Long-term Care Trajectories in Canadian Context: Patterns and Predictors of Publicly Funded Care

• Published in: The journals of gerontology. Series B, Psychological sciences and social sciences Psychological sciences and social sciences, 2018-08, Vol.73 (6), p.1077-1087
• Main Authors: Penning, Margaret J, Cloutier, Denise S, Nuernberger, Kim, MacDonald, Stuart W S, Taylor, Deanne
• Format: Article
• Language: English
• ISSN: 1079-5014; 1758-5368
• DOI: 10.1093/geronb/gbw104

Abstract Objectives Drawing on a structural life course perspective (LCP), we examined the most common trajectories experienced by older long-term care (LTC; home and community-based care, assisted living, and nursing home care) recipients. The overall sequencing of care transitions was considered along with the role of social structural location, social and economic resources, and health factors in influencing them. Method Latent class and latent transition analyses were conducted using administrative data obtained over a 4-year period for clients aged 65 and older (n = 2,951) admitted into publicly funded LTC in 1 Canadian health region. Results Four main LTC trajectories were identified within which a wider range of more specific or secondary subtrajectories were embedded. These were shaped by social structural factors (age, gender, rural–urban residence), social and economic resources (marital status, income, payment for services), and health factors (chronic conditions, functional and cognitive impairment and decline, problematic behaviors). Discussion Our findings support the utility of a structural LCP for understanding LTC trajectories in later life. In doing so, they also reveal avenues for enhancing equitable access to care and the need for options that would increase continuity and minimize unnecessary, untimely, or undesirable transitions.