Abstract
BackgroundAndersen’s Expanded Behavioral Model of Health Services Use describes factors associated with the use of long-term services and supports (LTSS). This model, however, has only been tested on the intent to use such services among African-American and White older adults and not the actual use. Given the increasing diversity of older adults in the U.S., the ability to conceptualize factors associated with actual use of LTSS across racial/ethnic groups is critical.MethodsWe applied Andersen’s Expanded model in the analysis of 2006–2010 qualitative data using multiple methods to understand both the relevancy of factors for older adults who currently use LTSS vs. those who intend to use LTSS (as described in Andersen’s original exploration). We additionally explored differences in these factors across racial/ethnic groups and included Hispanic older adults in our analyses.ResultsFour additional constructs linked with actual LTSS use emerged: losses and changes, tangible support, capability to provide informal support, and accessibility of informal support. Racial differences were seen in level of participation in decisions to use nursing home services (Not involved: 45% African-Americans vs. 24% Whites). Reports of LTSS use to avoid burdening one’s family were greater among White older adults compared to African-American older adults.ConclusionsFindings around decision-making and burden along with other constructs enhance our understanding of determinants that influence actual LTSS use and require targeted interventions.
Highlights
Andersen’s Expanded Behavioral Model of Health Services Use describes factors associated with the use of long-term services and supports (LTSS)
It is expected that restrictions older adults face as a result of progressive diseases and functional deficits will continue to escalate with the aging and increased longevity of the Baby Boomer population [2]
Services received from paid caregivers are termed “formal” [5] whereas those received from unpaid caregivers are termed “nonformal” LTSS
Summary
Andersen’s Expanded Behavioral Model of Health Services Use describes factors associated with the use of long-term services and supports (LTSS) This model, has only been tested on the intent to use such services among African-American and White older adults and not the actual use. LTSS provide assistance with basic activities of daily living (ADL; e.g., eating, walking, toileting, bathing, and dressing) along with instrumental activities of daily living (IADL; e.g., food preparation, shopping, and management of finances). These services may be provided in either institutional settings such as nursing homes (NHs) and assisted living (AL) or in non-institutional settings such as older adults’ homes. Services received from paid caregivers are termed “formal” [5] whereas those received from unpaid caregivers are termed “nonformal” LTSS
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.