THE CONNECTION BETWEEN PAID AND UNPAID SUPPORTS WITH PERSON-CENTERED OUTCOMES FOR OLDER ADULTS WITH DISABILITIES - Innovation in Aging 2025 - No. S2

Q: What dataset and study design does the research use?

The study uses data from the National Core Indicators—Aging and Disabilities Adult Consumer Survey (NCI-AD Adult Consumer Survey) to analyze self-reported service experiences among adults receiving HCBS.

Q: How do paid family caregivers compare with unpaid family caregivers in outcomes?

Unadjusted results show the highest likelihood of sufficient help with ADL and meeting needs when the primary caregiver is a paid family member, while unpaid family caregivers have the lowest likelihood.

Q: Do the findings hold after adjusting for other factors?

Yes. After adjusting for relevant service and recipient characteristics, the likelihood of sufficient ADL help and services meeting needs remains significantly higher for those with paid family caregivers relative to paid staff.

Sep 29, 2026

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Funding for long-term services and supports is shifting from institutional settings to home and community-based services, making consumer-reported outcomes essential. This study analyzes National Core Indicators—Aging and Disabilities Adult Consumer Survey data to examine how provider type (paid staff, paid family, unpaid supports) relates to self-reported service experiences among adults receiving HCBS. Results show higher odds of sufficient ADL help and better alignment of services with needs for paid family caregivers than paid nonfamily staff, with lowest odds for unpaid family caregivers; adjusted models preserve these associations, suggesting policy and practice relevance.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Background and Data Source

Provider Types and Study Approach

Key Findings for ADL and Needs-Matching

Adjusted Associations and Implications

Innovation in Aging, 2025, Vol. 9, No. S2 385 Abstract citation ID: igaf122.1310 THE CONNECTION BETWEEN PAID AND UNPAID SUPPORTS WITH PERSON-CENTERED OUTCOMES FOR OLDER ADULTS WITH DISABILITIES Lindsay Dubois1, Rosa Plasencia2, Stephanie Giordano1, and Nilufer Isvan1, 1. Human Services Research Institute, Cambridge, Massachusetts, United States, 2. ADvancing States, Arlington, Virginia, United States As funding for long-term services and supports shifts from institutional settings to home and community-based services (HCBS), the need for consumer-reported outcomes data is paramount. This study uses data from National Core Indicators—Aging and Disabilities™ (NCI-AD™) Adult Consumer Survey (ACS) to investigate the connection between types of providers (e.g., paid staff, paid family, unpaid supports) 386 Innovation in Aging, 2025, Vol. 9, No. S2 on self-reported service experiences of adults receiving HCBS, controlling for relevant service and recipient characteristics. The unadjusted likelihood of having sufficient help with activities of daily living (ADL) is highest among people whose primary caregiver is a paid family member compared to paid nonfamily staff (OR = 2.26, p < 0.001) and lowest for unpaid family caregivers (OR = 0.71, p < 0.001) . Likewise, the unadjusted likelihood of reporting that services and supports meet needs was highest among those whose primary caregiver is a paid family member compared to paid nonfamily staff (OR = 1.42, p < 0.001) and lowest for unpaid family caregivers (OR = 0.77, p < 0.001). Adjusting for covariates, the likelihood of having sufficient help with ADL and services meeting needs remains significantly higher for those with paid family caregiver relative to paid staff (aOR=1.66, p < 0.001, and aOR=1.42, p = 0.002 respectively) . These data suggest that even with the influence of demographic and service-related factors, paid family caregivers are associated with positive outcomes for older adults and people with disabilities using HCBS. These results can support policy and practice that workforce needs, improving benefits to reduce turnover, and implementing caregiver support initiatives.

FAQs

What dataset and study design does the research use?

The study uses data from the National Core Indicators—Aging and Disabilities Adult Consumer Survey (NCI-AD Adult Consumer Survey) to analyze self-reported service experiences among adults receiving HCBS.

How do paid family caregivers compare with unpaid family caregivers in outcomes?

Unadjusted results show the highest likelihood of sufficient help with ADL and meeting needs when the primary caregiver is a paid family member, while unpaid family caregivers have the lowest likelihood.

Do the findings hold after adjusting for other factors?

Yes. After adjusting for relevant service and recipient characteristics, the likelihood of sufficient ADL help and services meeting needs remains significantly higher for those with paid family caregivers relative to paid staff.

Sep 29, 2026

Upload by PakDamar76