scholarly journals Use of Informal Support as a Predictor of Home- and Community-Based Services Utilization

2020 ◽  
Vol 76 (1) ◽  
pp. 133-140
Author(s):  
Kristen N Robinson ◽  
Heather L Menne ◽  
Raphael Gaeta
Keyword(s):  
Older Adults ◽  
Informal Caregivers ◽  
Behavioral Model ◽  
Study Data ◽  
Informal Support ◽  
Health Services Use ◽  
Community Based ◽  
Logistic Regression Models ◽  
Andersen Behavioral Model ◽  
Community Based Services

Abstract Objectives Home- and community-based services (HCBS) help older adults remain living safely in their homes by delaying or preventing the need for institutionalization. This analysis is guided by the Andersen Behavioral Model of Health Services Use to examine the association between informal support and use of HCBS. Method Health and Retirement Study data from 2011 and 2012 are used in the bivariate analyses and multivariate logistic regression models to examine differences in HCBS utilization among extremely vulnerable older adults who have informal caregivers and those who do not. Results For extremely vulnerable older adults who report difficulties with any instrumental or basic activities of daily living, use of HCBS is not strongly associated with access to informal caregivers. However, for this same population of extremely vulnerable older adults, those who live alone have roughly 3 times the odds of using any HCBS compared to those who do not live alone. Discussion Among already vulnerable older adults, this study revealed that living alone is an important enabling factor of the Andersen Behavioral Model as applied in HCBS research. Further investigation is needed to see if more resources should be allocated to senior centers and local providers to identify vulnerable older adults who live alone and may have unmet needs.

scholarly journals Telehealth Use Among Older Adults During COVID-19: Associations With Sociodemographic and Health Characteristics, Technology Device Ownership, and Technology Learning

2021 ◽  
pp. 073346482110473
Author(s):  
Namkee G. Choi ◽  
Diana M. DiNitto ◽  
C. Nathan Marti ◽  
Bryan Y. Choi
Keyword(s):  
Older Adults ◽  
Communication Technology ◽  
Care Delivery ◽  
Behavioral Model ◽  
Health Services Use ◽  
Enabling Factors ◽  
Technology Learning ◽  
Logistic Regression Models ◽  
Study Results ◽  
Information And Communication

The COVID-19 pandemic ushered in rapid telehealth/telemedicine adoption. In this study, we (1) examined rates and correlates of telehealth (video call) use among those aged 70+, and (2) tested the significance of access to information and communication technology (ICT) device ownership and knowledge of how to use the internet and devices as telehealth-enabling factors. The Behavioral Model of Health Services Use served as the conceptual framework, and data came from the COVID-19 supplemental survey of the National Health and Aging Trend Study. Results show that telehealth use increased to 21.1% from 4.6% pre-pandemic. In logistic regression models without technology-enabling factors, older age and lower income were negatively associated with telehealth use; however, when technology-enabling factors were included, they were significant while age and income were no longer significant. Insuring that older adults have ICT devices and internet access may reduce health disparities and improve telehealth care delivery.

scholarly journals ELDER ABUSE AMID THE OPIOID EPIDEMIC: APS CASES IN RURAL AMERICA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S763-S763
Author(s):  
Pamela B Teaster ◽  
Karen A Roberto ◽  
Jyoti Savla
Keyword(s):  
Older Adults ◽  
Elder Abuse ◽  
Standard Errors ◽  
Opioid Misuse ◽  
Rural America ◽  
Opioid Use ◽  
Care Needs ◽  
Community Based ◽  
Community Based Services ◽  
Physical Care

Abstract Older adults are hidden victims of the opioid crises, suffering abuse at the hands of those who seek resources to support their addiction. Using APS data from 2015-2017 provided by the Kentucky Department for Community-Based Services, we used a logistic regression model with robust standard errors to examine whether substantiated cases of elder abuse were associated with opioid misuse by perpetrators. Overall, 9% of the 462 substantiated cases over the three-year period involved perpetrators were substance users. The percentage of these cases rose from 5% in 2015 to 13% in 2016 before dropping to 7% of elder abuse cases in 2017. Opioid use was most prevalent among perpetrators of financial abuse of older adults with cognitive and/or physical care needs. The current study offers a first look at empirical linkages between opioid misuse and elder abuse and revealed consistencies across cases that call for further investigation.

Conceptualizations of help-seeking for mental health concerns in First Nations communities in Canada: A comparison of fit with the Andersen Behavioral Model

2020 ◽  
Vol 57 (2) ◽  
pp. 346-362
Author(s):  
Corinne A Isaak ◽  
Natalie Mota ◽  
Maria Medved ◽  
Laurence Y Katz ◽  
Brenda Elias ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
First Nations ◽  
Help Seeking ◽  
Behavioral Model ◽  
Community Members ◽  
Health Services Use ◽  
Health Concerns ◽  
Andersen Behavioral Model ◽  
Nations Community

This qualitative study explored the fit between on-reserve First Nations community members’ conceptualizations of help-seeking for mental health concerns and the Andersen Behavioral Model of Health Services Use. Youth, adults and elders (N = 115) living and or working in eight distinct First Nations communities within a tribal council area in Canada participated in focus groups or individual interviews that were transcribed, coded and then analyzed using a thematic analysis approach informed by grounded theory methodology. Resulting themes were then mapped onto the Andersen Behavioral Model of Health Services Use. Participants’ conceptualizations of predisposing characteristics including social structures, health beliefs and mental illness, enabling and impeding resources had a high degree of fit with the model. While perspectives on perceived need for mental health care, and spirituality as a health and lifestyle practice had only moderate fit with the model, these domains could be modified to fit First Nations’ interpretations of help-seeking. Participants’ perceptions of avoidant strategies and non-use of mental health services, however did not map onto the model. These findings suggest conceptualizations of help-seeking for mental health issues in these First Nations communities are only partially characterized by the Andersen Behavioral Model, suggesting there are a number of considerations to Indigenize the model. Findings also highlight potential explanations for why some members of this population may not access or receive appropriate mental health treatment. Multi-pronged efforts are warranted to link culturally normed pathways of help-seeking with effective mental health supports for First Nations community members in Canada.

scholarly journals THE INTERSECTION OF ETHICS AND VULNERABLE ELDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S238-S238
Author(s):  
Pamela B Teaster ◽  
Georgia Anetzberger
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Ethical Issues ◽  
Elder Abuse ◽  
Cognitive Status ◽  
Ethical Challenges ◽  
Community Based ◽  
Conducting Research ◽  
Definition Of ◽  
Community Based Services

Abstract Researchers, practitioners and policymakers are daily confronted with multiple and competing situations regarding vulnerable older adults and the complex issues that they face in all aspects of their lives. Challenges can arise in the provision of social services, dispensing justice, conducting research, or addressing legal issues. The purpose of this symposium is to discuss dilemmas that vulnerable older adults and concerned others face by elucidating current and future challenges facing this population, particularly in the realms of compromised health (cognitive impairment); effective status (gender); care arrangements (home and community-based services); and abuse, neglect, and exploitation. Teaster and Anetzberger discuss relevant ethical theories and principles as well as a definition of vulnerability. Santos and Nichols-Hadeed report on ethical issues embedded in vulnerable elders’ cognitive status. Bowland and Halaas highlight the intersection of ethics, gender and vulnerable elders. Niles-Yokum and Beaumaster discuss the nexus of ethics and the provision of home and community based services for vulnerable older adults. Heisler considers vulnerabilities of older adults and ethical challenges when addressing elder abuse. Throughout the papers, we weave the ethical principles of autonomy, beneficence, nonmaleficence, and justice.

Community-Based Aging Services

2020 ◽  
Author(s):  
Jan Ivery
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Social Workers ◽  
Healthy Aging ◽  
Community Based ◽  
Limited Mobility ◽  
Age In Place ◽  
Increased Risk ◽  
Aging Services ◽  
Community Based Services

As individuals age, their physical community continues to be a primary entry point of intervention because of their attachment to place, social connections, and limited mobility to travel as far and as often as they would like or desire. The environment provides a context for understanding an older adult’s social interactions and the availability of and access to supportive services that reduce isolation and increased risk for reduced health status. When individuals age in place, social workers need to understand how community-based services can work with older adults in their community where they have lived for some time and have developed social networks. This knowledge will better assist social workers in their ability to effectively connect clients with appropriate resources. Unfortunately, it is not uncommon for an older adult’s environment to not reflect or adapt to their changing health status and physical mobility. Healthy aging (also referred to as age-friendly) and NORC (naturally occurring retirement communities) initiatives have emerged as examples of how to provide supportive, community-based services that will enable older adults to remain engaged in their community as they experience changes in their health status, mobility, and financial security. These community-level interventions emphasize the adaptability to an older adult’s changing lifestyle factors that influence how they navigate their community. These initiatives engage older adults in planning and implementing strategies to connect older adults with services and activities that promote aging in place. Social workers play a very important role in the provision of community-based aging services because they can serve as a bridge between older adults and the local, state, and federal level programs that may be available to them.

scholarly journals Self-Reported Dental Visits Among Older Adults Receiving Home- and Community-Based Services

2020 ◽  
pp. 073346482092532
Author(s):  
Steffany Chamut ◽  
Shahdokht Boroumand ◽  
Timothy J. Iafolla ◽  
Margo Adesanya ◽  
Elena M. Fazio ◽  
...  
Keyword(s):  
High School ◽  
Older Adults ◽  
Health Knowledge ◽  
Health Indicators ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Older Americans ◽  
Older Americans Act ◽  
Community Based Services

Objective: To investigate factors associated with infrequent dental use among older adults receiving home- and community-based services. Method: This cross-sectional study analyzed responses from the 2014 National Survey of Older Americans Act participants who received home- and community-based services. Descriptive and multivariable analyses were conducted to examine the association between infrequent dental use and key sociodemographic and health indicators. Results: Infrequent dental use was highest among adults participating in case management and home-delivered meals (63%); the lowest among those participating in congregate meals (41%). Participants who did not complete high school were 2 to 5 times more likely to be infrequent dental users compared to those with educational attainment beyond high school. Discussion: Among older adults receiving home- and community-based services, improving oral health knowledge and health literacy may reduce infrequent dental use.

scholarly journals Profile of Long-Term Care Recipients Receiving Home and Community-Based Services and the Factors That Influence Utilization in Taiwan

2020 ◽  
Vol 17 (8) ◽  
pp. 2649
Author(s):  
Chia-Mei Shih ◽  
Yu-Hua Wang ◽  
Li-Fan Liu ◽  
Jung-Hua Wu
Keyword(s):  
Low Income ◽  
Long Term Care ◽  
Common Factor ◽  
Behavioral Model ◽  
Care Needs ◽  
Community Based ◽  
Term Care ◽  
Care Recipients ◽  
Community Based Services

In response to the irreversible aging trend, the Taiwan government has promoted the Long-Term Care (LTC) policy 1.0 launched in 2007 and the LTC policy 2.0 reform since 2016. This study aimed to explore the utilization of formal home and community-based care under LTC policy 1.0 to add scientific support for the on-going LTC policy 2.0 reform. Methods: By using Andersen and Aday’s behavioral model of healthcare utilization, the long-term care dataset was analyzed from 2013 to 2016. A total of 101,457 care recipients were identified after data cleaning. Results: The results revealed that about 40.7% of the care recipients stayed in the care system for more than two years. A common factor influencing the length of home and community-based services (HCBS) utilization period included need factors, where more dependent recipients leave the LTC system regardless of their socio-economic status. However, the utilization period of non-low-income households is significantly affected by the level of service resources. Conclusion: For long-term care needs, the phenomenon of a short utilization period was concerning. This study adds information which suggests policy should reconsider care capacity and quality, especially for moderate to severely dependent recipients. This will allow for better understanding to help maintain care recipients in their own communities to achieve the goal of having an aging in place policy.

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