A dynamic model for explaining changes in use of IADL/ADL care in the community

Evidence exists that support services for community elders vary with need. However, few controlled longitudinal analyses have been carried out regarding descriptive profiles of elders experiencing differential change in service levels -- the focus of analysis here. Using a multivariate profile procedure (PC-Group), 1,730 elders followed over an 18-month period were first classified according to change in functional status groupings that predicted change in hours of service over this period, and each group was subsequently subdivided. Five of nine profiles identified (82% of the sample) were relatively stable functionally. In general, changes in service levels reflected change in functional status; profiles reflected differential change in service level depending upon whether functional status declined; the network provided an unusually high level of service (overextended) at baseline; or the informal network consisted exclusively of children.