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Correspondence: Address correspondence to Emily M. Agree, PhD, Department of Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E4014, Baltimore, MD 21205. E-mail: eagree{at}jhsph.edu
Purpose:The authors examine differences in reports of residual disability and unmet need by type of long-term care arrangement (assistive technology or personal care).Design and Methods:This study compares three specific dimensions of residual difficulty (pain, fatigue, and time intensity) and reports of unmet need across care arrangements. Samples from the U. S. 1994–1995 National Health Interview Survey Phase 2 Disability Supplements include adults with limitations in bathing, transferring, walking, and getting outside.Results:Even when differences in underlying disability are accounted for, assistive technology (AT) confers no additional benefit in the three dimensions of residual difficulty analyzed here. AT users equally or more often report that tasks are tiring, time consuming, or painful, even when they use assistance. Though this would appear to indicate unmet needs for care, fewer AT users report a desire for hands-on personal care.Implications:Though disability alleviation by technology is no better on specific dimensions of difficulty, technology users report less unmet need for personal care. Designing appropriate and cost-effective home care for adults with disabilities requires a better understanding of the ways in which technology users may differ from others and the circumstances under which technology can be most effective.
Key Words: Long-term care • Effectiveness • Activities of daily living
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