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Eldelry/Long-term Care

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Regular help with personal care from adult children substantially reduces the likelihood of nursing home use by the elderly

One-third of people aged 70 and older with physical limitations receive regular help from their children with basic personal care, such as eating, bathing, dressing, or maneuvering around their home, although only 7 percent receive help most of the time. About 11 percent receive both personal care and help with shopping and chores, according to a new study. These numbers may dwindle further, with more divorces, more women working, and couples having fewer children, which limit the number of family members available to provide informal care to frail elders at home.

The study findings underscore the importance of family caregiving. For example, the researchers found that disabled Americans aged 70 and older who received help from their adult children with basic personal care were 60 percent less likely to use nursing home care over a subsequent 2-year period than similar elders who did not receive family assistance. Help with activities such as preparing meals or shopping did not significantly reduce their use of nursing home services. The likelihood that frail elders would receive help increased with the number of adult children. Black and Hispanic elders were substantially more likely than whites to receive help from their children.

Initiatives such as respite care, tax breaks for family caregivers, and requirements that employers offer time off or flexible schedules for workers with caregiving responsibilities could reduce costly nursing home admissions ($36,000 a year in 1996, with 30 percent paid out of pocket) by encouraging more families to provide care for elderly Americans, conclude Anthony T. Lo Sasso, Ph.D., of Northwestern University, and Richard W. Johnson, Ph.D., of the Urban Institute. With support from the Agency for Healthcare Research and Quality (K02 HS11294), they analyzed data on elderly health, assistance from family members, characteristics of adult children, and nursing home admissions from a nationally representative longitudinal survey of over 7,000 Americans aged 70 and older living in the community. The survey was conducted in 1993 and again in 1995.

See "Does informal care from adult children reduce nursing home admissions for the elderly?" by Drs. Lo Sasso and Johnson, in the fall 2002 Inquiry 39, pp. 279-297.

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