Many Homebound Older Adults Don’t Receive Home-Based Care or LTSS They May Need

A new article from the LeadingAge LTSS Center @UMass Boston outlines a study examining the use of home-based clinical care and home-based long-term services and supports (LTSS) among homebound Medicare beneficiaries aged 65 and older. That study, co-authored by Robyn Stone of the LTSS Center, focused on a sample of 974 older adults.

Approximately 30% of the older adults in the study received home-based clinical care-provided at home by physicians, PAs, or nurse practitioners; skilled home health care; or home-based clinical care from other providers. Approximately 80% of the older adults received home-based LTSS, including assistive devices, paid helper assistance with a functional task, transportation assistance, senior housing, home-delivered meals, or 40 or more hours of caregiving support from nonpaid helpers each week.

The researchers found three distinct patterns of service use among those studied:

• 8.9% received extensive home-based clinical care.
• 44.5% received some home health services but few other forms of home-based clinical care.
• 46.6% received little home-based care of any kind.

"Given that this is a homebound population, such findings likely reflect not a lack of need but rather a lack of acceptability, availability, and/or affordability of home-based LTSS," wrote the authors.

For more details about the study, see the LTSS Center article, which also links to the full study in the Journal of the American Medical Directors Association (JAMDA), which can be viewed for free until June 15.