| Chapter 1: | Introduction |
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We defined cohorts by age, that is, individuals born within the same span of years were considered to share a cohort. This concept refers best to what Elder described as “the interplay of human lives and historical times.” As he noted, for example, the historical impact of World War II was much different for individuals who had already entered adulthood in the 1940s compared with those who were infants at the time. Similarly, the demographic and family transitions that have occurred in the United States since then affected these two groups differently, as we discuss in chapter 2.
Functional Limitation
Any study involving the receipt of community-based care must begin with a definition of those who may need or receive this care. We focused on individuals who stated that they have difficulty performing one or more ADLs or IADLs, defined previously.
Referring to individuals in this study as having a functional limitation rather than a disability was intentional, particularly in light of the revised paradigm of functioning, disability, and health put forward by the World Health Organization (WHO) in 2001 in the International Classification of Functioning, Disability and Health (referred to here as ICF, and previously also as ICIDH). The ICF framework considers individual, social, and environmental factors in its conceptual framework of disability and health (World Health Organization [WHO], 2001). Its most recent iteration focuses on disability as a continuum that is present in everyone’s life, rather than as a state into which an individual either falls or does not. It combines both a medical and social model that focuses not only on individual behaviors and health maintenance but also on social and environmental factors that enable or hinder the desired end point of participation (WHO, 2001).