Outcomes Associated with Home and Community-based Service Use Among Older Adults following a Nursing Home Transition

ABSTRACT

We examined relationships between home and community-based services (HCBS) and reinstitutionalization and choice and control in daily activities for older Money Follows the Person (MFP) Rebalancing Demonstration participants in Connecticut. Using Connecticut MFP program and Quality of Life survey data for 647 participants aged 65, and older who transitioned from a nursing home to the community between 2013–2016, we conducted logistic regressions to determine whether HCBS type (traditional HCBS; hourly personal care attendant [PCA]; live-in PCA) was associated with reinstitutionalization and choice and control 12 months after moving into the community. Relative to receiving traditional services, having hourly or live-in PCA services were associated with having lower odds of both reinstitutionalization and choice and control. Findings can help strengthen HCBS delivery for older adults living in the community.

KEYWORDS:

• Home and community-based services
• skilled nursing homes
• institutional care
• long-term care
• person-centered care
• quality of life

Acknowledgments

Dr. Chanee Fabius was responsible for developing the main ideas of the manuscript, conducted the data cleaning and statistical analysis, and writing the manuscript.

Ms. Noreen Shugrue made substantial conceptual contributions, assisted with organizing and completing data analyses, and critically revised the manuscript prior to submission

Dr. Julie Robison made substantial conceptual contributions, assisted with organizing and completing data analyses, and critically revised the manuscript prior to submission.

Declarations of Interest

The authors have no conflicts to disclose.