COMPENSATION FOR ADL LIMITATIONS IN OLDER ADULTS

这项拟议的研究将审查各州的长期护理政策和 当地社区的社会和卫生资源因素以及 个人的属性与使用补偿相关联 非制度化成年人的日常生活能力(ADL) 在美国，年龄在70岁及以上。个人援助(正式和 非正式帮手)和设备援助是两大战略 用于补偿活动限制，通常 老年人有过这种经历。以往关于补偿使用的研究 几乎只研究了个人层面的决定因素， 对宏观层面的社区因素重视不够。我们最重要的是 假设是各州对以社区为基础的家庭护理和 地方社区的社会和保健因素，除了 老年人的易感、使能和需要因素及其影响(1) 在有活动的人中使用非正式和正式的个人援助 限制，(2)在有以下情况的人中使用个人设备援助 行动困难，以及(3)日常生活中未得到满足的援助需求 活动。使用多层次分析框架，我们将 《资产与健康动态》中的个人调查数据 最古老的旧(前方)调查，第一波，与州和地方社区- 来自多个来源的水平数据，包括人口普查、区域资源 文件，联邦和州政府：统计数据和其他适当的 数据。地理编码的居住地点仅在受限制的 Ahead DAT将提供一个独特的机会来分析链接的宏观 级别和个人级别的数据。我们对与以下因素相关的发现 多个薪酬策略将有助于预测在 未来和发展中的长期护理政策。此外， 从这项研究中获得的实质性和方法性知识 将为未来的研究提供一个基础，以检查 老龄化与健康研究中的宏观和微观现象。

The proposed study will examine how states' long-term care policy and local communities' societal and health resource factors as well as individuals' attributes are associated with use of compensation for activities of daily living (ADL's) among non-institutionalized adults aged 70 and older in the United States. Personal assistance (formal and informal helpers) and equipment assistance are the two major strategies used to compensate for activity limitations that are, commonly experienced by older adults. Previous studies on use of compensation have almost exclusively examined individual-level determinants, paying little attention to macro-level community factors. Our overarching hypothesis is that states' commitment to community-based home care and local communities' societal and health-care factors, in addition to older adults' predisposing, enabling and needs factors, influence (1) use of informal and formal personal assistance among those with activity limitations, (2) use of personal equipment assistance among those with mobility difficulties, and (3) unmet need for assistance with daily activities. Using a multi-level analysis framework, we will link individual-level survey data from the Assets and Health Dynamics among the Oldest Old (AHEAD) survey, Wave I, with state-and local community- level data from multiple sources including the Census, the Area Resource File, federal and state governmental: statistics and other appropriate data. The geocoded place of residence available only in the restricted AHEAD dat will provide a unique opportunity to analyze linked macro- level and individual-level data. Our findings on factors related to multiple compensation strategies will be useful for predicting use in the future and developing long-term care policy. Furthermore, substantive and methodological knowledge to be obtained from this study will provide a basis for future studies to examine linkages between macro-level and micro-level phenomena in the study of aging and health.