Targeting community services to high-risk elders: toward preventing long-term care institutionalization.

Data from a probability sample of 1,625 elderly participants in the Massachusetts Health Care Panel Study were used to identify elders at high risk of long-term care (LTC) institutionalization. Advancing age, living alone, using assistance to perform basic and instrumental ADL, using an ambulation aid, and mental disorientation were significant predictors of entering a LTC facility during the six-year study period. A comparison of selected characteristics from the Massachusetts sample with a random sample of Massachusetts' Home Care Corporation recipients showed that the statewide approach to delivering home care successfully targeted services to high-risk elders. Future research should examine the extent to which targeting services to high-risk elders actually prevents or delays LTC institutionalization.