;Shea et al, 2003).…”

“…In the studies relying on subjective self-assessments, estimates of the prevalence of unmet need range from 20 percent among the population with activities of daily living (ADL) limitations (Desai, Lentzner, and Weeks, 2001) to 58 percent among disabled elderly who are dually eligible for Medicaid and Medicare (Komisar, Feder and Kasper, 2005). In studies using receipt of help measures, Muramatsu and Campbell (2002) report that 38 percent of persons with ADL limitations in US lack assistance.…”

Paramedics assessing Elders at Risk for Independence Loss (PERIL): Derivation, Reliability and Comparative Effectiveness of a Clinical Prediction Rule

“…2016;18 (2)In summary, only clinically relevant predictor variables were chosen and variables were not screened based on univariate association with the primary outcome to protect against type-I error. We refined the list by excluding predictors that lack variables with greater than 95% of observations in a single category, or variables with poor inter-rater agreement (κ < .60).…”

“…1 One in five seniors lack the support they need to function daily. 2 Gurley et al chillingly captured the potential severity of the problem: those found helpless or dead accounted for 3.7% of calls to emergency medical services (EMS). 3 This population-based study showed that the rate of being "found down" increased dramatically with age, from 3/1,000 person years in the 60-64 age group, to 27/1,000 person years among patients 85 and older.…”

“…3 Clearly, there are isolated vulnerable older people living in the community with unmet needs who could benefit from a safety net. 2 Due to social isolation and a lack of support and timely access to primary care, such frail older adults frequently depend on EMS to function as their safety net. 4 This may explain why, despite their increased disease burden, the proportion of non-urgent calls increases with age and is twice as common among patients 65 years and older compared to younger adults.…”