Community-Based Service Use by Elders With Dementia and Their Caregivers
- 1 September 2008
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Nursing Research
- Vol. 57 (5), 312-321
- https://doi.org/10.1097/01.nnr.0000313500.07475.eb
Abstract
Background: With the increase in the number of older adults with dementia, research efforts have focused on increasing community-based support service (CBSS) use to improve older adult and caregiver outcomes. However, the research on factors that may explain CBSS use has been focused on individual characteristics, and how the care recipient and caregiver as a pair influence CBSS use has not been accounted for. Objective: To classify care recipients with dementia and their caregivers who shared similar patterns of CBSS use and to identify predictors of class membership. Methods: Participants were 1,813 elders with dementia and their caregivers from the National Longitudinal Caregiver Study, a cross-sectional dataset from 1998. A latent class analysis was used to identify classes of CBSS users by examining use of caregiver support group, home aide, home health, adult day care, and respite care. Multinomial logistic regression analysis was used to examine relationships between predisposing, enabling, and need variables and class membership. Results: Three classes, that is, Low Users, Adult Day Users, and Home-Based Users, comprised 80%, 10%, and 10% of the sample, respectively. Adult Day Users reported significantly more enabling resources and greater service need. Predictors of home-based use included care recipient age, activities of daily living limitations, number of skilled nursing facilities in the local county, and the extent of caregiver physical limitations from comorbid conditions. Discussion: Using latent class analysis allows identification of specific subtypes of CBSS users, prevalence of user subtype, and risk factors for underutilization. Determining the long-term outcomes of class membership may identify specific groups at risk, which could inform the design of interventions to improve assessment for and delivery of CBSS.Keywords
This publication has 24 references indexed in Scilit:
- A latent class analysis of illicit drug abuse/dependence: results from the National Epidemiological Survey on Alcohol and Related ConditionsAddiction, 2006
- Patterns of early adherence to the antidepressant citalopram among older primary care patients: the prospect study.The International Journal of Psychiatry in Medicine, 2006
- Latent class models for use of primary care: evidence from a British panelHealth Economics, 2005
- Early Community-Based Service Utilization and Its Effects on Institutionalization in Dementia CaregivingThe Gerontologist, 2005
- Alzheimer Disease in the US PopulationArchives of Neurology, 2003
- Caregiving and Institutionalization of Cognitively Impaired Older People: Utilizing Dynamic Predictors of ChangeThe Gerontologist, 2003
- Types of nursing home residents with self‐destructive behaviours: analysis of the Harmful Behaviours ScaleInternational Journal of Geriatric Psychiatry, 2002
- Factors Associated With Formal Service Use by Family Members of Patients With DementiaJournal of Applied Gerontology, 1998
- Service Utilization by Wife Caregivers of Frail Older VeteransSocial Work in Health Care, 1997
- The Influence of Family Caregivers on Elder's Use of In-Home Services: An Expanded Conceptual FrameworkJournal of Health and Social Behavior, 1987