Health services utilization by community-dwelling dementia patients and their family caregivers

Abstract

In research as well as in the practice of home-living persons with dementia and their family caregivers, influencing the probability of institutionalization is considered an important characteristic of home care. Two presented studies implementing the behavioral model of Andersen provide information on predictors of utilization of care and support services, the utilization of nondrug therapies, and the utilization of health insurance and long-term care insurance benefits. Methods One study examined the awareness, utilization, need, and accessibility of ten specific services. It aims to clarify which of the three types of factors from the Andersen model is predictive of utilization (predisposing, enabling, and need factors). Binary-logistic regression analyses were conducted. The second study investigated the predictor of utilization in terms of mild or moderate dementia. Results Not all predisposing factors were as much conspicuous and for all services consistently predictive, as in case of the “need factor” (“need a service”). All types of services presented in the first study were used more often when the family caregiver subjectively believed he was in need of a service. In the second of our described studies, a factor in the evaluated need category (diagnosis of mild versus moderate dementia) was a significant predictor of the utilization of certain types of non-pharmacological treatments. The reasons for utilizing health insurance and long-term care insurance benefits were largely comparable between the two groups of diagnosis of mild versus moderate dementia. Conclusion To increase the utilization of care and support services, family caregivers should be made aware of the service or the available services; the advantages of using these services should be pointed out to them. Every family caregiver should be informed about the location and accessibility of the nearest support services that are not provided at the patient’s home.