This research has one major and two secondary goals. First, in the major goal, we examine through a longitudinal study how caregivers' mental, functional, and social health states, as well as their relationship to medicare-eligible patients, influence their level of involvement in caregiving and the burdens they perceive to be associated with that caregiving. We examine how caregivers' health states, involvement in caregiving and perceived burden associated with it are related to their patients' utilization of health services and rates of institutionalization in nursing homes. This prospective study will screen patients and caregivers on home health agency caseloads; it will identify clusters of patients and caregivers who are likely to vary on measures of burden and involvement due to the patients' levels of mental, physical and social functioning. Three hundred patient-caregiver dyads will be selected by sampling proportionally from the clusters and admitted to the study. Patients' and caregivers' mental, physical and social functioning and caregivers' involvement and perceived burden will be measured at intake, six and twelve months. As a result of this research we will be able to do the following: Describe how the number and severity of patients' functional, mental and social limitations are related to caregivers' involvement in caregiving and their perceptions of the burden that this care imposes upon them. Describe, over time, the interrelationships between patients' functional, mental and social limitations and caregivers' health states, their involvement in caregiving and their perceived burden. Describe, over time, how patients' functional, social and mental limitations, and caregivers' health states and their involvement in providing care and their perceptions of the burden of care predict the utilization of health services by patients and caregivers and the institutionalization of the patients.
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