"staying at home no matter what:" unmet needs for community dwelling older adults

The focus on consumer driven care in the US is part of the larger “aging in place” movement that emphasizes independence for older adults. However, for community dwelling older adults who rely on publicly financed programs to “age in place,” budget cutbacks of these programs have contributed to an increase in unmet needs. Drawing on a sample of qualitative interviews from a study of California older adults, who qualify for publically financed in-home supportive services (IHSS), this paper examines the impact of unmet needs on the quality of life of these older adults and explores how these individuals address these gaps in care. Data were collected over a two year-period on older adults (age 65 and over) who are consumers of public programs that provide long-term in-home care services and supports. In-depth, face-to-face interviews were conducted with the older adult and their paid caregiver. Data were independently coded by two researchers. The results of thematic analyses suggest that budget cutbacks to publicly financed programs contribute to the increase in unmet needs. Additionally, it was discovered that even for individuals with the maximum allotted hours of in-home supportive services had significant unmet needs, Finally, it was also discovered that unmet needs varied widely from individual to individual.