Li Lydia W
School of Social Work, University of Michigan, 1080 S. University, Ann Arbor, MI 48109-1106, USA.
Gerontologist. 2005 Aug;45(4):465-73. doi: 10.1093/geront/45.4.465.
This study examined how the amount of informal care received by disabled elders changes when they are receiving publicly paid home care, and whether formal service use, disability, caregiving arrangements, and demographic characteristics of older adults predict changes in the amount of informal care.
Hierarchical linear models were estimated, using 3-year data (12 repeated observations) collected from elderly participants (N = 888) in Michigan's Home- and Community-Based Medicaid Waiver Program.
The amount of informal care declined in the beginning period when publicly paid home care was received, and then it stabilized. Changes in activities and instrumental activities of daily living and caregiver residence predicted changes in the amount. The living arrangement and age of elders predicted different patterns of change over time. Neither formal service amount nor its change significantly predicted the amount of informal care.
Informal caregivers do not relinquish caregiving when publicly paid home care is available. Expanding community-based long-term care is a means of fostering partnerships between formal and informal caregivers.
本研究探讨了残疾老年人在接受公共支付的家庭护理时所接受的非正式护理量如何变化，以及老年人的正式服务使用情况、残疾状况、护理安排和人口统计学特征是否能预测非正式护理量的变化。
采用分层线性模型，使用从密歇根州基于家庭和社区的医疗补助豁免计划中的老年参与者（N = 888）收集的3年数据（12次重复观察）。
在开始接受公共支付的家庭护理时，非正式护理量下降，然后趋于稳定。日常生活活动和工具性日常生活活动的变化以及照顾者的居住情况可预测护理量的变化。老年人的居住安排和年龄可预测随时间变化的不同模式。正式服务量及其变化均未显著预测非正式护理量。
当有公共支付的家庭护理时，非正式照顾者不会放弃护理工作。扩大基于社区的长期护理是促进正式和非正式照顾者之间合作关系的一种方式。
