Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purposes. Due to the aging of baby boomers, the rapid growth of the oldest-old population, and its great potential of aging into disability, there will be a dramatic increase in the demand for community-based long-term care in the near future. However, with the shortfall of public funding and the devolution of long-term care from federal level to state, county, and community, it is very likely that long-term care and supportive services for older adults will be provided through collaborative organizational partnerships at local levels.

Methods. Using the data from Community Partnership for Older Adults Program Survey (CPOA), this study examines the availability of long-term care, home-based, and community-based supportive services and their associations with the expectations for aging in place. CPOA is an initiative of the Robert Wood Johnson Foundation aimed at promoting improvement in the community partnerships for organization and delivery of long-term care services. The survey interviewed a representative sample of older adults aged 50 and older in 13 communities (N=5,298). Multivariate analyses were used to test the associations between availability of community-based services and the expectation for aging in place.

Results. More than half of older adults were aware of the availability of various kinds of services; for example, 51% were aware of telephone helpline and 88% of nursing home. However, very few have ever used these services; 2% used assisted living and 18% visiting nurse. As to planning for aging in place, about 86% of older respondents expected to be living in the community in next five years. About 38% thought they would need regular help to remain living on their own until aged 80 and above. The availability of community-based services (i.e., senior center, adult day program, telephone helpline, senior lunch program, and transportation) was significantly related to the ‘aging in place' planning. Community-based services help elders remain living on their own for a longer period and move out of their current homes until very late in life. In contrast, home-based services (i.e., housekeeping, home repair assistance, visiting nurse, and personal assistance) and long-term care (i.e., nursing home, assisted living facility, and hospice care) were not significantly related to the ‘aging in place' planning.

Implications. Social workers need address the issues about how to raise the public awareness of community-based care services and improve the effective use of these services. Also older adults need help from long-term care providers and senior service organizations in their planning for aging in the community. Further research is needed to find out how to expand the role of home-based and long-term care services in older adults' living in the community.