The likelihood of dependent elderly remaining in the community: The impact of a mix of formal and informal care and change in functional status

Dinnie Chao, Purdue University

Abstract

Different aspects of formal and informal elder care have been examined by many researchers, but issues concerning mixed care and its impact on institutionalization have been relatively ignored. This research builds on an extended model of social support and the supplementary model of formal and informal care. The purpose of this research is to examine the care arrangements of community-dwelling elderly, using data from the Longitudinal Study of Aging (1984-1990). The 2,814 respondents participating in all four waves of the study comprised the study sample. Using logistic regression, the effects of types of care on institutionalization along with other demographic and health variables, were estimated. The findings indicate that race, IADL limitations, and decline in IADL consistently emerged as significant predictors of institutionalization for all three time periods (1984-1986, 1986-1988, and 1988-1990). Type of care, ADL limitations, and age were significant for the last two time periods. Compared with those with both types of care, the respondents with no care or formal care only are at a greater risk of becoming nursing home residents. Those with informal care only were less likely than those with both types of care to be institutionalized. To assess the relationship between transition of care arrangement during each time period and functional change in ADL and IADL, a series of cross-tabulations were performed. The findings indicate that a decline in functional difficulty is associated with stability of the care type or the shrinking of the caregiving network.

Degree

Ph.D.

Advisors

Targ, Purdue University.

Subject Area

Families & family life|Personal relationships|Sociology|Gerontology|Welfare

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