Hydra revisited: substituting formal for self- and informal in-home care among older adults with disabilities.
OBJECTIVE
In response to concerns among policymakers and others that increases in the availability of publicly funded formal services will lead to reductions in self- and informal care, this study examines the relationship between the extent of formal in-home care received and levels of self- and informal care.


METHODS
Two-stage least squares regression analyses were conducted, using data drawn from interviews conducted with a sample of 661 older users and nonusers of publicly subsidized home care services.


RESULTS
No evidence was found to indicate that more extensive use of formal services is associated with less extensive self- or informal care. This is true among those receiving publicly subsidized services as well as those required to pay part or all of the cost of the in-home services they receive.


CONCLUSIONS
The findings provide little support for the substitution hypothesis that an increase in the use of formal in-home services will tend to erode levels of informal or self-care.
Penning
Margaret J
MJ
Department of Sociology and Centre on Aging, University of Victoria, British Columbia, Canada. mpenning@uvic.ca
D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D012648:Self Care / Q000706:statistics & numerical data*; D014481:United States