The Effects of On‐ and Off‐reservation Residence on In‐home Service Use Among Great Lakes American Indians

Publisher Website
Google Scholar
Abstract
Community‐based, in‐home services are a crucial component in the long‐term care continuum. Research has shown rural populations to be less likely to use these services. American Indian elders are more likely than their non‐American Indian counterparts to reside in non‐metropolitan areas, yet little rural research has focused on this subpopulation. The purpose of this article is to explore differences in in‐home service use among urban, rural off‐reservation, and rural on‐reservation older American Indians using data from a statewide needs assessment. The sample includes 206 206 Great Lakes American Indians aged 55 and older. Predictor variables include the residential classification variable (rural off‐reservation, rural on‐reservation, and urban) along with sociodemographic, social support, health and functional status, and general knowledge of services. Results of logistic regression analysis indicate that the odds are significantly greater for on‐reservation rural American Indian elders use of home services, home health aides, and home visits, than for urban American Indian elders. The off‐reservation rural American Indian elder is significantly less likely than the urban American Indian elder to use a home health aid. Health rating, activities of daily living/instrumental activities of daily living (ADL/IADL) impairments, and general knowledge of in‐home service availability increase the odds for all groups use of home services and home health aides.