Aging in Place or Relocation, Perceived Awareness

PLEASESCROLLDOWNFORARTICLEThisarticlewasdownloadedby:[UniversityofMichigan]On:26February2009Accessdetails:AccessDetails:[subscriptionnumber906175854]PublisherRoutledgeInformaLtdRegisteredinEnglandandWalesRegisteredNumber:1072954Registeredoffice:MortimerHouse,37-41MortimerStreet,LondonW1T3JH,UKJournalofHousingFortheElderlyPublicationdetails,includinginstructionsforauthorsandsubscriptioninformation:~content=t792306896AginginPlaceorRelocation:PerceivedAwarenessofCommunity-BasedLong-TermCareandServicesFengyanTanga;JosephG.PickardbaSchoolofSocialWork,UniversityofPittsburgh,Pittsburgh,PennsylvaniabSchoolofSocialWork,UniversityofMissouri-SaintLouis,SaintLouis,MissouriOnlinePublicationDate:17November2008TocitethisArticleTang,FengyanandPickard,JosephG.(2008)'AginginPlaceorRelocation:PerceivedAwarenessofCommunity-BasedLong-TermCareandServices',JournalofHousingFortheElderly,22:4,404—422TolinktothisArticle:DOI:10.1080/02763890802458429URL:::PerceivedAwarenessofCommunity-BasedLong-TermCareandServicesFengyanTangJosephG.PickardABSTRACT.ThisstudyuseddatafromtheCommunityPartnershipforOlderAdultsProgramSurvey(N=4,611)toexamineassociationsbetweentheperceivedawarenessofcommunity-basedlong-termcareandsupportiveservicesandtheanticipationforaginginplaceandrelocation.Respondentsvariedsubstantiallyintheirknowledgeaboutservicesandanticipationforaginginplaceandrelocation.Perceivedavailabilityandunavailabilityofaseriesofcommunityserviceswasassociatedwiththelikelihoodofantici-patingaginginplaceandrelocation,andawarenessofthelackofvisitingnurses,personalassistance,ortransportationwasrelatedtorespondentsre-portingayoungerageatwhichtheyanticipatedneedinghelptoageinplaceoranticipatinganeedtorelocate.Findingshaveimplicationsforraisingthepublicawarenessofcommunity-basedservicesinaddressingtheneedsofcommunity-dwellingeldersforaginginplaceandrelocation.KEYWORDS.Aginginplace,relocation,community-basedservicesFengyanTangisaffiliatedwiththeSchoolofSocialWork,UniversityofPitts-burgh,Pittsburgh,Pennsylvania.JosephG.PickardisaffiliatedwiththeSchoolofSocialWork,UniversityofMissouri-SaintLouis,SaintLouis,Missouri.AddresscorrespondencetoFengyanTang,AssistantProfessor,SchoolofSocialWork,UniversityofPittsburgh,2217CCathedralofLearning,Pittsburgh,PA,USA(E-mail:[e-mail]).404JournalofHousingfortheElderly,Vol.22(4),2008C
2008byTheHaworthPress.Allrightsreserved.doi:10.1080/02763890802458429DownloadedBy:[UniversityofMichigan]At:18:2526February2009Tang&Pickard405INTRODUCTIONAmajorityofolderAmericansprefertoageinplaceandstayintheirownhome(AARP,2000)oratleastcontinuetoliveinthecommunityaslongaspossible(Burr,Mutchler,&Warren,2005).Recentpolicyandser-viceinitiativeshaveendeavoredtoaddressthedesirestoageinplaceandimprovethequalityoflifeamonganexpandingolderpopulation(Rowles,1993;Summer,2005).Onestrategyistoexpandhome-andcommunity-basedservicesbyimprovinglocalserviceinfrastructuresandcommunitypartnerships(Bolda,Saucier,Maddox,Wetle,&Lowe,2006).Theprovi-sionofavarietyofflexibleservicesunderinnovativedeliverysystemswillhelpmeetthechangingneedsofolderadultsandfacilitateaginginplace.Servicesrequiredbyolderadultsathomewithlong-termcareneedsincludein-homeserviceslikehomecare,homehealthservices,home-deliveredmeals,andhomeimprovementprogramsaswellascommunity-basedservicessuchasseniorcenters,adultdaycare,andtransportationprograms.Whenconfrontedwithahealthcrisis,olderadultsandtheirfam-ilycaregivershavetoconsideralternativeoptionssuchasassistedlivingornursinghomesiftheexistingcarearrangementnolongermeetstheirneeds(Nakashima,Chapin,Macmillan,&Zimmerman,2004).Infact,appropri-ateuseofin-homeandcommunity-basedserviceswasrelatedtodelayingnursinghomeplacement,reversingdeteriorationofphysicalfunctioning,andincreasingsurvival(Gaugler&Zarit,2001;McCannetal.,2005).Usingnationallongitudinaldata,Gaugleretal.(2005)documentedthatearlieruseofin-homeservicesbyfamilycaregiversofolderadultswithdementiapredictedadelayininstitutionalization.Burretal.(2005)foundthatolderunmarriedwomenwithfunctionallimitationsexperiencedareducedriskofinstitutionalizationwhenstatesincreasedspendingforhomeandcommunity-basedservices.Albert,Simone,Brassard,Stern,andMayeux(2005)foundthatMedicaidhomecareservice