Adult Day Center Use among Older Mexican Americans with Dementia in California and Texas
Main Article Content
Abstract
Background. Dementia is one of the most common causes of disability and dependence in the world and is a frequent reason that older people require supportive living arrangements. Providing such arrangements on a broad scale will require a broad public dialogue and insights from social science, especially with respect to the neediest, who suffer from a profound gap in access to care. New and innovative social policy, in line with Recommendation #10 of the European Society of Medicine Policy Framework Reducing the Burden of Neurodegenerative Diseases in Europe and Beyond, is vital. The current study offers insights based on dementia care for Latinos in California and Texas, a population with a high incidence of the disease and low access to resources.
Objective. This study investigates how a growing number of Latino families use adult day care services. We focus on California and Texas, the two states with the largest Latino populations of Mexican origin with dual-eligible (Medicare and Medicaid) beneficiaries.
Methods. We employ the 2015 Hispanic Established Epidemiologic Studies of the Elderly to compare the socioeconomic characteristics of Mexican Americans 80 and over who are day care service users living with and without dementia in both states (n = 406). Logistic regressions are used to determine the likelihood of participation in adult day care programs in both states by insurance status.
Results. Compared to California, restrictive income eligibility requirements in Texas limit participation in adult day care despite a higher need for care. Multivariate analyses reveal that foreign-born dual-eligibles in Texas are particularly dependent on family, to provide dementia caregiving in comparison to the native born; they do not report using adult day health services.
Conclusion. The paper ends with a discussion of viable policy options for promoting equity in access to affordable and sustainable adult day health centers as well as other community-based long-term care services in Texas and California. A multi-faceted approach is necessary and must involve all levels of government, as well as private and charitable organizations.
Keywords:
Alzheimer's Disease and Dementia, Adult Day Care, Medicare/ Medicaid insurance, Mexican Americans, Health Equity
Article Details
How to Cite
ANGEL, Jacqueline L.; ROTE, Sunshine M..
Adult Day Center Use among Older Mexican Americans with Dementia in California and Texas.
Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5936>. Date accessed: 15 nov. 2024.
doi: https://doi.org/10.18103/mra.v12i10.5936.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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20. Torres S, Cao X. Improving Care for Elders Who Prefer Informal Spaces to Age-Separated Institutions and Health Care Settings. lnnov Aging. 2019;3(3):igz019.
21. Angel JL, Lopez-Ortega M, Chiu CT, et al. Loss of Autonomy: Likely Dementia and Living Arrangement Transitions among Mexicans and Mexican Americans. Gerontologist. 2023.
22. National Adult Day Services Association. Adult Day ServicesThe Most Cost-Effective Option in Long-Term Care Today Retrieved 3/1/2020 from https://www.nadsa.org/wp- content/uploads/2017/05/Updated-NADSA Public-Policy-Day-2017-Documents.pdf. 2017.
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44. Angel JL, Rote SM. Dementia Support among Older Mexican Americans: Is Adult Day Care a Viable Alternative? In: Angel JL, ed. Understanding the Context of Cognitive Aging: Mexico and the United States. Vol 5. Cham Switzerland: Springer Nature; 2021:227-245.
45. U.S. Census Bureau. OuickFacts: Rio Grande City, Texas Retrievec 3/15/2020 from https://www.census.gov/quickfacts/fact/table/riograndecitycitytexas/RHl725218#RHl725218.ln:2019.
46. California Department of Social Services. The Regions of California: Recommended Grouping of the Counties for Regional Studies. Retrieved 3/15/2020 from https://www.cdss.ca.gov/research/res/pdf/muItire ports/RegionsofCalifornia.pdf. ln:2002.
47. Angel JL, Angel RJ, Cantu P. Medicaid Use among Older Low-Income Medicare Enrollees in California and Texas: A Tale of Two States. Journal of health politics, policy and law. 2019;44(6):885- 910.
48. Texas Aging Services Council. Aging Texas Well Strategic Plan: 2020-2021. Retrieved 8/24/24 from https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/ag ing-tx-well-strat-plan-2020- 21-sept-2019.pdf. 2019.
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