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CHANGES IN FORMAL-INFORMAL CAREGIVING OF ELDERLY STROKE SURVIVORS Dissertation Defense 5-18-07. Holly Beard, PhD candidate Health Services Research Old Dominion University College of Health Sciences Supported by: ODU Graduate Fellowship. Dissertation Committee: Chair: James Alan Neff, PhD
Holly Beard, PhD candidate
Health Services Research
Old Dominion University
College of Health Sciences
Supported by: ODU Graduate Fellowship
Chair: James Alan Neff, PhD
Stacey B. Plichta, ScD
Karen Karlowicz, EdD
Bonnie K. Lind, PhD
cross-sectional differences and changes in the caregiving source between formal and informal caregiving among stroke survivors over a six-year period.
1) What is the pattern of formal and informal caregiving among elderly stroke survivors over a six-year period?
2) To what extent does the Andersen-Aday Model (predisposing, enabling, and need variables) explain the receipt of formal and informal caregiving both cross-sectionally and longitudinally?
3) Are there differences between non-Hispanic Whites and minorities (African Americans and Hispanics) in terms of the specific Andersen-Aday model domains (predisposing, enabling, and need) that influence utilization of formal and informal caregiving?
477 respondents reported having a stroke
Several respondents had multiple strokes during the three waves
18.2% of stroke survivors had more than one stroke during the study period
3 waves of the Health and retirement study/assets and health dynamics among the oldest old study spanning 1998 through 2002
National area probability sample (Census)
African Americans, Hispanics, and Florida residents were over sampled
Health Care Financing Administration (HCFA) Enrollment Data Base (EDB) fileMethodologySample
1998 and 2002
Reference Category = Informal Only
Poor w/ Medicaid (5.2)
Has Resident Children (.05)
Poor w/ Medicaid (3.3)
Has Resident Children (.122)
Has Resident Children (.057)
African American (.114)
Has Resident Children (.064)
Reference Category=Informal Only
Stroke survivors rely on informal caregiving
The rehabilitation period presents a serviceable opportunity to provide caregiving support services to make better choices for the stroke survivor that requires long-term care
Ultimately the question is not what type of care is used, but how will the cost of care be distributed and in the long run how can the federal government in partnership with the states and individuals plan for this type of care while creating a sustainable system.Policy Implications