This project examines informal and formal help to impaired elderly and the use of formal services by their primary caregivers, with special attention to their use of community-based mental health services.
Its aims are: 1) to predict the broad range of services used by the elderly and their caregivers; 2) to predict the different combinations of primary caregivers, other informal helpers and formal helpers with care tasks: 3) to identify black-white differences in the predictors of service use and combin-ations of helpers; and 4) to determine the effects of the elderly cognitive status on service use and the combination of helpers. The study uses a unique conceptual framework derived from the widely applied Anderson model of service use, but broadened to include enabling, predisposing and need characteristics of both older persons and primary caregivers as predictor variables. The framework also includes a more comprehensive concep-tualization of assistance use by linking the range of care tasks with which informal caregivers help to the types of community-based services used by older persons. The study's long-term goal is to use these features to bring together two ares of research, one on service utilization by the aged and the other on family caregiving, by encompassing both under the rubric of assist-ance from informal and formal helpers The study is also distinguished by its inclusion of extended kin and non-kin as primary caregivers and its attention to informal caregivers' use of services, such as counseling, support groups and respite. The study design is a cross-sectional survey using in-person interviews with 500 dyads comprised of clients who receive case management and other services from nonprofit, multiservice agencies and their primary caregivers. Various statistical techniques will be used to estimate the additive and multiplicative effects of predictors on study outcomes and to examine measurement models. These include: multiple and logistic regression, discriminant analysis, exploratory factor analysis, and LISREL analysis.
