Factors that contribute to remaining in the community among older adults.

Objectives: Using national data on Medicare beneficiaries and their caregivers (CGs), we investigated CG and care recipient (CR) factors associated with the likelihood of remaining in the community.

Methods: We obtained data on 722 CG and CR dyads who lived in the community in 2011 from the National Study of Caregiving and the National Health Aging and Trend Study. We then used pooled data from 2011 to 2015 to track the CRs' likelihood of remaining in the community. Generalized Estimating Equation (GEE) analyses were used to assess the association between CG and CR factors and likelihood of community residence over five years.

Results: The GEE analyses showed that the strongest CR factors predicting continued community residence include lower CR age, higher CR ADL capabilities, not having dementia, and having a heightened sense of community. CG factors predicting continued community residence included reporting no physical difficulties from caregiving, and higher positive aspects of caregiving.

Conclusion: In addition to widely found predictors of remaining in the community (e.g., CR age and dementia), psychosocial variables (CG positive aspects of caregiving, CR sense of community engagement) were also significant independent predictors. Interventions that emphasize not only traditional risk factors for placement, but also psychosocial factors such as promoting CG positive aspects of caregiving and strengthening CRs' linkages with their neighbors or community members deserves greater attention.