Our current LTC system is burdensome to state and federal governments, to family members, and to individuals’ pocket books; it is not expected to endure the weight of the baby boom generation. Total national spending for long-term care in 2005 was $207 billion and is only expected to rise. This study examined the LTC planning behavior of individuals of baby boom birth years (1946 to 1964), focusing on the influence of individuals’ views about whose responsibility is the provision of LTC on planning behavior. Specifically, the study has three aims: to 1) to describe the LTC planning behavior among baby boom aged adults; 2) examine baby-boom aged adults’ views on whose responsibility is the planning/provision/cost of LTC (location of responsibility); and 3) examine the influence of potential predictors of individuals’ LTC planning with specific focus on the influence of location of responsibility (LOR). Data was collected between May and August of 2009 using a mixed modes self-administered 80-item original survey via the internet and regular mail (study sample = 1,066; 1,166 responding; response rate 58%). The study population consists of benefit-eligible Black, Hispanic/Latino, and Non-Hispanic White faculty/staff born in or between the years of 1946 and 1964 from a large southwestern university. This study found overall low levels of LTC planning; however, with regard to LTCI purchase, the participation rate is good relative to the national coverage rate. The study informs us that baby-boom aged individuals as a whole believe themselves (individuals) to have a high level of responsibility for their own potential LTC needs, but also that responsibility lies with the government, employers, and adult children as well. Consistent with hypotheses, LTC awareness/avoidance predicted a higher level of extent of planning (gathering, deciding, and concretizing); worthwhileness and self-efficacy predicted LTCI purchase; and awareness, subjective norm, worthwhileness, and self-efficacy predicted LTC specific savings. Additionally, individual responsibility (negatively), female (positively), income (positively), experience (self and other; positively), LTC knowledge (positively), and Hispanic (negatively) all predicted extent of planning. Employer responsibility (positively), faculty (negatively), marital status (married; negatively), Black (positively), and medical diagnoses all predicted LTCI purchase. And, employer responsibility (positively), government responsibility (negatively), income (positively), experience-other (positively), and knowledge (positively) all predicted LTC-specific savings. Implications for practitioners, employers, program planners, and policy-makers are presented. / text

We examined associations between trait hope and preparation for future care needs (PFCN) among 66 older adult primary care patients in western New York. Participants completed a questionnaire assessing PFCN (awareness, information gathering, decision-making, concrete planning, and avoidance), and the Adult Trait Hope Scale. In multivariate regressions, lower hope, particularly less agency, was associated with more awareness of needing care, whereas higher hopefulness, particularly pathways thinking, was associated with increased decision-making and concrete planning. Greater hopefulness appears to be linked to goal-directed planning behaviors, although those with lower hope may actually be more aware of the need for planning. Evidence-based programming that encourages learned hopefulness may contribute to enhanced health planning and decision-making among older adult primary care patients.

Older adults have an increased risk for illness and disease, factors that can lead to functional impairment and intensify the need for reliance on supportive services. Planning for long-term care needs is a vital component of healthy aging and continued autonomy. Yet, many older adults fail to make plans in advance, perhaps due to differences in personal characteristics. The moderating effects of trait hope on the relationship between health-related quality of life (HRQoL) and preparation for future care needs (PFCN) was studied in a sample of 65 older adult primary care patients (<65 years) in western New York. Participants completed a questionnaire on 5 dimensions of PFCN (awareness of risk, information gathering, decisions about care preferences, concrete planning, and active avoidance). In addition, data were collected on five HRQoL domains (physical function, physical role function, emotional role function, social function, and bodily pain) and trait hope. Moderated multiple regression was used to test the moderator hypothesis controlling for personal characteristics. Post-hoc probing was used to further examine significant interactions. At the bivariate level, social functioning, physical functioning, and emotion-based role were inversely related to PFCN and positively related to hope. Multivariate moderation models covarying age, sex, race, education, illness burden, and functional impairment indicated that hopefulness, particularly agentic thinking or goal identification, moderated the relationship between those three HRQoL dimensions and PFCN behaviors. Among those with greater role limitations, lower hope was associated with more awareness of risk and information gathering and less concrete decision making, whereas among individuals with fewer role limitations and better social and physical functioning, higher levels of hopefulness were associated with increased decision making. These results highlight the need for health professionals to gain a better understanding of their patients'intrapersonal characteristics when discussing issues related to future care planning.