303P
Effect of Community-Dwelling Older Adults' Personal Characteristics and Engagement with Case Management Services on Supported Independent Living
Background and Purpose: Average life span is expected to increase an additional ten years by 2050. A projected consequence of increased longevity is increased prevalence of older adults with functional impairment, defined as difficulty in handling one or more activities of daily living (ADLs) or instrumental activities of daily living (IADLs). Currently, 35% of U.S. adults 65 and older have some form of functional impairment. Social workers play an important role in helping functionally-impaired older adults remain independently in the community through provision of case management, the coordination of community-based health and social services. Little is known about client satisfaction with case management services or the predictors of successful outcomes of case management for functionally-impaired, community-dwelling older adults. This study examines older adult case management service recipients’ personal characteristics and engagement with case management services as predictors of whether service recipients perceive home and community-based services as supporting their efforts to live independently.
Methods: Data for this study were taken from the Case Management sub-section of the 2012 Administration on Aging National Participant Survey, an annual survey of service quality, consumer-reported outcomes, and special needs characteristics of a stratified sample of recipients of home and community-based services of Area Agencies on Aging (n=530). Using step-wise, logistic regression techniques, the dependent variable, whether service recipients did or did not perceive services received as supporting their efforts to live independently, was regressed on demographic variables (age, gender, race, income, educational level, and whether the service recipient lived alone), physical and mental health, number of ADLs and IADLs requiring assistance, number of home and community-based services received, and satisfaction with case management services.
Results: The regression model was statistically significant. Individuals who lived with others (O.R. = 4.847), had a smaller number of IADL needs (O.R. = .734), received a greater number of home and community-based services (O.R. = 1.278) and had greater satisfaction with case management services (O.R. = 1.701) were more likely to be correctly classified as perceiving the services received as supporting independent living.
Conclusions and Implications: Most demographic variables, and health and mental health status, may not be important predictors of supported independent living. However, older adults who live alone and who have greater numbers of IADL needs appear to experience the services they receiving as not supporting independent living, perhaps indicating that the services received are insufficient. On the other hand, the effectiveness of case management services, in terms of the number of home and community-based services to which recipients are linked and the level of recipient satisfaction with case management services, appear to play an important role in supported independent living. In a time of fiscal constraints and increasing need for services for older adults, social workers need to understand the factors related to the effectiveness of case management, and provide empirical evidence of the impact of case management services in helping older adults live independently in the community.