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Caregivers of frail elders: updating a national profile
- Authors:
- WOLFF Jennifer L., KASPER Judith D.
- Journal article citation:
- Gerontologist, 46(3), June 2006, pp.344-=356.
- Publisher:
- Oxford University Press
In this American study data are drawn from the 1989 and 1999 National Long-Term Care Survey and Informal Caregiver Survey to develop nationally representative profiles of disabled older adults and their primary informal caregivers at two points in time. The proportion of chronically disabled community-dwelling older adults who were receiving informal assistance from family or friends declined over the period of interest, whereas the proportion receiving no human help increased. On average, recipients of informal care were older and more disabled in 1999 than in 1989. Primary caregivers were children (41.3%), spouses (38.4%), and other family or friends (20.4%); children were more likely and others less likely to serve as primary caregivers in 1999 relative to 1989. Primary caregivers provided frequent and high levels of help at both points in time. A striking increase was found (from 34.9% to 52.8%) in the proportion of primary caregivers working alone, without secondary caregiver involvement. In the context of projected demographic trends and budgetary constraints to public health insurance programs, these data underscore the importance of identifying viable strategies to monitor and support family caregivers in the coming years.
Care arrangements of older adults: what they prefer, what they have, and implications for quality of life
- Authors:
- KASPER Judith D., WOLFF Jennifer L., SKEHAN Maureen
- Journal article citation:
- Gerontologist, 59(5), 2019, pp.845-855.
- Publisher:
- Oxford University Press
Background and Objectives: Meeting individual preferences for long-term services and supports (LTSS) is a policy priority that has implications for quality of care. Evidence regarding preferences is sparse. In addition, little is known regarding whether preferences and care arrangements match for those receiving care, and implications for quality of life. Research Design and Methods: A random sample (n = 1,783 in 2012) of National Health and Aging Trends Study participants were asked the best care option for someone 80+ who needs help with personal care and mobility. Analyses examine variations in care preferences, the relationship of preferences to care arrangements, and the association of matched preference and care arrangements to quality of life indicators. Results: Care preferences vary by demographics. Equal proportions (3 in 10) of older adults chose assisted living or continuing care retirement communities (CCRC), care in own home with family help, and care in own home with paid help, as the best options. Persons in assisted living/CCRC settings were significantly more likely to choose this option as best. Only 1 in 3 older persons receiving care are in arrangements that match preferences. No association with quality of life indicators was found. Discussion and Implications: Aging in place remains the care preference of a majority, but close to one-third chose assisted living/CCRC, suggesting preferences are evolving. Aligning care preferences and arrangements is a policy goal, but many do not achieve a match and there remain gaps in understanding trajectories in preferences and care arrangements and implications for quality of life. (Edited publisher abstract)
Long-term care preferences among older adults: a moving target?
- Authors:
- WOLFF Jennifer L., KASPER Judith D., SHORE Andrew D.
- Journal article citation:
- Journal of Aging and Social Policy, 20(2), 2008, pp.182-200.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Long term care preferences in relation to three hypothetical scenarios were investigated over a year in a sample of 420 community-dwelling older women with disabilities who were receiving informal care. Unpaid or paid help in the home was preferred when help was needed with instrumental activities of daily living (IADL) or activities of daily living (ADL), while nursing home care was preferred where dementia was the hypothesised problem. Aggregate preferences for long term care were relatively stable but there was considerable fluctuation in individuals’ preferences over time, with only 52.%, 44.4% and 44.6% retaining their initial first choice for the IADL, ADL and dementia scenarios. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).