Caregivers to the elderly with dementia: Informal care provided, employment choices, and formal care arranged

This study examined the determinants of hours of informal care provided, employment choices, and formal-care service use among caregivers to the elderly with dementia. Secondary objectives of the study were to examine the associations between policy variables and the study outcomes as well as to examine the economic relationships among various care services for this population. Two variables served as proxies for price and are of policy interest: the care recipient's Medicaid status and the geographic availability of formal-care services. The economic relationships among informal care and various formal-care services were determined by examining the price coefficients in derived-demand equations for the care services.; Derived-demand equations were estimated for hours of informal care provided per week, the caregiver's employment status, and the use of community service centers, skilled in-home services, unskilled in-home services, and any of the three services. The study was cross-sectional and caregivers to the elderly with dementia were the units of analysis. Data from the Memory and Medical Care Study (MMCS), a cohort study of community-dwelling elderly with dementia and their informal caregivers, were employed in the analysis.; Results from the derived-demand equations suggest that the caregiver's age and health status are important determinants of hours of informal care provided and the caregiver's employment status; the caregiver's education level predicts her employment status only. The care recipient's race, gender, and physical and mental health status are also significant determinants of the caregiver's time allocation decisions with respect to informal care and market work. The care recipient's race and physical health status are the most important determinants of the use of formal-care services. However, while the care recipient's physical functioning is positively associated with the use of community service centers, it is negatively associated with the use of skilled and unskilled in-home services. Caregivers to care recipients who are married and in higher income groups are significantly more likely to be using community service centers. Marital status and income do not predict the other study outcomes. Finally, living arrangement is strongly predictive of all study outcomes except for the caregiver's work status.; With respect to the policy variables, the care recipient's Medicaid status is not associated with any of the care or employment outcomes, and the availability of community service centers and the availability in-home services affect the work choice only. (Abstract shortened by UMI.)...