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Elder disability as an explanation for racial differences in informal home care
- Authors:
- LI Lydia W., FRIES Brant E.
- Journal article citation:
- Gerontologist, 45(2), April 2005, pp.2-6-215.
- Publisher:
- Oxford University Press
Adjusting for sociodemographic characteristics and disability levels, this study examines whether differences exist in the structure and function of community-dwelling Black and White frail elders' informal care networks. Data from in-person assessments of Michigan's Home and Community-Based Medicaid Waiver applicants were analyzed. The sample consisted of 936 Black and 3,182 White frail elderly persons. When sociodemographic characteristics were controlled for, racial differences were found in all informal care components except out-of-home chores. Differences in functional components (amount of care, scope of assistance, and personal care) were largely accounted for by disability, whereas racial differences in the structural components (source of care, living arrangement, and sole caregiver) and in-home chores were not. Findings suggest that Black elders are not better off than White elders in the receipt of informal care. Although Black elders receive more informal help, this difference is primarily because of level of disability. This study calls for heightened awareness of disability among low-income Black elders and the potential burden experienced by their caregivers
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.