| Recent research of the type of assistance elders use for activities of daily living (ADLs) has suggested that the type of assistance used (assistive devices only, personal assistance only or combination assistance) may depend upon the characteristics of the task, the device, the person and his environment. While previous studies have focused on the type of assistance used for ADLs in general, this study analyzes the type of assistance used for each of the specific ADLs of bathing, dressing, toileting and walking. Each task and its assistive devices are analyzed examining their demands and specific characteristics. In addition, the influence of personal, social and physical factors on the use of assistance and the type of assistance use are conceptualized for each task. An assistance choice model was estimated for each ADL using the complete sample of elders in the SOA II, 1994 & 1995, those with and without reported difficulty in the specific ADL. Results supported the premise that different factors affect the type of assistance used for specific ADLs. Elders who live alone use the assistive device only strategy for each of the ADLs suggesting they are substituting the use of assistive devices for human assistance. Elders with supplemental insurance used the assistive device only strategy for bathing, toileting and walking suggesting coverage of this equipment by supplemental insurance. Elders with lower levels of yearly income use personal assistance or combination assistance for bathing and dressing, suggesting an inability to purchase assistive devices and/or the availability of assistance from family members. In these cases, assistive device use appears to be supplementing the work of the caregiver. Policy implications are discussed supporting the role of community-based programs in providing education about and accessibility to assistive devices. Also discussed is the role of occupational therapists as consultants to community-based programs, including the Area Agencies on Aging, to provide needed education to staff, community-dwelling elders and family caregivers. |
