An emphasis upon quality has broadened perspectives on conceptualizing and measuring health statu... more An emphasis upon quality has broadened perspectives on conceptualizing and measuring health status. The initial term used by many REVES investigators 'disability-free life expectancy' (DFLE) clearly implied that disability was a key concept, but precisely how it should be measured has been widely debated. The WHO International Classification of Impairments, Disabilities and Handicaps (WHO, 1980) and the efforts of the US National Academy of Sciences have offered relatively little help in clarifying the issue. Increasingly, it has been accepted that there is no 'gold standard', but rather that multiple indicators contribute to measuring the quality or, more commonly, the poor quality of remaining years (e.g. presence of disease; physical handicaps; subjective evaluations of ability, capacity and performance; actual performance; needs for assistance; mental states). Each approach is meritorious and contributes to capturing the multidimensionality of health, but because of its widespread use in surveys and other collection procedures, the presence and number of self-reported limitations in the activities of daily living (ADL) has come to be a widely used metric for assessing disability.
The older population in the US has grown twice as fast as the rest of the population in the last ... more The older population in the US has grown twice as fast as the rest of the population in the last 20 years. This growth is expected to accelerate early in the next century as the large baby boom cohorts move through middle age and become elderly. Today, about 1 in 8 Americans is 65 years of age or older. By 2030, 1 out of every 4 persons will be in older person. Substantial improvements in life expectancy at all ages, particularly at extreme old age, mean that not only will there be a greater proportion of elderly in the population, but the more will be the "oldest-old," over 85. By 2050, they will be more than 1/4 of the population. As people live longer, many are active and healthy well past retirement. However, many individuals living into their 80s have to cope with chronic disabilities affecting their capacity to perform day-to-day activities. Modern medicine has made great inroads against mortality from such illnesses as heart disease and stroke, but has not eliminate...
Assistive technology has become increasingly important in facilitating independence among older A... more Assistive technology has become increasingly important in facilitating independence among older Americans. It remains unclear, however, whether this trend has been experienced broadly. Using the 1992 to 2001 Medicare Current Beneficiary Survey, we provide evidence that among older people who have difficulty with daily activities, there were substantial increases in the independent use of assistive technology (without help from another person). Controlling for shifts in the composition of the older population reporting difficulty with daily activities, the independent use of assistive technology increased on average 4% to 5% per year, amounting to a 6 percentage point increase over the entire period. These increases were accompanied by declines in the use of any help and in unassisted difficulty, with larger declines in the latter. Substantial differentials in assistance-which favor the more highly educated in the case of technology and favor minorities in the case of help-persisted over this period. All else equal, 5-percentage point gaps were evident between more and less advantaged education groups with respect to the independent use of assistive technology for walking. Gaps in the independent use of assistive technology to bathe were even larger, amounting to 7 to 8 percentage points in 2001 by education and race. We discuss the implications of findings for the study of latelife disability trends and disparities therein. Hartke, R.J., T.R. Prohaska, and S.E. Furner. 1998. Older adults and assistive devices: Use, multiple-device use and need. Journal of Aging and Health 10(1): 99-116. Kemper, P. 1992. The use of formal and informal care by the disabled elder. Health Services Research 27(4):421-451. Kington R.S. and J.P. Smith. 1997. Socioeconomic status and racial and ethnic differences in functional status associated with chronic diseases. American Journal of Public Health. 87(5):805-10.
Promoting independence through increased use of assistive technology has been a goal of federal p... more Promoting independence through increased use of assistive technology has been a goal of federal programs and policies, beginning with the passage of the Americans with Disabilities Act over a decade ago, and continuing with the 1998 Assistive Technology Act, and ...
... SEPAM / IBV: An expert system for assisted prescription of technical aids for mobility. ... A... more ... SEPAM / IBV: An expert system for assisted prescription of technical aids for mobility. ... An expertsystem (SEPAM/IBV) has been created, aimed at making prescrip-tion and subsequent selection of technical aids for mobility more reliable and procedural. ...
Purpose. To examine differences in reports of residual disability and unmet need by type of care ... more Purpose. To examine differences in reports of residual disability and unmet need by type of care arrangement (assistive technology and/or personal care) amongst disabled adults.
A large research literature has emerged on resource transfers between adult children and their ag... more A large research literature has emerged on resource transfers between adult children and their aging parents, and the potential effects of declining fertility rates, increasing migration and female labor force participation rates, and rising affluence on the nature and direction of these flows ). The parent-child relationship is certainly unique among kin ties, and carries with it particularly strong normative obligations for mutual support. However, resource transfers in families occur in a wide range of circumstances, and can involve a variety of other kin (e.g., Cox and Jimenez 1998). Motivations for the involvement of a broader network in family transfers are especially strong in environments where state or market based alternatives for economic support (e.g., social security systems, private pensions, or formal credit markets) or social and health support (e.g., child care providers or home health care agencies) are not available or accessible. This study focuses on these larger kin networks in order to better understand the nature of family exchange.
This study draws on social network measures to describe complex flows of resources between older ... more This study draws on social network measures to describe complex flows of resources between older parents and their adult children. Using data from the 1989 Taiwan Survey of Health and Living Status of the Elderly and the 1996 Philippine Elderly Survey, we find that more than 80 percent of older Taiwanese and more than 97 percent of Filipino elderly are actively engaged in transfers with their children, yet few older persons are engaged in all of the possible transfer activity with children. Redistributive transfer patterns, where older parents receive resources from one or more children and then give resources to another child, characterize about 10 percent of older parent networks in Taiwan and 64 percent in the Philippines. In the majority of these cases, the older parents are involved in more than one redistributive flow with children. Most of these redistributive flows take place across household boundaries rather than exclusively within or outside of the household.
An emphasis upon quality has broadened perspectives on conceptualizing and measuring health statu... more An emphasis upon quality has broadened perspectives on conceptualizing and measuring health status. The initial term used by many REVES investigators 'disability-free life expectancy' (DFLE) clearly implied that disability was a key concept, but precisely how it should be measured has been widely debated. The WHO International Classification of Impairments, Disabilities and Handicaps (WHO, 1980) and the efforts of the US National Academy of Sciences have offered relatively little help in clarifying the issue. Increasingly, it has been accepted that there is no 'gold standard', but rather that multiple indicators contribute to measuring the quality or, more commonly, the poor quality of remaining years (e.g. presence of disease; physical handicaps; subjective evaluations of ability, capacity and performance; actual performance; needs for assistance; mental states). Each approach is meritorious and contributes to capturing the multidimensionality of health, but because of its widespread use in surveys and other collection procedures, the presence and number of self-reported limitations in the activities of daily living (ADL) has come to be a widely used metric for assessing disability.
The older population in the US has grown twice as fast as the rest of the population in the last ... more The older population in the US has grown twice as fast as the rest of the population in the last 20 years. This growth is expected to accelerate early in the next century as the large baby boom cohorts move through middle age and become elderly. Today, about 1 in 8 Americans is 65 years of age or older. By 2030, 1 out of every 4 persons will be in older person. Substantial improvements in life expectancy at all ages, particularly at extreme old age, mean that not only will there be a greater proportion of elderly in the population, but the more will be the "oldest-old," over 85. By 2050, they will be more than 1/4 of the population. As people live longer, many are active and healthy well past retirement. However, many individuals living into their 80s have to cope with chronic disabilities affecting their capacity to perform day-to-day activities. Modern medicine has made great inroads against mortality from such illnesses as heart disease and stroke, but has not eliminate...
Assistive technology has become increasingly important in facilitating independence among older A... more Assistive technology has become increasingly important in facilitating independence among older Americans. It remains unclear, however, whether this trend has been experienced broadly. Using the 1992 to 2001 Medicare Current Beneficiary Survey, we provide evidence that among older people who have difficulty with daily activities, there were substantial increases in the independent use of assistive technology (without help from another person). Controlling for shifts in the composition of the older population reporting difficulty with daily activities, the independent use of assistive technology increased on average 4% to 5% per year, amounting to a 6 percentage point increase over the entire period. These increases were accompanied by declines in the use of any help and in unassisted difficulty, with larger declines in the latter. Substantial differentials in assistance-which favor the more highly educated in the case of technology and favor minorities in the case of help-persisted over this period. All else equal, 5-percentage point gaps were evident between more and less advantaged education groups with respect to the independent use of assistive technology for walking. Gaps in the independent use of assistive technology to bathe were even larger, amounting to 7 to 8 percentage points in 2001 by education and race. We discuss the implications of findings for the study of latelife disability trends and disparities therein. Hartke, R.J., T.R. Prohaska, and S.E. Furner. 1998. Older adults and assistive devices: Use, multiple-device use and need. Journal of Aging and Health 10(1): 99-116. Kemper, P. 1992. The use of formal and informal care by the disabled elder. Health Services Research 27(4):421-451. Kington R.S. and J.P. Smith. 1997. Socioeconomic status and racial and ethnic differences in functional status associated with chronic diseases. American Journal of Public Health. 87(5):805-10.
Promoting independence through increased use of assistive technology has been a goal of federal p... more Promoting independence through increased use of assistive technology has been a goal of federal programs and policies, beginning with the passage of the Americans with Disabilities Act over a decade ago, and continuing with the 1998 Assistive Technology Act, and ...
... SEPAM / IBV: An expert system for assisted prescription of technical aids for mobility. ... A... more ... SEPAM / IBV: An expert system for assisted prescription of technical aids for mobility. ... An expertsystem (SEPAM/IBV) has been created, aimed at making prescrip-tion and subsequent selection of technical aids for mobility more reliable and procedural. ...
Purpose. To examine differences in reports of residual disability and unmet need by type of care ... more Purpose. To examine differences in reports of residual disability and unmet need by type of care arrangement (assistive technology and/or personal care) amongst disabled adults.
A large research literature has emerged on resource transfers between adult children and their ag... more A large research literature has emerged on resource transfers between adult children and their aging parents, and the potential effects of declining fertility rates, increasing migration and female labor force participation rates, and rising affluence on the nature and direction of these flows ). The parent-child relationship is certainly unique among kin ties, and carries with it particularly strong normative obligations for mutual support. However, resource transfers in families occur in a wide range of circumstances, and can involve a variety of other kin (e.g., Cox and Jimenez 1998). Motivations for the involvement of a broader network in family transfers are especially strong in environments where state or market based alternatives for economic support (e.g., social security systems, private pensions, or formal credit markets) or social and health support (e.g., child care providers or home health care agencies) are not available or accessible. This study focuses on these larger kin networks in order to better understand the nature of family exchange.
This study draws on social network measures to describe complex flows of resources between older ... more This study draws on social network measures to describe complex flows of resources between older parents and their adult children. Using data from the 1989 Taiwan Survey of Health and Living Status of the Elderly and the 1996 Philippine Elderly Survey, we find that more than 80 percent of older Taiwanese and more than 97 percent of Filipino elderly are actively engaged in transfers with their children, yet few older persons are engaged in all of the possible transfer activity with children. Redistributive transfer patterns, where older parents receive resources from one or more children and then give resources to another child, characterize about 10 percent of older parent networks in Taiwan and 64 percent in the Philippines. In the majority of these cases, the older parents are involved in more than one redistributive flow with children. Most of these redistributive flows take place across household boundaries rather than exclusively within or outside of the household.
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