Caring for the Disabled Elderly: Who Will Pay?

By Alice M. Rivlin; Joshua M. Wiener et al. | Go to book overview
Save to active project

Chapter Fourteen
Expanded Home Care

Most disabled elderly are at home and want to stay there. Home care services, such as home health care, homemaker help, personal care, meals-on-wheels, respite care, and adult day care, enable them to do so. Only a small minority of the chronically disabled elderly, however, receive any paid home care services. In 1982 only 25 percent of the 4.65 million disabled elderly living at home used any paid in-home care. 1 Public expenditures for long-term care are overwhelmingly for nursing home rather than home care. Less than 5 percent of medicaid long- term care expenditures for the elderly in 1984 went for home care. 2 An obvious approach to reforming long-term care is to increase public finding for home care.

Supporters often justify expanded home care services by arguing that these will substitute for nursing home care and thus actually reduce public long-term care expenditures. Evaluations of community care programs, however, tend to show not only that expansion of community care has little effect on nursing home use, but that it raises, rather than lowers, total expenditures. 3 One reason for the cost increase is that the expanded home care goes primarily to people who were not receiving paid services. Another is that home care services do not keep disabled people out of nursing homes. They are almost always a complement to, not a substitute for, nursing home care in the overall system of long-term care.

Saving public money may be the most popular way to justify an expansion of home care, but there are other reasons to expand home care. One is that the elderly strongly prefer home care and that their demands for that care are unmet. Others are to establish a more

-190-

Notes for this page

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this page

Cited page

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited page

Bookmark this page
Caring for the Disabled Elderly: Who Will Pay?
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this book

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen
/ 318

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?