Adverse Consequences of Unmet Needs for Care in High Need/High Cost Older Adults.
Objectives We explore adverse consequences of unmet needs for care among high need/high cost (HNHC) older adults. Method Interviews with 4,024 community dwelling older adults with ADL/IADL/mobility disabilities from the 2011 National Health and Aging Trends Study (NHATS) Reports of socio demographics, disability compensatory strategies, and adverse consequences of unmet needs in the past month were obtained from older adults with multiple chronic conditions (MCC) probable dementia (DEM) and/or near end of life (EOL) and compared older adults not meeting these criteria. Results Older adults with MCC (31.6% DEM (39.6% and EOL (48.7% reported significantly more adverse consequences than low need older adults (21.4% Persons with MCC DEM (53.4% MCC EOL (53.2% and all three (MCC, DEM, EOL, 65.6% reported the highest levels of adverse consequences. HNHC participants reported more environmental modifications, assistive device, and larger helper networks. HNHC status independently predicted greater adverse consequences after controlling for disability compensatory strategies in multivariate models. Discussion Adverse consequences of unmet needs for care are prevalent among HNHC older adults, especially those with multiple indicators, despite more disability related compensatory efforts and larger helper networks. Helping caregivers provide better informal care has potential to contain healthcare costs by reducing hospitalization and unplanned readmissions.
The journals of gerontology. Series B, Psychological sciences and social sciences