Understanding Factors That Influence Success of Home- and Community-Based Services in Keeping Older Adults in Community Settings

Abstract

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. 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. 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. 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).