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      Unmet needs in long-term care and their associated factors among the oldest old in China

      BMC Geriatrics

      BioMed Central

      Unmet needs, Long-term care, Oldest old, China

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          Abstract

          Background

          With a rapidly aging population and a decline in the availability of family caregivers, the number of elders in China who have unmet long-term care needs is increasing. Because unmet needs often have negative consequences, it is increasingly important to identify factors associated with unmet needs. Utilizing Andersen’s behavioral model of health services use, this study examines the roles of predisposing factors (demographics), enabling factors (resources), and need (e.g., illness level) in long-term care among the oldest old in China.

          Methods

          Data from three waves (2005, 2008, and 2011) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed. Four sequential, logistic regression models were designed to investigate how predisposing factors, enabling factors, and need were associated with unmet needs in long-term care.

          Results

          Logistic regression analyses reveal that the significant factors for both rural and urban residents were economic status, someone other than a family member as the primary caregiver, caregivers’ willingness to provide care, timely medication, self-rated health, and self-rated life satisfaction. Significant factors among only urban residents were age, a son/daughter-in-law as the primary caregiver, activities of daily living (ADL) disabilities expectation of access to community-based care services, and optimism. Significant factors among only rural residents were gender and cognitive function.

          Conclusions

          The risk of having unmet needs associated with ADL disabilities in long-term care is largely determined by the oldest old’s economic status and caregivers’ willingness to provide care for both rural and urban residents. Given that the availability of informal caregivers—mainly family members—is declining, it is crucial to provide financial assistance to the oldest old, to increase formal services such as paid home service and community-based care services, and to reduce family caregivers’ burden in order to reduce the unmet needs of the oldest old in China.

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          Most cited references 37

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          "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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            Revisiting the behavioral model and access to medical care: does it matter?

             John Andersen (1995)
            The Behavioral Model of Health Services Use was initially developed over 25 years ago. In the interim it has been subject to considerable application, reprobation, and alteration. I review its development and assess its continued relevance.
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              Gender differences in caregiving: fact or artifact?

              This study applies meta-analysis techniques to the results of 14 descriptive studies of gender differences in caregiving to determine the size and significance of gender differences in caregiving stressors (level of elder impairment and level and type of task involvement) and in caregiver burden. There were essentially no significant gender differences in functional impairment of the frail care recipient, total caregiver involvement in care, or in money management tasks. Female caregivers were more likely to carry out personal care and household tasks and more likely to report greater burden. Given the relatively small size of the effects found, we conclude that future research should focus on the part that gender-role explanations play in assigning meaning to caregiving behaviors.
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                Author and article information

                Affiliations
                Department of Sociology, Virginia Tech, 650 McBryde Hall (0137), 225 Stanger Street, Blacksburg, Virginia 24061 USA
                Contributors
                zhuh09@vt.edu
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                12 April 2015
                12 April 2015
                2015
                : 15
                45
                10.1186/s12877-015-0045-9
                4408585
                25880545
                © Zhu; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Geriatric medicine

                china, oldest old, long-term care, unmet needs

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