Older adults home- and community-based care service use and residential transitions: A longitudinal study
Journal
BMC Geriatrics
Journal Volume
12
Date Issued
2012
Author(s)
Abstract
Background: As Home-and Community-Based Services (HCBS), such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults use of home- and community-based services and their residential transitions. Methods: The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults residential status at the three follow-up interviews, four residential transitions were tracked: (1) Community-Community-Community (CCC: Resided in community during the entire study period); (2) Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3); (3) Community-Community- Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3); (4) Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.). Results: Older adults use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS) and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other services, such as senior center services or meal services, were associated with different directions in residential transition, such as CIC and CII respectively. Conclusions: Older adults differing HCBS use patterns may be the key to explaining older adults transitions. Attention to older adults HCBS use patterns is recommended for future practice. However, this was an exploratory study and the analyses cannot establish causal relationships. ? 2012 Chen and Berkowitz; licensee BioMed Central Ltd.
Subjects
Home- and community-based care services (HCBS); Older adults; Policy implications; Residential transitions.; Service use patterns
SDGs
Other Subjects
aged; article; community care; daily life activity; elderly care; female; health behavior; home care; human; independent living; longitudinal study; male; nursing home; statistics; utilization review; Activities of Daily Living; Aged; Aged, 80 and over; Community Health Services; Female; Health Behavior; Health Services for the Aged; Home Care Services; Humans; Independent Living; Longitudinal Studies; Male; Nursing Homes
Type
journal article