Factors and Home- and Community-Based Services (HCBS) that Predict Older Adults’ Residential Transitions

Objectives: This study identified specific personal factors and homeand community-based services (HCBS) that predict older adults’ residential transitions between community and institutional settings. Method: Logistic regression of interview data from 5294 participants in the Second Longitudinal Study of Aging identified predictors of three residential transition patterns and of frequency and duration of institutional services use. Results: Different HCBS services differently affected residential transitions. Informal support and paid personal care services (PCS) were the main factors affecting older adults’ ability to reside in community settings or to remain in community longer. Frequency of HCBS use and quantity of paid PCS used indicated direction of transitions: from communities into institutions or vice versa. Discussion: Integration of informal and formal care systems and attention to community-dwelling older adults’ HCBS use and paid PCS use, as a guide for possible future transitions, are tasks for community care professionals.