Inequality in housing transitions during cognitive decline.
Inequality in housing transitions during cognitive decline.
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DOI：
10.1371/journal.pone.0282329
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
独立生活对于认知能力下降的人来说可能会变得具有挑战性。随着功能下降和更大的护理需求，许多痴呆症患者（PWD）可能需要搬到另一个具有更好安全功能的家中，搬到离可以提供护理的亲属更近或与他们住在一起，或者进入养老院。住房在支持残疾人及其照顾者的生活质量方面发挥着关键作用，因此在需要时移动的能力对他们的福祉至关重要。然而，搬迁、住房和护理的巨大成本意味着经济资源有限的残疾人可能无法负担搬迁，加剧了更多和更少残疾人之间的不平等。新兴的定性研究考虑了残疾人及其照顾者的住房选择，但在更广泛的范围内，对残疾人在认知下降过程中实际进行的住房过渡知之甚少。之前的定量研究主要集中在养老院的招生;问题仍然是PWD搬到另一个家或与亲戚住在一起的频率。这项研究调查了美国残疾人住房过渡时间和类型的社会经济和种族/民族差异，使用2002年至2016年的健康和退休研究数据。我们发现，超过一半的PWD在痴呆症发作的几年内移动（28%移动一次，28%移动两次或更多次），而44%保持不变。检查各种类型的搬家，35%的人搬到另一个家，32%的人搬进疗养院，11%的人搬到亲戚家。我们发现受教育程度和种族/民族的差异：更多的残疾人更有可能搬到另一个家，更有可能进入养老院比不太容易的群体。这凸显了为残疾人士及其家庭提供支持的重要性，以适应他们住房需求的变化，过渡到不同的生活安排。
Independent living can become challenging for people experiencing cognitive decline. With reduced functioning and greater care needs, many people with dementia (PWD) may need to move to another home with better safety features, move to live closer to or with relatives who can provide care, or enter a nursing home. Housing plays a key role in supporting quality of life for both PWD and their caregivers, so the ability to move when needed is crucial for their well-being. Yet the substantial costs of moving, housing, and care mean that PWD with limited financial resources may be unable to afford moving, exacerbating inequalities between more and less advantaged PWD. Emerging qualitative research considers the housing choices of PWD and their caregivers, yet little is known on a broader scale about the housing transitions PWD actually make over the course of cognitive decline. Prior quantitative research focuses specifically on nursing home admissions; questions remain about how often PWD move to another home or move in with relatives. This study investigates socioeconomic and racial/ethnic disparities in the timing and type of housing transitions among PWD in the United States, using Health and Retirement study data from 2002 through 2016. We find that over half of PWD move in the years around dementia onset (28% move once, and 28% move twice or more) while 44% remain in place. Examining various types of moves, 35% move to another home, 32% move into nursing homes, and 11% move in with relatives. We find disparities by educational attainment and race/ethnicity: more advantaged PWD are more likely to move to another home and more likely to enter a nursing home than less advantaged groups. This highlights the importance of providing support for PWD and their families to transition into different living arrangements as their housing needs change.
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