Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T05:26:13.388Z Has data issue: false hasContentIssue false
  • English
  • Français

Service use barriers differentiating care-givers' service use patterns

Published online by Cambridge University Press:  07 February 2011

SONG-IEE HONG ,
LESLIE HASCHE  and
MI JIN LEE
SONG-IEE HONG*
Affiliation:
Department of Social Work, National University of Singapore, Singapore.
LESLIE HASCHE
Affiliation:
School of Social Welfare, University of Kansas, Lawrence, USA.
MI JIN LEE
Affiliation:
Department of Social Welfare, Konkuk University, Chungcheongbuk-do, South Korea.
*
Address for correspondence: Song-Iee Hong, Department of Social Work, National University of Singapore, Faculty of Arts and Social Sciences Block AS3, Level 4, 3 Arts Link, Singapore, 117570. E-mail: swkhs@nus.edu.sg
Get access Rights & Permissions [Opens in a new window]

Abstract

This study describes what types of service use barriers older adults' informal care-givers perceive and examines how these barriers differentiate care-giver service use patterns. Analysing the 2004 National Long-Term Care Survey and Informal Care-giver Data Set (N=1908) in the United States of America, this study reports the prevalence of service barriers for each type of service as well as for overall service use. Service barriers are measured in terms of availability, awareness, affordability, staff quality, privacy violation, complex bureaucracy, language barriers, qualification of each programme and no thought of service. Andersen's health behaviour model guides determinants related to care-giver service use patterns. As a main outcome, care-giver service use patterns (light service users, selective in-home users, and multiple service users) are examined in relation to service use barriers when other predisposing, enabling and need variables are controlled. Of the ten service use barriers defined in this study, awareness and no thought of service are the most prevalent barriers. Care-givers reporting service barriers of availability, awareness and affordability are more likely to be light service users compared to multiple service users and selective in-home service users. These findings highlight the significance of enhancing awareness of care-giver supportive services as well as increasing availability and financial support for service use.

Keywords

informal care-givingservice use patternservice use barrierawarenessavailabilityaffordability
Type
Articles
Information
Ageing & Society , Volume 31 , Issue 8 , November 2011 , pp. 1307 - 1329
Creative Commons
The contribution by Lee, is a work of the U.S. Government and is not subject to copyright protection in the United States
Copyright
Copyright © Cambridge University Press 2011. The contribution by Lee, is a work of the U.S. Government and is not subject to copyright protection in the United States.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agree, E. M., Freedman, V. A., Cornman, J. C., Wolf, D. A. and Marcotte, J. E. 2005. Reconsidering substitution in long-term care: when does assistive technology take the place of personal care? Journals of Gerontology: Psychological Sciences and Social Sciences, 60B, S272–80.CrossRefGoogle Scholar
Allen, S. M. 1994. Gender differences in spousal caregiving and unmet need for care. Journals of Gerontology: Social Sciences, 49, 4, S187–95.CrossRefGoogle ScholarPubMed
Alzheimer's Association and National Alliance for Caregiving 2004. Families Care: Alzheimer's Caregiving in the United States. Alzheimer's Association, Chicago.Google Scholar
Ambler, G., Omar, R. Z. and Royston, P. 2007. A comparison of imputation techniques for handling missing predictor values in a risk model with a binary outcome. Statistical Methods in Medical Research, 16, 3, 277–98.Google Scholar
Anderson, R. 1995. Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior, 36, 1, 1–10.Google Scholar
Anderson, R. and Newman, J. F. 2005. Societal and individual determinants of medical care utilization in the United States. The Milbank Quarterly, 83, 4, 1–28.Google Scholar
Bass, D. M., Looman, W. J. and Ehrlich, P. 1992. Predicting the volume of health and social services: integrating cognitive impairment into the modified Andersen framework. The Gerontologist, 32, 1, 33–43.CrossRefGoogle ScholarPubMed
Bass, D. M. and Noelker, L. S. 1987. The influence of family caregivers on elders' use of in-home services: an expanded conceptual framework. Journal of Health and Social Behavior, 28, 2, 184–96.CrossRefGoogle ScholarPubMed
Bass, D. M., Noelker, L. S. and Rechlin, L. R. 1996. The moderating influence of service use on negative caregiving consequences. Journal of Gerontology, 51B, 3, S121–31.Google Scholar
Bookwalla, J., Zdaniuk, B., Burton, L., Lind, B., Jackson, S. and Schulz, R. 2004. Concurrent and long-term predictors of older adults' use of community-based long-term care services: The Caregiver Health Effects Study. Journal of Aging and Health, 16, 88–115.Google Scholar
Brodaty, H., Thomson, C., Thompson, C. and Fine, M. 2005. Why caregivers of people with dementia and memory loss don't use services. International Journal of Geriatric Psychiatry, 20, 6, 537–46.Google Scholar
Carpentier, N. and Ducharme, F. 2003. Care-giver network transformations: the need for an integrated perspective. Ageing & Society, 23, 4, 507–25.Google Scholar
Catlin, A., Cowan, C., Hartman, M., Heffler, S. and the National Health Expenditure Accounts Team 2008. National health spending in 2006: A year of change for prescription drugs. Health Affairs, 27, 1, 14–29.Google Scholar
Cavaye, J. 2006. Hidden Carers. Dunedin Academic Press, Edinburgh.Google Scholar
Dale, S., Brown, R., Phillips, B., Schore, J. and Lepidus Carlson, B. 2003. The effects of cash and counseling on personal care services and Medicaid costs in Arkansas. Health Affairs, Web exclusive, 3, 566–75.Google Scholar
Doty, P. 2010. The evolving balance of formal and informal, institutional and non-institutional long-term care for older Americans: a thirty-year perspective. Public Policy & Aging Report, 20, 1, 3–9.Google Scholar
Gaugler, J. E., Davey, A., Pearlin, L. I. and Zarit, S. H. 2000. Modeling caregiver adaptation over time: The longitudinal impact of behavior problems. Psychology and Aging, 15, 437–50.Google Scholar
Gaugler, J. E., Kane, R. L., Kane, R. A., Clay, T. and Newcomer, R. 2003. Caregiving and institutionalization of cognitively impaired older people: utilizing dynamic predictors of change. The Gerontologist, 43, 2, 219–29.Google Scholar
Gibson, M. J., Gregory, S. R. and Pandya, S. M. 2003. Long-term Care in Developed Nations: A Brief Overview. Public Policy Institute, AARP, Washington DC.Google Scholar
Haberkern, K. and Szydlik, M. 2010. State care provision, societal opinion and children's care of older parents in 11 European countries. Ageing & Society, 30, 2, 299–323.Google Scholar
Hayden, M. F. and Heller, T. 1997. Support, problem-solving/coping ability, and personal burden of younger and older caregivers of adults with mental retardation. Mental Retardation, 35, 5, 364–72.2.0.CO;2>CrossRefGoogle ScholarPubMed
Hong, S.-I. 2010. Understanding heterogeneous service utilizations among informal caregivers of community older adults. The Gerontologist, 50, 1, 87–99.CrossRefGoogle ScholarPubMed
Hooyman, N. 2006. Introduction: our aging society. In Berkman, B. and D'Ambruso, S. (eds), Handbook of Social Work in Health and Aging. Oxford University Press, New York, xxxi–xl.Google Scholar
Institute of Medicine 2003. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. National Academy of Sciences, Washington DC.Google Scholar
Jacobs, S., Xie, C., Reilly, S., Hughes, J. and Challis, D. 2009. Modernising social care services for older people: scoping the United Kingdom evidence base. Ageing & Society, 29, 4, 497–538.Google Scholar
Jarrott, S. E. 2000. Caregiver Report: Final Report Made to the Organization for the Needs of the Elderly, Joining Older and Younger. Organization for the Needs of the Elderly, Van Nuys, California.Google Scholar
Johnson, R. W. and Lo Sasso, A. T. 2001. The employment and time costs of caring for elderly patients. Poverty Research News, 5, 5, 5–7.Google Scholar
Kosloski, K. and Montgomery, R. V. 1994. Investigating patterns of service use by families providing care for dependent elders. Journal of Aging and Health, 6, 1, 17–37.Google Scholar
Laditka, S. B., Pappas-Rogich, M. and Laditka, J. N. 2001. Home and community-based services for well educated older caregivers: gender differences in attitudes, barriers, and use. Home Health Care Services Quarterly, 19, 3, 1–17.Google Scholar
Lee, E. S. and Forthofer, R. N. 2006. Analyzing Complex Survey Data. Second edition, Sage, Thousand Oaks, California.Google Scholar
Leitsch, S. A., Zarit, S. H., Jarrott, S. E., Greene, R. and Stephens, M. A. 2001. Adult day care: medical versus social models. Research on Aging, 23, 473–98.Google Scholar
Li, H. 2006. Rural older adults' access barriers to in-home and community-based services. Social Work Research, 30, 2, 109–18.Google Scholar
Mason, A., Weatherly, H., Spilsbury, K., Golder, S., Arksey, H., Adamson, J. and Drummond, M. 2007. The effectiveness and cost-effectiveness of respite for caregivers of frail older people. Journal of the American Geriatrics Society, 55, 2, 290–9.Google Scholar
Miller, B. and McFall, S. 1991. The effect of caregiver's burden on change in frail persons' use of formal helpers. Journal of Health and Social Behavior, 32, 2, 165–79.Google Scholar
Moon, A. and Rhee, S. 2006. Introduction: our aging society. In Berkman, B. and D'Ambruso, S. (eds), Handbook of Social Work in Health and Aging. Oxford University Press, New York, 205–17.Google Scholar
Morgan, D. G., Semchuk, K. M., Stewart, N. J. and Arcy, C. D. 2002. Rural families caring for a relative with dementia: barriers to use of formal services. Social Science and Medicine, 55, 7, 1129–42.Google Scholar
National Family Caregivers Association and Family Caregiver Alliance 2006. Prevalence, Hours and Economic Value of Family Caregiving, Updated State-by-State Analysis of 2004 National Estimates by Peter S. Arno. National Family Caregivers Association, San Francisco, California.Google Scholar
National Alliance for Caregiving & American Association of Retired Persons 2004. Caregiving in the U.S. Author, Washington, DC.Google Scholar
Navaie-Waliser, M., Feldman, P. H., Gould, D. A., Levine, C., Kuerbis, A. N. and Donelan, K. 2002. When the caregiver needs care: The plight of vulnerable family caregivers. American Journal of Public Health, 92, 3, 409–13.Google Scholar
Noelker, L. and Bass, D. 1989. Home care for elderly persons: Linkages between formal and informal caregivers. Journal of Gerontology, 44, S63–S72.Google Scholar
Ostwald, S., Hepburn, K., Caron, W., Burns, T. and Mantell, R. 1999. Reducing caregiver burden: a randomized psychoeducational intervention for caregivers of persons with dementia. The Gerontologist, 39, 3, 299–309.Google Scholar
Schoenberg, N. E. and Coward, R. T. 1998. Residential differences in attitudes about barriers to using community-based services among older adults. Rural Health Research, 14, 4, 295–304.Google Scholar
Schwarz, K. A. and Blixen, C. E. 1997. Does home health care affect strain and depressive symptomology for caregivers of impaired older adults? Journal of Community Health Nursing, 14, 1, 39–48.Google Scholar
Skipwith, D. 1994. Telephone counseling interventions with caregivers of elders. Journal of Psychosocial Nursing, 32, 3, 7–12.Google ScholarPubMed
Smith, G. C. 2003. Patterns and predictors of service use and unmet needs among aging families of adults with severe mental illness. Psychiatric Services, 54, 6, 871–77.Google Scholar
Talley, R. C. and Crews, J. E. 2007. Framing the public health of caregiving. American Journal of Public Health, 97, 2, 224–8.Google Scholar
The Kaiser Family Foundation 2010. Health Care Reform and the Class Act. Available online at www.kff.org/healthreform/upload/8069.pdf.Google Scholar
The Staff of the Washington Post. 2010. Landmark: The Inside Story of America's New Health Care Law and What It Means for Us All. Publicaffairs Reports, New York.Google Scholar
Toseland, R. W., McCallion, P., Gerber, T. and Banks, S. 2002. Predictors of health and human services use by persons with dementia and their family caregivers. Social Science & Medicine, 55, 7, 1255–66.Google Scholar
United States Department of Health and Human Services and the Administration on Aging. 2004. The Older Americans Act: National Family Caregiver Support Program (Title III-E and Title VI-C): Compassion in Action. Rockville, MD.Google Scholar
Zarit, S. H., Stephens, M. A. P., Townsend, A. and Greene, P. 1998. Stress reduction for family caregivers: effects of adult day care use. Journal of Gerontology, 53B, 5, S267–77.Google Scholar