Three studies sponsored by HHS confirm previous research linking health impairment levels, advanced age, and various indicators of caregivers' physical burden and emotional stress with individual caregivers' decisions to stop giving care and increased likelihood of nursing home placement. In contrast, the lack of association between caregivers' em
An Examination of Issues Related to How HCBS Programs Operate Within Fixed Budgets and to the Administrative Linkages Between Eligibility Determination, Needs Assessment and Care Planning Functions
This paper reports the findings of an exploratory study to document and analyze selected best practices related to state-administered home and community-based services (HCBS) programs.
This report examines the issues involved in seeking to address the long-term care service needs of persons with severe mental illness (SMI) in a generic long-term care financing and service delivery system, as was proposed in the home and community-based services provisions of the Health Security Act. SMI, as defined by the Center for Mental Healt
The 1989 National Long Term Care Survey is the first nationally representative survey to collect data on weekly hours of assistance received by ADL and/or IADL disabled elders living in the community by individual caregivers, both formal and informal. Thus, it is now possible to investigate the effects of primary caregivers' employment status on t
This paper was used as a handout at a workshop, held as a catalyst for DALTCP's major new initiative to study ways to expand consumer choice and empowerment in obtaining personal assistance services. [15 PDF pages]
In-Home Supportive Services for the Elderly and Disabled: A Comparison of Client-Directed and Professional Management Models of Services Delivery--Non-Technical Summary Report
Elderly and younger persons with disabilities who require help from others to perform many of the most ordinary activities of daily living are said to require "long-term care." These services, when provided in the home or other non-institutional settings, may be termed personal assistance services, home and community-based services, or in-home sup
A Descriptive Analysis of Patterns of Informal and Formal Caregiving among Privately Insured and Non-Privately Insured Disabled Elders Living in the Community
This research was designed to answer current questions surrounding long-term care insurance. It was also designed to provide basic sociodemographic and service utilization profiles for disabled private long-term care insurance policyholders, and to compare such data and findings to the experiences of non-insured disabled community-dwelling elders.
In 1985 there were about 5.5 million functionally disabled elderly persons (65+) in the United States (U.S.) living in the community and an additional 1.3 million in nursing homes. By 2020, these figures are expected to almost double to 10.1 million and 2.5 million respectively. The long-term care (LTC) system in the U.S. is large and complex.
Easing the Burden of Caregiving: The Effect of Consumer Direction on Primary Informal Caregivers in Arkansas
Cash and Counseling, an innovative model of consumer direction, has been implemented as a three-state demonstration designed to weigh the advantages and disadvantages of allowing Medicaid beneficiaries to assume more responsibility for the supportive services they may need.
This booklet, developed by the U.S. Department of Health and Human Services (HHS) is about informal caregiving unpaid care given voluntarily to ill or disabled persons by their families and friends. Informal caregiving by families and friends is the backbone of America's long-term care system. According to recent surveys sponsored by HHS, 52 m
The purpose of the synthesis paper is to review, summarize, and discuss the significance of available research findings on the frontline long-term care (LTC) workforce since 1999, in both home and community-based and nursing home settings. This paper provides an updated review of the status of empirical findings, focusing on what has been learned
"Consumer-direction" is a philosophy and orientation to the delivery of home and community-based long-term care that puts informed consumers and their families in the driver's seat with respect to making choices about how best to meet their disability-related supportive service needs.
This paper examines the current state of nurse practice acts and their implementing regulations to determine the extent to which they permit more consumer direction in home and community based services. This analysis may be helpful to consumers and states that are seeking ways to balance better state policies to support consumer-directed care. [38
Update of ASPE Activities Related to Community-Integration Executive Order for People with Disabilities
President Bush signed Executive Order 13217 on June 18, 2001, "to place qualified individuals with disabilities in community settings whenever appropriate...so as to ensure that all Americans have the opportunity to live close to their families and friends, to live more independently, to engage in productive employment, and to participate in commu
A Compendium of Intervention and Descriptive Studies Designed to Promote the Health of Caregivers for Older Adults
An important component of the ASPE Health (Promotion and Aging Project is the development of such an inventory of health promotion, disease prevention, and health education activities targeted at informal caregivers for HHS. The specific focus of this report is to highlight some state and local initiatives that have developed promising programs to
Informal Caregiving for Older Americans: An Analysis of the 2011 National Study of Caregiving. Methods
For all estimates, we use the analytic weights that take into account differential probabilities of selection and non-response at the NHATS sample person and caregiver level (Kasper et al. 2013a) and statistical software that adjusts standard errors for survey design.
Informal Caregiving for Older Americans: An Analysis of the 2011 National Study of Caregiving. Analysis Measures
Measures used in this report include both care-recipient characteristics drawn from the NHATS and caregiver characteristics and experience drawn from the NSOC. Care-Recipient Measures The care-recipient measures used are a hierarchical assistance level measure developed and further described in Freedman & Spillman (2013), a dementia me
Informal Caregiving for Older Americans: An Analysis of the 2011 National Study of Caregiving. Sample
The NSOC sample was drawn from 4935 eligible informal caregivers to 2423 eligible NHATS respondents. (For a small number of NHATS respondents identifying more than five eligible caregivers, five caregivers were selected randomly.) Eligible NHATS respondents refused to provide contact information for 1573 eligible caregivers, and of the remaining 3
Report to Congress: Aging Services Technology Study June 2012
Department of Health and Human Services Dawn Alley , Ph.D., Office of the Surgeon General, Office of the Assistant Secretary for Health Lynda Anderson , Ph.D., Director, Healthy Aging Program, Centers for Disease Control and Prevention Linda Elam , Ph.D., Deputy Assistant Secretary for Disability, Aging and Long-Term Care Policy, Offi