The role of cognitive status in the use of inhome services: implications for nursing assessment

The link between cognitive status and use of home-care services by elders and their informal caregivers has received limited research attention. The purpose of this study was to determine whether an association exists between cognitive status and inhome service utilization by elders and their identified informal caregiver (N = 380). A modification of the Andersen-Newman health service utilization model was constructed to facilitate analysis and comparison with other studies. Data from the Manitoba Study on Health and Aging-1 (MSHA-1) were analyzed using hierarchical logistic regression modelling. Elders of 3 types of cognitive status--dementia, cognitive loss without dementia, and no cognitive impairment--were studied; 4 different inhome services--homemaking, inhome nursing, personal care, and home-delivered meals--were examined. The study revealed a weak association between cognitive status and use of inhome services. The findings raise implications for eligibility assessment by nurses and home-care policy.