| Chapter 1: | Introduction |
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Most of the conditions asked about in the HRS are naturally correlated with age, but in themselves say nothing about one’s functional/health status so important to needing assistance that is not already captured in the other variables previously mentioned. If a medical condition results in need for assistance, it is through the bodily limitations it imposes. In fact, controlling for them would potentially mask a possible age effect. The presence of a psychological disorder is different from other conditions, however, in that it has historically been stigmatizing to be labeled with a psychological disorder—and this stigma may affect the availability of care. Because psychological disorders were more prevalent among younger cohorts, we controlled for them in all analyses.
Community-Based Care
Here, community-based care referred to any combination of the use of community-based services, including informal (unpaid) help from family and friends, as well as formal (paid) help. Institutionalization, rare among people in late middle age, was not considered in this study. Institutionalization refers specifically to living in a nursing home. The Health and Retirement Study (2000) provided the following definition of nursing home in its survey instrument: “A nursing home provides all of the following services for its residents: dispensing of medications, 24-hour nursing assistance and supervision, personal assistance, and room and meals” (p. 6, Coverscreen questionnaire). Respondents who lived in retirement or assisted living communities were considered to be living in the community; therefore, care provided by these residences was considered community-based care. We used other terms throughout the study to denote various aspects of community-based care, such as supports, formal and/or informal care/help, helping networks, and care networks.