Browsing by Author "Weaver, Raven H."

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    Home and Community-Based Service Use by Vulnerable Older Adults
    Weaver, Raven H. (Virginia Tech, 2014-04-25)
    Home and community based services (HCBS) are designed to provide services that meet the increasing and diverse needs of the older adult population who wish to age-in-place for as long as possible in their homes and community. Yet, little is known about the choices people make when selecting services. The purpose of this study was to assess HCBS use among vulnerable older adults. Andersen’s (1995) behavioral model of health services use provided theoretical guidance for selecting and explaining predisposing, enabling, and need-based variables associated with service use within the Community Living Program (CLP) federal initiative. Through consumer direction of services, 18 routine or one-time services were offered to 76 participants enrolled in the Virginia CLP. Two-step cluster analysis identified four distinct profiles of service users, ranging in size from 7 to 34 members. Services used within the groups ranged from 11 to 16 services. Use of personal care services (p=.033) and respite (p=.010) were significantly associated with group membership differentiation. Within each cluster, the percentage of participants using each service varied greatly. The most important variables that differentiated service user membership were caregiver relationship to participant, participant living arrangement, participant disability type, and length of time caregiver provided care. Between-cluster membership was significantly different with regard to average service cost per day for services used (p=.002) and the likelihood of moving to a nursing home if services were not provided (p=.034). Findings inform future research and have implications for practitioners assisting vulnerable older adults in selecting services to meet different care needs.
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    Home and Community-Based Service Use by Vulnerable Older Adults
    Weaver, Raven H.; Roberto, Karen A. (Virginia Tech, 2014-11-07)
    The purpose of this study was to identify distinct profiles of service users and determine whether certain service user profiles have greater potential to meet older adults’ care needs.
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    Service Use and Health Outcomes of Low Income Older Adults with Unmet Needs
    Weaver, Raven H. (Virginia Tech, 2017-03-17)
    The goal of this investigation was to assess service use, self-management strategies, and health status of older adults (60+ years) with perceived need who sought assistance from the Virginia Medicaid Elderly and Disabled Consumer-Direction (EDCD) waiver services. A sequential explanatory mixed method design was used to address the overall research question: How do older adults manage unmet needs? Using health services data from two independent State agencies, regression techniques were used to examine predictors of service use, hospitalization, and mortality among 1,008 individuals. A purposive subsample of eight rural-dwelling waiver-ineligible individuals was identified for follow-up semi-structured telephone interviews to explore self-management strategies for confronting functional care needs. Waiver-ineligible individuals were at risk for hospitalization and mortality; rural-dwelling individuals were more likely to be waiver-ineligible and had increased risk of mortality. Analysis of interviews revealed individuals had ongoing unmet needs and relied on family and community services and used internal and external strategies to manage them; plans were not in place should their health continued to decline. For this group of near-risk older adults who are waiver-ineligible and do not have financial means to pay for more help, accessible preventive services are necessary to reduce risk of adverse health outcomes. Policymakers are encouraged to advocate for preventive services that assist individuals before care needs become unmanageable. Agencies responsible for service delivery need to target efforts toward this group, particularly those residing in rural areas. Researchers must continue forging partnerships that permit use of health services data to identify when and how older adults use services, and explore how self-management strategies influence health and functioning over time.
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    Understanding Falls in Late Life: A Review of the Empirical Literature
    Weaver, Raven H.; Roberto, Karen A.; Brossoie, Nancy (Virginia Tech, 2013-04)
    One in three Americans aged 65+ experience unanticipated falls requiring medical care annually. Falls are associated with physical and psychological morbidities, decreased quality of life, and high health care costs. From a review of the falls literature published from 2002-2012, three distinct interrelated dimensions of falls emerged: (1)Prevention; (2)Risk Factors; and (3)Intervention strategies. Studies on falls among older community-dwelling adults dominated the literature, although residents of care facilities generally have greater risks of falling. Findings suggest the need for interdisciplinary approaches for fall prevention and intervention that focuses on common risk factors as well as individual circumstances.