Early community-based service utilization and its effects on institutionalization in dementia caregiving

Joseph E Gaugler, Robert L. Kane, Rosalie A Kane, Robert Newcomer

Research output: Contribution to journalArticlepeer-review

176 Scopus citations


Purpose: The present study attempts to determine whether utilizing community-based long-term-care services early in the dementia caregiving career delays time to nursing home placement (adjusting for severity of dementia). Design and Methods: With a reliance on data from 4,761 dementia caregivers recruited from eight catchment areas in the United States and followed over a 3-year period, a Cox proportional hazards model was conducted that considered key components of the stress process (e.g., context of care, primary objective and subjective stressors, and resources), duration, and community-based long-term-care use. Results: An analysis of interaction terms in the Cox regression model found that those individuals who utilized in-home help services earlier in their dementia caregiving careers were more likely to delay institutionalization. Implications: The findings suggest the practical importance and cost-effectiveness implications of early community-based service use, and they emphasize the role of timing when one is conceptualizing the proliferation of stress in the dementia careaivina career.

Original languageEnglish (US)
Pages (from-to)177-185
Number of pages9
Issue number2
StatePublished - Apr 2005

Bibliographical note

Funding Information:
This research was supported by a New Investigator Research Grant (NIRG-2249) from the Alzheimer’s Association to Dr. Gaugler and a contract (509-89-0069) from the Health Care Financing Administration to Dr. Newcomer.


  • Caregiving
  • Community-based long-term-care use
  • Dementia


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