Use of Adult Day Services and Home Health Care Services by Older Adults: A Comparative Analysis

Abstract

This study compares adult day services (ADS) and home health care (HHC) users on the indicators of personal characteristics, physical health, mental health and social network contacts. Analysis includes all 62 reported ADS users and a random sample of 91 HHC users from the Longitudinal Study of Aging. Results indicate that ADS users are younger, have greater cognitive impairment, need more supervisory assistance with activities of daily living (ADLs), and have more social contacts than HHC users. The findings also underscore the importance of emphasizing the functional and cognitive limitations in differentiating home- and community-based services. Instead of exclusively focusing on physical needs, authors suggest strategies that ensure integrated care models to address physical, mental and social needs of elders in both settings.

Home- and Community-Based Service Use by Older African American, Hispanic, and Non-Hispanic White Women and Men

“…Some previous studies examining service use among these population groups have found fewer differences (Dabelko & Balaswamy, 2000;Dunlap et al, 2002;Mui & Burnette, 1994;White-Means, 2000). What may account for the findings of greater service use, and intensity of use, for some services by minority populations in this study?…”

“…Using three sources of national data, including samples of disabled older people, Miller and colleagues (1996) also found no such differences. A primarily descriptive study focusing on a small proportion of respondents in a large nationally representative survey found no race or ethnicity differences in use of home care or adult day care (Dabelko & Balaswamy, 2000). The smaller body of research examining service use by older Hispanics also has mixed findings.…”

Comparing PACE with a Medicaid‐Only Managed Long‐Term Care Plan: Health Outcomes Over Time

“…The fact that PACE participants have higher rates of cognitive impairment, adult day center attendance, and caregiver support points to potential unmeasured differences between the two groups, supported by research findings that people attending adult day centers differ from those receiving other home‐ and community‐based services: They are more likely to be cognitively impaired and less likely to live alone (Dabelko, ; Dabelko & Balaswamy, ; Zarit et al, ); one study summarized reasons for enrollment as signs of family caregivers in crisis (MetLife Mature Market Institute, ).…”

Correlates of Service Delivery and Social Environment in Adult Day Service Programs

“…More recent research that utilized quasi-experimental or single group longitudinal designs found that families who utilized ADS reported significant decreases in caregiver stress and depression (Cho, Zarit, & Chiriboga, 2009; Femia, Zarit, Stephens, & Greene, 2007; Gaugler, Jarrott, Zarit, Stephens, Townsend, & Greene, R., 2003a; Gaugler et al, 2003b; Warren, Kerr, Smith, & Schalm, 2003; Zank, & Schacke, 2002; Zarit, Stephens, Townsend, & Greene, 1998; Zarit et al, 2011; Zarit, Kim, Femia, Almeida, & Klein, 2013). A variety of descriptive studies have also examined variations in ADS design, service delivery, and utilization of ADS (Bull, 2011; Cohen-Mansfield & Wirtz, 2007; Dabelko-Schoeny & Balaswamy, 2000; Douglass & Visconti, 1998; Iecovich & Biderman, 2013; Skarupski et al, 2008). …”