Unmet need for personal assistance with activities of daily living among older adults.

PURPOSE This study examined the prevalence, correlates, and negative consequences of unmet need for personal assistance with activities of daily living (ADLs) among older adults. DESIGN AND METHODS The authors analyzed cross-sectional data from the 1994 National Health Interview Survey's Supplement on Aging. Data were weighted to be representative of the noninstitutionalized population aged 70 years and older. RESULTS Overall, 20.7% of those needing help to perform 1 or more ADLs (an estimated 629,000 persons) reported receiving inadequate assistance; for individual ADLs, the prevalence of unmet need ranged from 10.2% (eating) to 20.1% (transferring). The likelihood of having 1 or more unmet needs was associated with lower household income, multiple ADL difficulties, and living alone. Nearly half of those with unmet needs reported experiencing a negative consequence (e.g., unable to eat when hungry) as a result of their unmet need. IMPLICATIONS Greater, targeted efforts are needed to reduce the prevalence and consequences of unmet need for ADL assistance in elderly persons.

[1]  J. P. Maloney,et al.  Social support: a conceptual analysis. , 1997, Journal of advanced nursing.

[2]  K. Robinson The family's role in long-term care. , 1997, Journal of gerontological nursing.

[3]  L. Verbrugge,et al.  The great efficacy of personal and equipment assistance in reducing disability. , 1997, American journal of public health.

[4]  N. Chappell Living arrangements and sources of caregiving. , 1991, Journal of gerontology.

[5]  L. Kasten,et al.  Unmet need among disabled elders: a problem in access to community long term care? , 1994, Social science & medicine.

[6]  S. Katz Studies of illness in the aged , 1963 .

[7]  V. Raveis,et al.  Caregiver burden and unmet patient needs , 1991, Cancer.

[8]  V Mor,et al.  The prevalence and consequences of unmet need. Contrasts between older and younger adults with disability. , 1997, Medical care.

[9]  David G. Kleinbaum,et al.  Logistic Regression. A Self- Learning Text , 1994 .

[10]  S. Furner,et al.  Older Adults and Assistive Devices , 1998, Journal of aging and health.

[11]  G. Koch,et al.  Self-care and assistance from others in coping with functional status limitations among a national sample of older adults. , 1995, The journals of gerontology. Series B, Psychological sciences and social sciences.

[12]  S. Katz,et al.  STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. , 1963, JAMA.

[13]  K. Manton,et al.  Changes in the use of personal assistance and special equipment from 1982 to 1989: results from the 1982 and 1989 NLTCS. , 1993, The Gerontologist.

[14]  K. Manton Epidemiological, demographic, and social correlates of disability among the elderly. , 1989, The Milbank quarterly.

[15]  A. Agresti,et al.  Categorical Data Analysis , 1991, International Encyclopedia of Statistical Science.

[16]  S. Crawford,et al.  Determining the pattern of community care: is coresidence more important than caregiver relationship? , 1993, Journal of gerontology.

[17]  S. Crawford,et al.  Is family care on the decline? A longitudinal investigation of the substitution of formal long-term care services for informal care. , 1993, The Milbank quarterly.

[18]  Massey Jt,et al.  Design and estimation for the National Health Interview Survey 1985-94. , 1989 .

[19]  F. Hobbs,et al.  65+ in the United States. , 1996 .

[20]  M C Chenier,et al.  Review and analysis of caregiver burden and nursing home placement. , 1997, Geriatric nursing.