Older adults who seek care in the home

Purpose - This paper aims to identify the characteristics of 260 adults, 65 and over, who applied for services through an Area Agency on Aging in a western state in the United States, and to determine the conditions that resulted in referral to the state-funded Home and Community Based Alternatives Program (Alternatives) or the Medicaid Aging Waiver (Waiver) program. Design/methodology/approach - The study was an exploratory one utilizing quantitative data from an existing database of older adults who sought home and community based services from Mountainlands Area Agency on Aging (AAA) between January 1, 2006 and December 31, 2007. Findings - Although most of the sample lived at or near poverty levels, results suggest that higher monthly income and living alone predict referral to the Alternatives program, whereas greater need for assistance with bathing and performing heavy housework are the primary determinants of referral to the Medicaid Waiver program. Originality/value - This study adds to the body of knowledge concerning the characteristics of people who access home and community based services. Most people in this study, who were seeking assistance from public programs, were living at or below the US Federal Poverty Line. One home and community based program was more likely to serve people who lived with others and had cognitive impairments, and referral to a Medicaid home and community based program was more likely for people who needed assistance with bathing and heavy housework.