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Promoting independence for wheelchair users: the role of home accommodations
- Authors:
- ALLEN Susan, RESNIK Linda, ROY Jason
- Journal article citation:
- Gerontologist, 46(1), February 2006, pp.115-123.
- Publisher:
- Oxford University Press
The objective of this research was to investigate whether home accommodations influence the amount of human help provided to a nationally representative sample of adults who use wheelchairs. The authors analyzed data from the Adult Disability Follow-back Survey (DFS), Phase II, of the Disability Supplement to the 1994–1995 National Health Interview Surveys (NHIS-D). The analytic sample consisted of 899 adults aged 18 and older who reported using wheelchairs in the previous 2 weeks. The authors conducted logistic regression and ordinary least squares (OLS) regression analyses to test the influence of home accommodations on the receipt of any human help, and among respondents who received help, on the hours of help received, respectively. The authors analyzed paid and unpaid help separately. Home accommodations were related to the receipt of unpaid, but not paid, help. Relative to having no home accommodations, the presence of each additional accommodation decreased the odds of having unpaid help by 14%. Additionally, the authors observed an inverse relationship between the number of accommodations in the home and hours of unpaid help. For wheelchair users who live alone, specific types of home accommodations were also inversely related to hours of unpaid help. Policies that reimburse for home accommodations may be an efficient response to the growing demand for home-care support while enabling greater autonomy and independence for people who use wheelchairs.
Use of home care services effectively reduces feelings of burden among family caregivers of disabled elderly in Japan: preliminary results
- Authors:
- KUMAMOTO Keigo, ARAI Yumiko, ZARIT Steven H.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(2), February 2006, pp.163-170.
- Publisher:
- Wiley
The aim was to examine whether the use of care services reduces the feelings of burden among family caregivers in Japan. Specifically, the study was aimed at testing the following three hypotheses: (1) The severity of impairment and the dementia among the disabled elderly increases the feelings of burden among family caregivers and the support from family members decreases burden: (2) the amount of services used by older people and their caregivers is affected by the severity of dementia and ADL deficiencies among the disabled elderly and the amount of support from family members: and (3) controlling for severity, the use of care services under the LTC insurance program serves to reduce the feelings of burden among family caregivers. A structural equation model using the data obtained from 82 pairs of community-dwelling disabled elderly and their principal family caregivers. The model included the following variables: age of the disabled elderly; the severity of ADL deficiency and behavioral disturbances; use of formal (public) care services; support from family members; and feelings of burden among family caregivers.The structural equation model revealed that, after controlling for the effects of severity on service use, home care services effectively reduce feelings of burden among family caregivers. The findings suggest that care services provided under the LTC insurance have been successfully reducing burden among family caregivers in the study area.
Longitudinal changes in the amount of informal care among publicly paid home care recipients
- Author:
- LI Lydia W.
- Journal article citation:
- Gerontologist, 45(4), August 2005, pp.465-473.
- Publisher:
- Oxford University Press
This study examined how the amount of informal care received by disabled elders changes when they are receiving publicly paid home care, and whether formal service use, disability, caregiving arrangements, and demographic characteristics of older adults predict changes in the amount of informal care. Hierarchical linear models were estimated, using 3-year data (12 repeated observations) collected from 888 elderly participants in Michigan's Home- and Community-Based Medicaid Waiver Program. The amount of informal care declined in the beginning period when publicly paid home care was received, and then it stabilized. Changes in activities and instrumental activities of daily living and caregiver residence predicted changes in the amount. The living arrangement and age of elders predicted different patterns of change over time. Neither formal service amount nor its change significantly predicted the amount of informal care. The study concludes informal caregivers do not relinquish caregiving when publicly paid home care is available. Expanding community-based long-term care is a means of fostering partnerships between formal and informal caregivers.
User-defined outcomes of community care for Asian disabled people
- Author:
- VERNON Ayesha
- Publisher:
- Policy Press,|Joseph Rowntree Foundation
- Publication year:
- 2002
- Pagination:
- 38p.,bibliog.
- Place of publication:
- Bristol
A study in the North of England collected the views of 28 Asian disabled people on what would make their lives better) and on what would make community care services better. Asian disabled people and their families lacked confidence and trust in service provision. This contributed to low take-up of services. Low take-up of services did not mean low levels of need. People reported feelings of isolation, forced dependency on family members, frustration at not being able to move about freely at home, anxiety and distress. People felt that service providers lacked cultural knowledge, and that they expected Asian disabled people to 'fit in' with existing provision. Several people felt discriminated against on the grounds of disability and race - sometimes by service providers, sometimes by attitudes within their families and communities.