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dc.contributor.authorWeaver, Raven Hannahen_US
dc.date.accessioned2018-09-09T06:00:08Z
dc.date.available2018-09-09T06:00:08Z
dc.date.issued2017-03-17
dc.identifier.othervt_gsexam:10115en_US
dc.identifier.urihttp://hdl.handle.net/10919/84981
dc.description.abstractThe 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.en_US
dc.format.mediumETDen_US
dc.publisherVirginia Techen_US
dc.rightsThis item is protected by copyright and/or related rights. Some uses of this item may be deemed fair and permitted by law even without permission from the rights holder(s), or the rights holder(s) may have licensed the work for use under certain conditions. For other uses you need to obtain permission from the rights holder(s).en_US
dc.subjectservice useen_US
dc.subjectunmet needsen_US
dc.subjectadverse health outcomesen_US
dc.subjectnear-risken_US
dc.subjectolder adultsen_US
dc.subjectself-managementen_US
dc.subjectlow-incomeen_US
dc.titleService Use and Health Outcomes of Low Income Older Adults with Unmet Needsen_US
dc.typeDissertationen_US
dc.contributor.departmentHuman Developmenten_US
dc.description.degreePh. D.en_US
thesis.degree.namePh. D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.grantorVirginia Polytechnic Institute and State Universityen_US
thesis.degree.disciplineHuman Developmenten_US
dc.contributor.committeechairRoberto, Karen A.en_US
dc.contributor.committeememberTeaster, Pamela B. (Pamela Booth)en_US
dc.contributor.committeememberSavla, Jyoti Shitalen_US
dc.contributor.committeememberBlieszner, Rosemaryen_US


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