Social Ties and Community Service Utilization Among Alzheimer's Caregivers
Methods: The study was conducted using baseline data from the NIH-funded Resources for Enhancing Alzheimer’s Caregivers Health (REACH) II project (n=670) which studied the different risk factors and interventions for AC’s health and well-being. The dependent variable for the study is the level of community service utilization by the AC. AC’s social ties include size of social network and quality of social support. Size of social network was measured by the number of relatives, friends, and neighbors that AC see or hear, feel close to, and can call on for help. To address the skewness, two equal-sized groups were created. Quality of social support was measured in three domains (instrumental, informational, and emotional) and two indicators (frequency and satisfaction). SPSS was used to conduct bivariate and multivariate logistic regression. All significance tests were two-tailed, p<.05.
Results: Quality of social support and size of social network are both important factors in predicting community service utilization. Specifically, after controlling social demographic factors, people who receive emotional support "once in a while" are more likely to have higher level of community service utilization than people who receive no emotional support. People who have larger social networks of relatives, friends, and neighbors are more likely to use community service than people who have smaller social networks.
Conclusions and Implications: The findings that social ties contribute to the utilization of community services among AC suggest that social policies and programs should aim to target the more under-utilizing groups by strategizing to reach AC’s social networks. Especially, as different social support domains are related to AC’s service use, social work practitioners should identify and explore the diverse sources and degrees of AC’s social support. Further research is needed to explain the complexity of the effects of social ties on service utilization. Such knowledge will help design policies and programs to better meet the needs of AC, who are the backbone of the long term care system.