Background: Although a 'person-centred focus' is a legislated objective for both aged-care and disability services sectors in Australia, evidence suggests limited translation into systems and practices due to entrenched silos. This paper proposes a Best Practice Framework to mitigate these silos. Methods: Mixed-methods research comprising key…

Objective: To construct a needs assessment instrument for older people using a standardized terminology (International classification of functioning, disability, and health [ICF]) and assess its psychometrical properties. Method: An instrument was developed comprising questions to older people regarding their perceived care needs. The instrument's…

Purpose: To assess the predictive validity of frailty and its domains (physical, psychological, and social), as measured by the Tilburg Frailty Indicator (TFI), for the adverse outcomes disability, health care utilization, and quality of life. Design and Methods: The predictive validity of the TFI was tested in a representative sample of 484…

The purpose of this study was to develop appropriate somatosensory video game interventions on enhancing selective attention of institutional-dwelling elderly with disabilities. Fifty-eight participants aged 65[approximately]92 were recruited and divided into four groups, 4-week and 8-week experimental and two control groups, for evaluating the…

Purpose: When government funding for long-term care is reduced, participant outcomes may be adversely affected. We investigated the effect of program resources on individuals enrolled in the Michigan Home- and Community-Based Services (HCBS) waiver program for elderly and disabled adults. Design and Methods: Using dates of major policy and budget…

Purpose: To report the impact on patient and informal caregiver satisfaction, patient empowerment, and health and disability status of a primary care-affiliated disease self-management-health promotion nurse intervention for Medicare beneficiaries with disabilities and recent significant health services use. Design and Methods: The Medicare…

In this article, the author presents a historical overview of four decades of scholarship and changing public policy on family and informal caregiving for older adults. Families are changing at a dizzying pace. Changes in family composition, cultural diversity, geographic mobility, and societal norms, coupled with increasing numbers of older…

Context: Years lived with and without physical impairment are central measures of public health. Purpose: We sought to determine whether these measures differed between rural and urban residents who were impaired at the time of a baseline measurement. We examined 16 subgroups defined by rural/urban residence, gender, race, and education. Methods:…

Purpose: 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. Design and Methods: Hierarchical…

Purpose: The purpose of this study was to examine racial/ethnic differences in the relationship between functional disability and the use of health care services in a nationally representative sample of older adults by using the Andersen behavioral model of health services utilization. Design and Methods: The study used 12 years of longitudinal…

Purpose: Family caregivers comprise the backbone of long-term-care provision in the United States, yet little is known about how the composition and experience of family caregiving has changed over time. Design and Methods: Data are drawn from the 1989 and 1999 National Long-Term Care Survey and Informal Caregiver Survey to develop nationally…

Research has found that approximately 80 percent of the care received by elderly people living at home is provided by family members. Although assistance provided by informal supports can be important in sustaining the functionally disabled elderly at home, caregiving can have important negative effects on the informal providers. To examine the…

An analysis of data from the National Health Interview Survey shows consistent and substantial improvements in the relative health of the aged from 1961-81. Explanations for this trend include cohort effects, Medicare and Medicaid, and other programs for the aged. Increasing health service needs should be partially offset by this trend.…

Objective: Despite past findings about the contribution of home care services to older users' functional ability, the effective processes and components of the services are not transparent. Such processes appear to rely on the actual use of component services of the home care program. Method: The study gathered 116 observations during 2 years…

The complex formed by chronic illness, episodes of acute illness, physiological disabilities, functional limitations, and cognitive problems is prevalent among frail elderly persons. These individuals rely on assistance from social and health care programs, which in Canada are still fragmented. SIPA is an integrated service model based on…