Long-term care services use and reasons for non-use by elders with dementia and their families

Objectives: The goals of this study were to describe the pattern and predictors of long-term care (LTC) services utilization elders with dementia and their families, and to determine reasons for non-use of LTC services. Methods: The study sample included 231 elders with dementia and caregiver dyads recruited from a dementia clinic at a medical center in Tainan. Caregivers were interviewed via telephone using a structured questionnaire. Results: The LTC services use rate was 8% among the sample, 35% hired foreign care workers, and 57% did not use any LTC services. The main reasons given for families not using LTC services were the perceived lack of need (64%), followed by the service not meeting the patient's needs (20%). The main reason for not using caregiver support services was caregivers being unaware of the availability of services (56%). Logistic regression results showed that knowledge about LTC resources (OR=1.76, 95% CI=1.19-2.61) was the only significant predictor of LTC services use, while the patient's level of cognitive impairment and physical disability were significant predictors of hiring a foreign care worker. Conclusions: Because the utilization rates of LTC services by elders with dementia and their caregivers were low, and the main reason for non-use was due to caregivers being unaware of services, we recommend that the government strengthen educational campaigns for family caregivers and provide caregiver support services. There should be more choices regarding LTC services available to families caring for an elder with dementia in addition to hiring a foreign care worker.