Living quarters and unmet need for personal care assistance among adults with disabilities.
OBJECTIVE
This study used a person-environment (P-E) framework to examine individual capabilities and social and physical environmental attributes for their association with unmet assistance needs in activities of daily living (ADLs). Analyses were replicated among five ADLs (bathing, dressing, transferring, toileting, eating) and test the relative risk of apartment dwellers compared to those living in houses.


METHODS
Data were obtained from the National Health Interview Survey, Supplement on Disability Followback Survey. Analyses consisted of a nationally representative sample of aged and nonaged adults with one or more ADL limitations.


RESULTS
Slightly less than 1 in 5 subjects with a specific ADL limitation had unmet needs for that ADL. This was true across all ADLs. The likelihood of unmet ADL assistance increased with the number of ADL limitations and other health status indicators. It was at least 50% higher among those living in apartments than in houses and higher among Hispanics. There were no differences by age or gender.


CONCLUSIONS
The P-E framework postulates that individuals seek settings matched to their capabilities, but findings suggest that many are at risk for adaptation at any one time. Specific risk factors are identified. Selection factors like preferences, expectations, and adaptation options available have not been directly measured.
Disability Statistics Rehabilitation Research and Training Center, University of California, 3333 California Street, Suite 455, San Francisco, CA 94118, USA. rjn@itsa.ucsf.edu
Robert
R
Newcomer
Taewoon
T
Kang
Mitchell
M
Laplante
Stephen
S
Kaye
D000203:Activities of Daily Living; D000368:Aged; D040561:Assisted Living Facilities; D006233:Persons with Disabilities; D004777:Environment; D005260:Female; D006301:Health Services Needs and Demand; D006379:Helping Behavior; D006801:Humans; D008297:Male; D010548:Personal Health Services / Q000600:supply & distribution*; D012111:Residence Characteristics; D012944:Social Support