Understanding factors that influence success of home- and community-based services in keeping older adults in community settings.
OBJECTIVE
To understand factors that influence success of home- and community-based services in keeping older adults in community settings, we examined the causal relationships among older adults' personal factors, older adults' home- and community-based services use, and older adults' remaining in communities.


METHODS
Structural equation modeling was employed to test a home- and community-based services model based on Andersen's Health Behavioral Model. Data from 5,294 elders in a nationally representative dataset, the Second Longitudinal Study of Aging, were included for analysis.


RESULTS
Two significant supportive factors for older adults to remain in communities were use of paid instrumental activities of daily living (IADL) personal care services and awareness of unmet needs.


CONCLUSIONS
Our findings suggest the importance of encouraging older adults to acknowledge their unmet needs and to seek community-based support services early, rather than wait until they have developed more serious needs, such as difficulties in activities of daily living (ADL).
Chen
Ya-Mei
YM
University of Washington, Seattle, WA 98195, USA. yameic@u.washington.edu
Thompson
Elaine Adams
EA
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016009:Chi-Square Distribution; D003153:Community Health Services; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D006301:Health Services Needs and Demand; D006699:Home Care Services; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008390:Markov Chains; D008962:Models, Theoretical; D009735:Nursing Homes; D012111:Residence Characteristics; D012944:Social Support; D013223:Statistics as Topic