Determining the amount of help used by disabled elderly persons at home: the role of coping resources

The purpose of this study is to quantify the effects of coping resources on the amount (hours) of help used by disabled elderly persons in their home. The findings are based on the 1989 National Long-Term Care Survey. The distribution of help-hours is very skewed, mirroring the skewness of limitations in physical and cognitive functioning. Controlling for these limitations, the most important coping resources are the combinations of helpers who join forces, and coresidence with a helper. The effect of helpers' networks is large and consistent across marital status and living arrangements. The networks are more extensive for married than for unmarried persons. In reference to persons who rely only on nonrelatives: (a) a network of a spouse and children enables a married person to have 40 additional weekly hours of help, (b) a network of children and others enables an unmarried person to have 29 additional help-hours per week if he/she coresides with other adults and 10 additional weekly help-hours if he/she does not. The issue of concern for public policy is whether such family networks will be preserved and, if not, how to obtain the funds for the alternative of sufficient paid help in the community.