Early community-based service utilization and its effects on institutionalization in dementia caregiving

Gerontologist. 2005 Apr;45(2):177-85. doi: 10.1093/geront/45.2.177.


Purpose: The present study attempts to determine whether utilizing community-based long-term-care services early in the dementia caregiving career delays time to nursing home placement (adjusting for severity of dementia).

Design and methods: With a reliance on data from 4,761 dementia caregivers recruited from eight catchment areas in the United States and followed over a 3-year period, a Cox proportional hazards model was conducted that considered key components of the stress process (e.g., context of care, primary objective and subjective stressors, and resources), duration, and community-based long-term-care use.

Results: An analysis of interaction terms in the Cox regression model found that those individuals who utilized in-home help services earlier in their dementia caregiving careers were more likely to delay institutionalization.

Implications: The findings suggest the practical importance and cost-effectiveness implications of early community-based service use, and they emphasize the role of timing when one is conceptualizing the proliferation of stress in the dementia caregiving career.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Catchment Area, Health
  • Community Health Services / statistics & numerical data*
  • Dementia / nursing*
  • Female
  • Humans
  • Institutionalization*
  • Long-Term Care / statistics & numerical data
  • Male
  • United States