Use of In-Home Care by Very Old People

This paper addresses three questions related to the use of in-home care by persons 75 years of age or older: (1) Is there a hierarchy or dimensionality to types of care received in the home? (2) Can the number of in-home services received be explained by the background characteristics, the mental or physical status, or the level of functional impairment of the individual? (3) What factors distinguish users of formal services from those who rely exclusively upon informal sources? Findings indicate that service use by very old community residents follows a pattern reflecting a hierarchy of need. Four characteristics-better education, more social resources, worse mental health, and worse functional status-account for a large portion of the variance in number of services used. Use of formal services is more likely among persons who are better educated, live in urban areas, are in better condition regarding instrumental activities of daily living (ADL) and have more physical ADL problems.