SUA Resource Library: 

Community Assessment Materials 
Foreword 

In 2012, the Administration for Community Living (ACL), an operating division of the US 

Department of Health and Human Services, began a comprehensive evaluation of its National 

Family Caregiver Support Program (NFCSP). This was the first comprehensive federal evaluation 

of the NFCSP, which serves over 800,000 family caregivers annually. The NFCSP evaluation has 

three broad goals to benefit policy and program decision-making: 

1. Collect and analyze information on program processes and site operations; 

2. Evaluate program efficiency and cost issues for approaches best suited to specific 

contexts; and

3. Evaluate effectiveness of the program’s contribution to family caregivers in terms of 

maintaining their health and well-being, improving their caregiving skills, and 

avoiding or delaying institutional care of the care recipient.

As part of the evaluation survey, State Units on Aging (SUAs) were asked to submit relevant 

documents if they answered ‘yes’ to any of the following five questions: 

 Do you have a statewide task force, commission or coalition specifically to examine 

family caregiver issues?

 Have community needs assessments for caregiver support services been conducted?

 Does your state have a standardized caregiver assessment?

 Does your SUA conduct routine programmatic monitoring of the NFCSP program?

 Do you use a uniform caregiver satisfaction survey across all AAAs?

ACL received assessment tools and grouped them into the following categories:

1. Community Assessment Materials

2. General Customer Satisfaction Survey Materials

3. Grandparent Assessment Materials

4. High-Level Administrative Materials

5. Program Monitoring Materials

6. State Caregiver Assessments

7. State Care Recipient Assessments

8. Task Force Materials

9. Uniform Satisfaction Materials

10. Other Materials

While ACL does not specifically endorse these tools, we are sharing them because they may be 

helpful to other programs. For more information on the NFCSP please go to: 

http://www.aoa.acl.gov/. For more information on the evaluation of the NFCSP please go to: 

http://www.aoa.acl.gov/Program_Results/Program_Evaluation.aspx
Community Assessment Materials 

Idaho Commission on Aging Needs Assessment Survey Results .................................................................. 3 

Idaho Caregiver Needs and Respite Capacity Report, 2014 ....................................................................... 68

Michigan Office of Services to the Aging Needs Assessment Summary ................................................... 109 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey .................................. 134 

Ohio Compilation of AAA Service Needs and Gaps .................................................................................. 175

2
i 

Idaho Commission on Aging Needs Assessment Survey Results 

May 2012 

Conducted by

Center for the Study of Aging 

Boise State University 

Funded by 

Idaho Commission on Aging

Tamra Fife, MHS

Lee Hannah, DVM, MS, MPH 

Idaho Commission on Aging Needs Assessment Survey Results 3
ii

Table of Contents 

Table of Contents ............................................................................................................................ ii

List of Tables ................................................................................................................................. iii

List of Figures ................................................................................................................................ iv

Appendices ...................................................................................................................................... v

Executive Summary ........................................................................................................................ 1

Introduction ..................................................................................................................................... 3

Survey Instrument ....................................................................................................................... 3

Sampling ..................................................................................................................................... 3

Data Collection ........................................................................................................................... 4

Response Rates and Sample and Respondent Characteristics ................................................... 4

Data Preparation and Analyses .................................................................................................. 4

Demographic Characteristics .......................................................................................................... 5

Social Activities .............................................................................................................................. 7

Physical Activity ............................................................................................................................. 9

Sources of Information ................................................................................................................. 13

Long-Term Care Insurance Plans ................................................................................................. 18

Care Giving ................................................................................................................................... 19

Assistance and Support ................................................................................................................. 21

Other Concerns ............................................................................................................................. 24

Summary and Implications ........................................................................................................... 25

Idaho Commission on Aging Needs Assessment Survey Results 4
iii

List of Tables 

Table 1. Demographic information of sample population. ............................................................. 4

Table 2. Survey participant age from 2012 (top row) versus the .................................................... 5

Table 3. Demographic characteristics of survey respondents ......................................................... 6

Table 4. Household characteristics of 2012 versus 2008 survey respondents ................................ 7

Table 5. Social activity participation from the 2012 respondents .................................................. 8

Table 6. Ability of respondents to perform various activities ...................................................... 10

Table 7. Frequency of use of information sources for services or activities ............................... 13

Table 8. Reasons for difficulties in finding or arranging transportation ....................................... 16

Table 9. Reasons for difficulties in finding or arranging transportation ..............................19

Table 10. Type of help caregivers could use in caregiving ......................................................... 21

Table 11. Sources and level of support ......................................................................................... 21

Table 12. Major and minor problems self-reported by respondents from 2012 versus 2008 Error! 

Bookmark not defined.3

Idaho Commission on Aging Needs Assessment Survey Results 5
iv

List of Figures 

Figure 1. Percentage of respondents’ interest in attending a senior center by age ........................4

Figure 2. Percentage of respondents’ interest in working for pay by age ......................................5

Figure 3. Respondents’ level of help needed to perform light housework by age.........................6

Figure 4. Respondents’ level of help needed to perform heavy housework by age ......................7

Figure 5. Respondents’ level of help needed to perform interior or exterior repairs by age .........7

Figure 6. Respondents’ level of help needed to do yard work or shovel snow by age ..................8

Figure 7. Respondents’ level of help needed to walk by age.........................................................8

Figure 8. Respondents age 50-57 frequently used information sources... .....................................9

Figure 9. Respondents age 58-65 frequently used information sources..................... ................10

Figure 10. Respondents age 66-74 frequently used information sources.... .................................10

Figure 11. Respondents age 75 and older frequently used information sources ...........................11

Figure 12. Use of newspaper, internet and senior publications for service information by age 

Figure 13. Percentage of respondents who needed help getting or arranging transportation ........11

Figure 14. Percentage of individuals who need a lot or some help finding or arranging 

 transportation by age ....................................................................................................13 

Figure 15. Comparison of percentage of respondents' ease in getting transportation 

 within the last 12 months by income level..................................................................13

Figure 16. Percentage of respondents by age that have long-term care insurance ........................14

Figure 17. Percentage of care recipients among respondents who are caregivers .........................15

Figure 18. Caregiver rate of stress experienced in the past two months ........................................16

Figure 19. Percentage of respondents that receive a lot, some or a little support or assistance 

 from various sources by age ........................................................................................18 

Figure 20. Percentage of respondents not able to afford necessities .............................................20

Idaho Commission on Aging Needs Assessment Survey Results 6
v 

Appendices 

Appendix A. Survey Instrument 

Appendix B. Idaho Commission on Aging Area Map 

Appendix C. Overall 2012 Survey Results 

Appendix D. Area Agency on Aging Results 

 

Idaho Commission on Aging Needs Assessment Survey Results 7
1 

Executive Summary 

The findings reported in this document are based on a statewide survey of individuals 50 and older 

conducted for the Idaho Commission on Aging in March 2012. The survey, based on a similar assessment 

conducted in 2008, was designed to provide information for future planning for the long-term care needs of 

older Idahoans. A unique feature of this assessment as compared to the 2008 survey was the collection of 

information from participants at selected congregate meal sites representing each of the six Agency on Aging 

Area (AAA) regions in addition to a mailed survey. A total of 4,000 surveys were distributed, 3,000 through 

direct mail and 1000 at congregate meal sites, and 814 surveys were returned representing a response rate of 

20 %. 

The demographic characteristics of this population differ slightly from the 2008 report. In 2012, the age 

range of respondents was 51 to 97 years, with an average age of 71 in comparison to an average age of 67 for 

respondents to the 2008 survey. In 2012, 55% of respondents were retired compared with 62% in 2008. In 

this survey an additional 28% were still working either part- or full-time. Only 48% of the respondents were 

married, compared to 73% in the 2008 study, and 28% were widowed. For income, 29% reported being in 

the less than $20,000 income group, compared to 17% reporting that income level in the 2008 study. 

For transportation, 85% of respondents indicated they drive themselves and those that indicated having 

problems with transportation reported health or disability as the major reasons. In the 2008 survey the 

question regarding transportation was asked as “Drive or ride in a car”, making direct comparison difficult 

but when you combine this question from the 2012 survey with “Ride with a family member or friend” at 

12.4% we come close to the 98% from 2008 who “Drive or ride in a car” with about 97% in the current 

survey falling into these two categories. 

Overall 85% of respondents indicated their community is a good place to grow old with the remaining 15% 

reported transportation and lack of access to health services as factors contributing to their selection of a 

“No” response. The majority of respondents, almost 80%, indicated they did not have trouble affording 

items that were needed, but among those who did report difficulties, access to dental care and eye glasses 

were significantly different from other items. 

As in the 2008 study, respondents provided information about their ability and desire to participate in 

activities, their ability to perform varying levels of physical activities, and ways they obtain information 

about services. New to the 2012 survey, respondents were asked how often they accessed the internet for 

information. Respondents were also asked about long-term care planning, support from community and 

family members, and their current quality of health. 

Key results derived from the 2012 report were very consistent with the 2008 study and include the following: 

 The majority of respondents do not have long-term care insurance (79.1%) and when asked how they 

were going to pay for long-term care, they indicated Medicare. 

 Most respondents either participate in activities as much as they would like or are not interested. 

Overall, 46% of respondents indicated they were not interested in attending a Senior Center, which is 

much lower than the 61% who were not interested in the 2008 survey. 

 Of those that provide care for someone else, 68% indicated they were not aware of care giver services 

provided in their community. 

 Overall, 42% of respondents access the internet frequently or somewhat frequently, and most do so 

from their homes. Between ages 50-65, about 60% of respondents reported frequently using the 

Idaho Commission on Aging Needs Assessment Survey Results 8
2 

internet. In the 66-74 year old age group this dropped to 42% who frequently use the internet, and in 

the oldest age group only 19% reported frequently using the internet. 

 Some individuals receive support from family and friends, but over 85% indicated they do not get 

support from their community or through community services. 

 The majority of respondents (80%) indicate their quality of life is good to very good, with another 

11% indicating neither bad nor good. 

 The top concerns among this population were the cost of healthcare, long term care, and their concern 

about their ability to stay in their homes as they age.

Idaho Commission on Aging Needs Assessment Survey Results 9
3 

Introduction 

The purpose of this study was to investigate the current and future long-term care needs of older adults in 

Idaho. A random sample of 3,000 individuals aged 50 and older throughout Idaho were sent a survey asking 

them a range of questions about their needs, abilities, preferences and activities. This document is organized 

in sections to report the results 

First, the report begins with a description of the study and the study instrument. The sampling procedure is 

detailed, as well as the data collection methods and the analysis plan. Next, the report summarizes the return 

rate and the demographic information about the survey participants. Preferences and needs of the participants 

follow the description of the survey participants. These preferences are divided into seven categories: social 

activities, physical activities, sources of information, transportation, care giving, assistance and support, and 

other concerns. The report ends with a summary of the results and implications for future planning and 

policy development. 

Survey Instrument

The survey items and format were adapted from an existing needs assessment tool administered in 2008 by

the Center for the Study of Aging at Boise State University under a subcontract from the Idaho Commission 

on Aging (ICOA). Other questions were created based on the needs and interests of the Idaho Commission 

on Aging and from a review of needs assessment tools used in other states. The survey was designed to 

collect basic demographic and socio-economic information, transportation uses and needs, sources of support 

and assistance, and potential caregiver responsibilities. Specific items included frequency of attendance at 

such services as senior centers, exercise and fitness classes, sporting events or religious services. In addition, 

respondents were asked how they find out about services, items that were needed but could not be afforded, 

and the activities they need help with or are able to perform for themselves. The survey form is reproduced 

in Appendix A. 

Sampling 

The Center for the Study of Aging contracted with AccuData to select a population of 3,000 individuals who 

mirrored the percent of aged 50 and older residents from each of the six AAA areas (shown in Appendix B). 

These were then sorted to select 50% males and 50% females within each area. All addresses were for noninstitutional settings. The area population percentages aged 50 and older were obtained from the Department 

of Labor statistics. The Center for the Study of Aging purchased a one time mailing option and received the 

list in an Excel dataset. The envelopes were printed by the BSU Printing and Graphics Department and bulk 

mailed after printing. Because the envelopes were bulk mailed by zipcode, we did not receive undeliverable 

envelops back to BSU. Therefore we have no way to calculate the proportion of the mailing addresses which 

were no longer valid at the time of mailing. (Overall results from the survey are found in Appendix C). 

In addition to the 3,000 randomly selected individuals who received a mail survey, 1,000 surveys were 

distributed to a representative sample of congregate meal sites. ICOA provided the researchers with a list of 

all congregate meal sites in the six AAA areas. Using the same percentage of the population in each area that 

was used from the random selection of mail participants, the researchers calculated the number of surveys to 

be sent to each Area. Using this population estimate, the researchers randomly selected small, medium, and 

large meal sites across the state as survey distribution points. The coordinator at each site was contacted to 

inform them of the purpose of the survey and distribution process and verify the mailing address. A packet 

of surveys and postage paid return envelopes were sent to each site and the site coordinators were asked to 

Idaho Commission on Aging Needs Assessment Survey Results 10
4 

give them to persons aged 50 and over receiving services at the center. The distribution of surveys by Area 

and meal site was as follows: 

 Area 1: 6 sites selected and 165 surveys distributed; 

 Area 2: 6 sites selected and 95 surveys distributed; 

 Area 3: 5 sites selected and 400 surveys distributed; 

 Area 4: 8 sites selected and130 surveys distributed; 

 Area 5: 7 sites selected and 100 surveys distributed; and

 Area 6: 6 sites selected and 110 surveys distributed. 

Results by area, based on findings from congregate meal sites are located in Appendix D. Although these 

results are based on a smaller sample of the population, because they were completed by individuals 

receiving services, they provide insight into the needs and concerns of some of the most vulnerable Idaho 

elderly. This provides a snapshot of a population of high interest to ICOA and the areas. 

 

Data Collection

Prior to contacting any persons in the sample, approval for the study was received from the Institutional 

Review Board (IRB), approval #EX 193-SB12-039, of Boise State University, which is the federally 

mandated mechanism used to protect human subjects in research. The cover letter to the survey stated that 

this research was approved by the IRB and provided phone and address information for both the lead 

researcher of the Center for the Study of Aging and the IRB staff person who could be contacted with any 

questions. In addition, AccuData reviewed both the survey and cover letter to ensure that we were not 

purchasing the list for purposes other than our stated intent. AccuData required several minor wording 

changes which were sent through the BSU IRB for a second time to ensure both entities were aware of all 

changes to the documents prior to mailing. 

Response Rates and Sample and Respondent Characteristics 

Of the 3,000 surveys distributed by mail, 550 or 18.8% were returned with the survey form completed in 

total or in part. Of the 1,000 surveys sent to congregate meal sites, 236 or 23.6%, were returned. There was 

also an additional 28 surveys completed using the on-line version of the survey. The respondents of the 

survey were slightly different than Idaho’s population. For example, the female response rates are slightly 

higher than the population mix. In the 2010 U.S. Census, 48% of the population age 50 and older in Idaho 

was male and 52% was female whereas the survey respondents were 43% male and 58% female. 

Table 1. Demographic information of sample population. 

Idaho Population 

over 50 years old 

Sample Sent Survey

N=4000

Respondents

N=814

(2010) 

Male 50+ 48% 50% 42%

Female 50+ 52% 50% 58%

Data Preparation and Analyses 

Data entry was performed by Center for the Study of Aging staff. Data entry checks were conducted after 

data entry was completed. Prior to analyses, data were checked for out-of-range values, appropriate skip 

patterns and patterns of missing responses. All analyses were conducted by staff at the Center for the Study 

of Aging using the statistical software package, SPSS v.19. 

Idaho Commission on Aging Needs Assessment Survey Results 11
5 

Demographic Characteristics 

The survey respondents were generally equally represented across all demographic categories. Two 

participants ages were not included in the age characteristics (ages 34 & 37) as they appear to be care givers. 

Table 2 reports the survey participants’ average age, standard deviation, and the range of ages. Overall the 

average age of respondents was 70 years old and participants ranged from 51-97 years old. Table 2 also 

represents the difference from the 2008 survey where the average age was slightly less at 67.5. 

Table 2. Survey participant age 

Survey Year Average Standard Deviation (sd) Range

2012 70.5 11.1 51-97

2008 66.9 10.8 50-99

Table 3 provides additional demographic characteristics of the survey respondents. Approximately 61% of 

respondents have lived in their community for 20 years or more. Most of the respondents can be described as 

retired (55%), married (48%), and white (95%) and describe their health as very good or good (86%). 

The income levels of respondents were 29% reporting being in the less than $20,000 group, compared to 

17% reporting that income level in the 2008 study. In addition, the income range from $50,000-$59,999 was 

only 6% of the 2012 population. Thirty percent of respondents self-reported having an educational 

attainment of high school or less, 33% reported some college, with the remaining 34% reporting an 

Associate’s degree or higher. Respondents also relied heavily on private insurance (38%) and Medicare 

(39%) for their health insurance. Forty-three percent of respondents indicated they used a combination of 

Medicare and private insurance. Only 6% of the respondents indicated they only used Medicaid as their 

health insurance, a reduction of 3% from the 2008 study. Of the 17% that reported “other insurance”, 35% of 

those respondents indicated having no insurance. 

Idaho Commission on Aging Needs Assessment Survey Results 12
6 

Table 3. Demographic characteristics of survey respondents 

 Characteristic (n=815) n 2012 Results 2008 Results

Gender

Male 333 41.8 43.3

Female 463 58.2 55.7

Health Status

Very Good 334 41.0 47.2

Good 364 44.7 41.8

Neither Good nor Bad 90 11.0 7.8

Bad 6 0.7 0.7

Very Bad 1 0.1 0.4

Household 

Income

Less than $10, 000 65 8.0 4.1

$10,000 to $19,999 167 20.5 13.4

$20,000 to $29,999 114 14.0 14.0

$30,000 to $39,999 84 10.3 11.2

$40,000 to $49,999 71 8.7 10.7

$50,000 to $59,999 53 6.5 6.9

$60,000 to $74,999 49 6.0 10.0

$75,000 and over 100 12.3 19.3

Education

0-11 years, no diploma 56 6.9 6.2

High School graduate/GED 191 23.4 22.3

Some college/technical training 272 33.4 33.3

Associate’s degree 55 6.7 5.5

Bachelor’s degree 134 16.4 17.4

Graduate/Professional degree 92 11.3 14.7

Employment

Retired 445 54.6 50.4

Working part-time 78 9.6 7.9

Working full-time 156 19.1 26.6

Unemployed/looking for work 22 2.7 0.4

Homemaker 32 3.9 4.6

Disabled 44 5.4 2.9

Other 19 2.3 1.3

Marital Status Married 391 48.0 72.9

Widowed 228 28.0 13.5

Divorced 117 14.4 9.1

Single 51 6.3 3.5

Partnered 12 1.5 0.1

Other 3 0.4 0.1

Race White White 771 94.6 96.2

Black /African American 2 0.2 0.1

American Indian /Alaskan Native 7 0.9 1.2

Native Hawaiian/Other Pacific 

Islander

0 0.0 0.1

Other 15 1.8 1.5

Ethnicity Hispanic or Latino 7 0.9 1.5

Years

in Community

0-5 101 12.4 10.6

6-10 78 9.6 8.6

11-15 75 9.2 8.8

16-20 48 5.9 7.7

20 or more 495 60.7 62.4

Idaho Commission on Aging Needs Assessment Survey Results 13
7 

Most respondents live in a single family home (78%) and reported owning their home (81%), 

with most having two people per household. Sixty-three percent live with their spouse and 17% 

live with at least one child (Table 4). 

 

Table 4. Household characteristics of 2012 versus 2008 survey respondents 

Household Characteristics (n=815) n

2012 

Results

2008

Results

Ownership

Rent 112 14.1 6.3

Own 646 81.2 90.5

Type of Home

Single family home 633 77.7 86.5

Townhouse, condo, duplex or 

apartment

61 7.5 6.1

Mobile home 61 7.5 4.4

Assisted living residence 8 1.0 0.4

Nursing home 4 .5 0.0

Subsidized housing 26 3.2 1.0

Other 10 1.2 0.9

Residents

Spouse 313 63.0 72.4

Significant Other 26 4.0 1.0

At least one child 32 17.0 13.0

Child(ren) and his/her/their family 2 2.0 1.7

Other relative(s) 17 5.0 1.7

Unrelated adults/friends 10 2.0 0.9

Grandchildren/great-grandchildren 5 5.0 1.3

Other 8 1.0 1.2

1 person 304 37.3 23.7

Number of 

Residents

2 people 387 47.5 59.9

3 people 57 7.0 8.5

4 people 26 3.2 3.8

5 or more people 24 2.9 2.7

Social Activities 

Social activities can provide a plethora of benefits that can sometimes be overlooked in planning 

for older adults. Engaging with others can enhance the well-being of older adults, thus, survey 

respondents were asked about their ability to, and interest in, participating in various types of 

social activities. 

When asked about the frequency of participating in different types of social activities, there was 

greater variation based on the type of activity. Remove “return” here

Table 5 illustrates the interest level as well as whether individuals are able to participate as often 

as they would like. The activities where respondents indicated they are not able to participate as 

often as they like included: exercise or fitness (21%), community events (16%), and volunteer 

Idaho Commission on Aging Needs Assessment Survey Results 14
8 

work (15%). Respondents also did not get to attend degree/non-degree courses (16%) or family 

activities (16%) as often as they would like. 

Table 5. Social activity participation from the 2012 respondents 

As often as 

I’d like

Almost as 

often as I’d 

like

Not nearly 

as often as 

I’d like

Not 

interested

Community Events/ Social Clubs 43.1% 15.1% 16.4% 25.5%

Degree/non-degree courses 16.1% 4.0% 16.0% 63.9%

Exercise / Fitness / Workouts /

Activities 40.1% 11.9% 20.7% 27.3%

Family Activities 58.2% 19.5% 16.4% 5.9%

Library/Internet 48.3% 11.3% 14.3% 26.1%

Medical and pharmacy visits 76.8% 13.7% 4.0% 5.5%

Parks 58.1% 13.2% 13.8% 14.9%

Religion/worship 61.7% 8.0% 8.4% 21.9%

Senior centers 40.8% 6.8% 6.4% 46.0%

Shopping 73.4% 15.6% 7.1% 3.9%

Sporting events 42.8% 10.8% 12.8% 33.6%

Volunteer work 45.5% 10.8% 15.6% 28.1%

Working for pay 35.4% 6.4% 9.8% 48.4%

Two areas are notable, first almost half of survey respondents reported not being interested in

taking degree and non-degree courses (64%) and going to senior centers (46%). Second, 

respondents were either not interested in working for pay (48%) or they were working for pay as 

often as they would like (35%).

Interest in senior centers was very different by age group (

Figure 1). The majority of 50-57 year olds (79%) were not interested in using senior centers, 

followed closely by 58-65 years olds at 69%. Yet, of the age group that had the highest interest 

in going to a senior center, those age 75 and older, only 9% do not get to go as often as they 

would like. Figure 1 shows that, compared to 2008, there was a decrease in respondents who 

reported that they were not interested in a senior center among the 66 years and older age groups. 

Figure 1. Percentage of respondents’ interest in attending a senior center by age

0%

10%

20%

30%

40%

50%

60%

70%

80%

50 - 57 58 - 65 66 - 74 75 +

2012 Not

interested

2012 Not nearly

as often as I'd

like

2008 Not

interested

2008 Not nearly

as often as I'd

like

Idaho Commission on Aging Needs Assessment Survey Results 15
9 

As might be expected, the percentage of individuals who were not interested in working for pay 

increased dramatically by age (Figure 2) with 78% of respondents age 75 and older not interested 

in working for pay compared to 9% of those 50-57 years old. Conversely, the highest percentage 

of individuals who were not working for pay nearly as often as they would like was found in the 

50-57 year old group (11%). 

Physical Activity 

In order for older adults to remain independent, they must be able to perform a variety of tasks. 

These tasks can include Activities of Daily Living (ADLs) and Instrumental Activities of Daily 

Living (IADLs). ADLs include basic personal care activities such as eating, walking and bathing. 

IADLs include more complex activities such as managing finances, home care and grocery 

shopping. 

Most of the survey respondents were able to complete ADLs and IADLs without any help from 

others (Table 6). However, there are certain activities, particularly activities that require physical 

exertion, where respondents indicated more help is needed. For example, 27% of survey 

respondents indicated they need some help with heavy housework like moving furniture or 

washing windows and 15% indicated they cannot do this at all. Additionally, 34% need some 

help doing interior or exterior repairs and 27% need some help doing yard work and shoveling 

snow. The 2012 results of those able to complete ADLs and IADLs were similar to the 2008 

results, with the exception that the percentage of those who cannot do activities such as interior 

or exterior repairs, yard work and heavy housework increased for those 65 years or older. 

Figure 2. Percentage of respondents’ interest in working for pay by age

0%

10%

20%

30%

40%

50%

60%

70%

80%

50 - 57 58 - 65 66 - 74 75 +

2012 Not

interested

2012 Not nearly as

often as I'd like

2008 Not

interested

2008 Not nearly as

often as I'd like

Idaho Commission on Aging Needs Assessment Survey Results 16
10 

Table 6. Ability of respondents to perform various activities 

Activity Without any 

help

With some 

help

Cannot do this 

at all

n % n % n %

Prepare own meals 737 90.9 56 6.9 18 2.2

Shop for personal items 735 91.1 57 7.1 15 1.9

Manage own medications 757 93.9 33 4.1 16 2.0

Manage own money 745 92.2 54 6.7 9 1.1

Use a telephone 775 96.6 19 2.4 8 1.0

Do light housework like dusting or 

vacuuming

688 85.3 80 9.9 39 4.8

Do heavy housework like moving 

furniture or washing windows

463 57.6 218 27.1 123 15.3

Do interior or exterior repairs 339 42.4 270 33.8 191 23.9

Do yard work and snow shoveling 445 55.3 217 27.0 143 17.8

Walk 720 89.6 66 8.2 18 2.2

Eat 795 98.8 8 1.0 2 .2

Dress self 786 97.3 20 2.5 2 .2

Bathe 774 95.7 29 3.6 6 .7

Use the toilet 797 98.6 9 1.1 2 .2

Get in and out of bed 795 98.1 10 1.2 2 .2

Respond to emergencies 720 90.0 63 7.9 17 2.1

The need for assistance or the inability to perform certain activities was exacerbated for the 

oldest survey respondents. Light and heavy housework, interior or exterior repairs, yard work, 

shoveling snow and walking presented increasing challenges as age group increased. Figures 3 

through 7 illustrate the percentage of individuals by age group that reported the ability to do a 

particular activity with some help or if they cannot perform the activity at all. 

Figure 3. Respondents’ level of help needed to perform light housework by age

0%

2%

4%

6%

8%

10%

12%

14%

16%

50-57 58-65 66-74 75+

2012 Some

Help

2012 Cannot

do this at all

2008 Some

help

2008 Cannot

do this at all

Idaho Commission on Aging Needs Assessment Survey Results 17
11 

Sixteen percent of survey respondents age 75 and older needed some help with light housework 

compared to 7% of 66-74 year olds and 3% of 50-57 year olds (Figure 3). 

A larger proportion of survey respondents age 75 and older (34%) needed some help with heavy 

housework compared to 20% of individuals age 50-57. In addition, 28% of those 75 and older 

reported that they cannot do heavy housework, like moving furniture or washing windows at all 

compared to only 5% of 50-57 year olds (Figure 4). 

Performing interior and exterior repairs not only presents difficulties for the oldest group (37%), 

but also for the 66-74 (36%) and 58-65 (29%) year old groups (Figure 5). Overall, 42% of those 

surveyed in 2012 who self-reported being age 75 and older cannot do interior or exterior repairs 

at all, compared to 25% in 2008. 

Figure 4. Respondents’ level of help needed to perform heavy housework by age

0%

5%

10%

15%

20%

25%

30%

35%

40%

50-57 58-65 66-74 75+

2012 Some

help

2012 Cannot

do this at all

2008 Some

help

2008 Cannot

do this at all

Figure 5. Respondents’ level of help needed to perform interior or exterior repairs by age

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50-57 58-65 66-74 75+

2012 Some help

2012 Cannot do

this at all

2008 Some help

2008 Cannot do

this at all

Idaho Commission on Aging Needs Assessment Survey Results 18
12 

Physical work, such as yard work or shoveling snow, also presented increasing difficulties for 

the older groups (Figure 6). Twenty-nine percent of those age 75 and older and 14% of age 66-74 

year olds cannot do any yard work or snow shoveling. More than a third (35%) of those 

respondents age 75 and older and another 41% of those respondents age 58-74 can perform those 

activities only with some help. 

The percentage of respondents who need help walking also increased with age (Figure 7). Only 

2% of 50-57 year olds needed some help with walking compared to 14% of respondents 75 and 

older. 

Figure 6. Respondents’ level of help needed to do yard work or shovel snow by age

0%

5%

10%

15%

20%

25%

30%

35%

50-57 58-65 66-74 75+

2012 Some help

2012 Cannot do

this at all

2008 Some help

2008 Cannot do

this at all

Figure 7. Respondents’ level of help needed to walk by age

0%

2%

4%

6%

8%

10%

12%

14%

50-57 58-65 66-74 75+

2012 Some

help

2012 Cannot

do this at all

2008 Some

help

2008 Cannot

do this at all

Idaho Commission on Aging Needs Assessment Survey Results 19
13 

Sources of Information 

A key part of service delivery is understanding how the individuals who may require services 

prefer to receive information. In Idaho, respondents age 50 and older primarily use a newspaper 

to get information about available services and activities. Fifty-seven percent of respondents 

indicated they frequently use a newspaper to get information about services and activities. 

Another 31% sometimes use this medium. The next most frequently used sources were television 

(55%), word of mouth (49%) and the Internet (42%). Overall, 52% of respondents indicated they 

never use the library and 41% never use senior publications as a source of information for 

services or activities (Table 7). 

Table 7. Frequency of use of information sources for services or activities 

2012

Frequently

2012

Sometimes

2012

Never

2008 

Frequently

2008 

Sometimes

2008 

Never

Newspaper 57% 31% 11% 65% 25% 7%

Radio 30% 40% 31% 33% 38% 22%

Television 55% 34% 11% 56% 31% 9%

Library 15% 33% 52% 12% 35% 44%

Internet 42% 26% 33% 42% 24% 25%

Word of mouth 49% 46% 5% 44% 45% 6%

Senior 

publications 18% 41% 41% 15% 36% 42%

Across all age groups newspapers remain the most frequently used source of information for 

services and activities. However, there are interesting differences between the age groups. For 

instance, respondents age 50-57 are much more likely to frequently use the Internet (57%) as a 

source than respondents age 66-74 (43%) and respondents, age 75 and older (19%). Frequent 

library use is also higher for the older groups; 17% of respondents age 66-74 and 12% of 

respondents age 75 and older frequently use the library as a source of information for services 

and activities (Figures 8-12). 

Figure 8. Respondents age 50-57 frequently used information sources 

0%

20%

40%

60%

News Paper Radio Television Library Internet Word of

Mouth

Senior

Publication

38%

26%

41%

6%

57% 52%

3%

Idaho Commission on Aging Needs Assessment Survey Results 20
14 

Figure 9. Respondents age 58-65 frequently used information sources 

Figure 10. Respondents age 66-74 frequently used sources of information 

0%

20%

40%

60%

80%

News Paper Radio Television Library Internet Word of

Mouth

Senior

Publication

57%

36%

54%

21%

62%

40%

13%

0%

20%

40%

60%

80%

News Paper Radio Television Library Internet Word of

Mouth

Senior

Publication

62%

34%

60%

12%

43%

53%

21%

Idaho Commission on Aging Needs Assessment Survey Results 21
15 

Figure 11. Respondents age 75+ frequently used information sources 

The most important differences between the age groups and the sources they frequently use for 

information about services and activities are TV, Internet, and senior publication use. Figure 12

shows that the use of senior publications and TV as a source of information increases as the age 

of the respondents’ increases. The percentage of respondents using the Internet as a frequent 

source of information for services decreases with the increasing age, where as printed sources 

increase. 

0%

20%

40%

60%

80%

News

Paper

Radio Television Library Internet Word of

Mouth

Senior

Publication

63%

24%

58%

17% 19%

51%

26%

Figure 12. Use of newspaper, internet and senior publications for service information by age

0%

10%

20%

30%

40%

50%

60%

70%

50-57 58-65 66-74 75+

Newspaper

Internet

Senior

Publication

Idaho Commission on Aging Needs Assessment Survey Results 22
16 

Access to transportation is often cited as a major problem for seniors in western states like Idaho, 

where distances to medical facilities or locations where seniors might receive services can be 

many miles away. However, 84% of 2012 survey respondents indicated they have not needed 

any help getting or arranging transportation, down slightly compared to 88% in 2008 (Figure 13). 

Survey respondents drive themselves (85%) or ride with friends or family members (12%) for 

most of their trips. Less than 1% walk, use public transportation, or take a senior van, shuttle, 

minibus, or taxi. Table 8 shows that when individuals do have trouble getting transportation, the 

most common reasons are; having to rely on others (7% vs.15% in 2008), disability (5% vs. 5%), 

or weather (4% vs. 13%). Overall the 2012 respondents seemed to have much lower difficulty 

with transportation problems than the 2008 survey results. 

Table 8. Reasons for difficulties in finding or arranging transportation 

Reasons for Difficulty n 2012 % n 2008 %

Have to rely on other(s) 56 6.9 121 14.7

Not available when I need to go 16 2.0 46 5.6

Can’t afford it 21 2.6 59 7.2

Not available in my community 16 2.0 51 6.2

Have trouble getting around without someone to help 28 3.4 26 3.2

Unfamiliar with transportation options or systems 12 1.5 45 5.5

Car doesn’t work/problems with vehicle 15 1.8 78 9.5

Don’t know who to call 12 1.5 23 2.8

Too far/Distance related 18 2.2 33 4.0

Weather 33 4.0 109 13.3

Transportation does not go where I need to go 22 2.7 54 7.8

Disability/health related reasons 44 5.4 44 5.4

Other 13 1.6 33 4.0

Figure 13. Percentage of individuals who need help getting or arranging transportation

4%

84%

Trouble getting or arranging transportation

A lot or Some

None

Idaho Commission on Aging Needs Assessment Survey Results 23
17 

Of those individuals who indicated they needed a lot or some help getting or arranging 

transportation, half (50%) were age 75 and older and 25% were in the 66-74 year age group. 

Figure 14 illustrates how the need remains fairly stable among respondents aged 50-65. 

Respondents with lower household income levels had increased difficulty with transportation. 

Figure 15 shows that as respondents’ household income increases, their need for help in finding 

transportation decreases. Over half (61%) of the respondents who needed a lot or some help in 

finding or arranging transportation had a reported household income of less than $20,000 per 

year, compared to 46% in 2008. Conversely, only 10% of those with a household income of 

$60,000 or more needed a lot or some help. 

Figure 14. Percentage of individuals who need a lot or some help finding or arranging 

transportation by age group

Figure 15. Comparison of percentage of respondents’ ease in getting transportation, by income level 

10%

14%

25%

50%

Trouble getting or arranging transportation

50-75

58-65

66-74

75+

0%

20%

40%

60%

80%

Less than

$20,000

$20,000 to under

$40,000

$40,000 to under

$60,000

$60,000 or more

61%

19%

11% 10%

27% 29%

19% 24%

A lot or

some

None

Idaho Commission on Aging Needs Assessment Survey Results 24
18 

Difficulty in arranging transportation for specific trips tended to be more problematic. Over 17% 

of survey respondents either frequently or sometimes had trouble arranging transportation for 

medical trips, similar to the 2008 study (17%). Additionally, 11% and 10% frequently or 

sometimes had trouble arranging transportation for shopping or personal errands, respectively. 

Transportation difficulties can also hinder the ability for seniors to be social, with 14% noting 

they frequently or sometimes had difficulty arranging transportation for recreation or social trips; 

similar to the 15% from 2008. 

 

Long-Term Care Insurance Plans 

The majority (79%) of survey respondents do not have long-term care insurance. Most 

individuals (51%) noted they plan on paying for long-term care with Medicare. Additionally, 6% 

plan to use Medicaid (down from 15% in 2008), and of the 27% who indicated “other” (down 

from 32% in 2008). Overall in 2012, 30% don’t know how they will pay for long term care, 8% 

plan to rely on family and 35% indicate savings and investments. Ten percent of respondents 

responded that they will rely upon their private insurance or veteran’s benefits. Fewer 

respondents age 50-57 have long-term care insurance than those ages 75 and older (Figure 16). 

Still, over 75% of respondents age 66 and older do not have long-term care insurance, which is 

consistent with the 2008 survey results. 

Figure 16. Percentage of respondents by age that have long-term care insurance

0%

5%

10%

15%

20%

25%

50-57 58-65 66-74 75+

12%

18%

24% 24%

Idaho Commission on Aging Needs Assessment Survey Results 25
19 

Care Giving 

Among survey respondents, 19% (n=156) indicated they provide care for at least one friend or 

family member on a regular basis. Of those who provide care for friends or family members, 

63% provide care for one person, 21% for two people and 16% for three or more people. 

Twenty-three percent of the caregivers in the sample are taking care of a parent and 24% are 

taking care of their spouse. In addition, 21% are taking care of a grandchild (Figure 17). 

Caregivers who provide care for family and friends spend a great deal of time providing care. 

The average number of hours per week is illustrated in Table. The highest average (68 hours) is 

for spousal care giving, followed by caring for an adult child (49 hours), then grandchild member 

(35 hours). 

Table 9. Average number of hours of care by care recipient 

Care Recipient Average number of hours per 

week

Spouse 68

Parent 10

Friend/neighbor 11

Adult child 49

Grandchild 35

Partner 34

Other family member 21

Other 23

Figure 17. Percentage of care recipients among respondents who are caregivers

0% 5% 10% 15% 20% 25%

Spouse

Parent

Grandchild

Adult child

Friend

Other

Partner

24%

23%

21%

18%

10%

4%

1%

Idaho Commission on Aging Needs Assessment Survey Results 26
20 

Forty-six percent of caregivers were providing care without any help from friends or family 

members (41% in 2008), and on average spend $293 per month of their own money to provide 

this care. Over half (68%) of caregivers are not aware of services in their community that could 

help them provide care, compared to 54% in 2008. Of those who are aware of available services, 

they were familiar with include home health care and Meals on Wheels. Few were aware of 

respite and transportation options. 

Twenty-one percent of respondents who are caregivers said they receive no help or far less help 

than they need; a 3% increase from 2008. For those respondents who do share caregiving 

responsibilities, they share duties with other family members, such as taking turns providing 

transportation to appointments, cooking meals, and overseeing finances. Fifty-one percent of 

caregivers noted they are frequently or sometimes stressed by their caregiving responsibilities, 

which is down slightly from 2008 (59%). (Figure 18). 

Caregivers noted numerous types of supports that would help them in their care giving role 

(Table ). The greatest need was for services such as financial support or formal advice. In 2012, 

financial support became the top need for caregivers, compared to adult day care services, which 

was the top need in 2008. Additionally, the 2012 results indicate a stronger need for formal 

advice or emotional support compared to 2008, 17% and 13% respectively. 

Figure 18. Caregiver rate of stress experienced in the past two months

12%

39%

42%

7%

Frequently

Sometimes

Never

Don't

Know

Idaho Commission on Aging Needs Assessment Survey Results 27
21 

Table 10. Type of help caregivers could use in caregiving 

Type of Help 2012 2008

Financial support 21% 13%

Formal advice or emotional support (from a therapist, counselor, 

psychologist, or doctors) on issues such as caring for grandchildren 

and other caregiving issues

17% 12%

Services such as adult day services, supervision, benefits, 

transportation 14% 20%

Equipment (such as assistive devices, ramps, rails, etc.) 10% 11%

Communication tips for people with reduced mental function (i.e. 

dementia, Alzheimer’s) 9% 11%

Organized support groups 8% 6%

Legal Assistance 8% 10%

Physical care information (lifting, diapering, transporting, cleaning for 

an ill person 4% 7%

Respite (services that allow me to have free time for myself) 7% 12%

Assistance and Support 

Respondents were asked how much practical support they receive; such as being given a ride, 

having someone shop for them, loan them money, or do a home repair. Respondents indicated 

that do not receive much support. The most frequent source of support reported was from family 

members, with 32% receiving a lot of support, 19% some support, and 19% a little support. 

These findings were generally consistent with those from the 2008 survey. Table 9 illustrates the 

percentage of individuals receiving the different levels of support from different sources. 

Table 9. Sources and level of support 

A lot of 

support

Some 

support

A little 

support

No support

Your family 31.8% 18.6% 18.6% 31%

Your friends 14.8% 21.9% 25.5% 37.8%

Your neighbors 8.0% 16.5% 24.8% 50.7%

A church or spiritual group 10.5% 13.1% 12.8% 63.6%

A club or social group 3.2% 7.1% 10.4% 79.3%

A non-profit community agency 2.3% 4.9% 7.0% 85.8%

Despite reporting that they do not receive a lot of support from any one source, respondents 

overwhelmingly reported they could call a family member for help (74%). Fifteen percent said 

they had a friend or neighbor they could call. Of those who had someone they could call, 80% 

lived less than 10 miles from this person and 9% lived within 10-25 miles. Six percent said there 

was no one they could call for help. The results for assistance were consistent with the 2008 

results. 

Respondents of varying ages receive significantly different levels of assistance and support. As 

might be expected, the level of support received from all types of resources increased for the 

Idaho Commission on Aging Needs Assessment Survey Results 28
22 

older groups. Figure 19 shows the percentage of respondents who receive some level of 

assistance or support (a lot, some, or a little) by entity or organization. Family members provide 

the most support across all age groups followed by friends and neighbors. The percentage of 

respondents receiving some level of support or assistance from family members increases from 

the 50-57 year old group to the 58-65 year old group and again from the 66-74 year old group to 

the oldest group, age 75 and older. Respondents in the 58-65 year old and 66-74 year old groups 

are relatively consistent. 

The respondents have numerous areas of concern emotionally, physically and financially that 

might indicate that, while they have individuals they can call in an emergency situation, they

may not be calling for help - especially for their emotionally needs. The area of most concern for 

respondents was their physical health. Forty-one percent said it was a minor problem and 14% 

said it was a major problem and an additional 4% anticipate having a problem with their health 

in the future representing a slight increase from 2008. While most respondents do not consider 

their emotional problems major, many noted feeling depressed (21%), feeling lonely, sad or 

isolated (19%) or having too few activities or feeling bored (16%) as a minor problem. Having 

financial problems (20%) and feeling lonely or depressed, 19% and 21%, respectively are among 

the top minor problems. The issues most concerning for respondents in the future (anticipating a 

problem in the future) were having financial problems (8% in 2012 and 4% in 2008), affording 

needed medications (6% in 2012 and 3% in 2008) and having housing suited to their needs (10% 

major and minor – or should this be a comparison to 2008). 

Table 12 illustrates the areas respondents describe as major or minor problems. In all categories, 

major and minor problems increased from 2008 to 2012 with the exception of physical health, 

which was unchanged. 

Figure 19. Percentage of respondents that receive a lot, some or a little support or 

assistance from various sources by age 

0%

10%

20%

30%

40%

50%

60%

70%

50-57 58-65 66-74 75+

Community

Agency

Church/Spritual

Group

Friends

Community/Social

Group

Neighbors

Family

Idaho Commission on Aging Needs Assessment Survey Results 29
23 

2012 Major 2012 Minor 2008 Major 2008 

Minor

Your physical health 14.8% 41.0% 14.0% 41.4%

Having housing suited to your 

needs 2.5% 7.2% 0.9% 5.7%

Getting the health care you need 6.9% 11.4% 3.6% 10.2%

Having inadequate transportation 3.7% 7.8% 0.7% 7.2%

Feeling lonely, sad or isolated 3.3% 18.8% 2.9% 16.5%

Having enough food to eat 4.5% 5.0% 1.2% 2.6%

Affording the medications you need 6.1% 13.0% 3.4% 13.1%

Having financial problems 5.5% 20.3% 4.0% 16.7%

Feeling depressed 3.8% 20.8% 3.5% 23.1%

Being physically or emotionally 

abused 1.4% 3.0% 0.0% 1.0%

Being financially exploited 1.7% 6.4% 1.0% 3.9%

Being a victim of crime 1.4% 3.8% 0.4% 2.4%

Dealing with legal issues 2.6% 10.2% 1.2% 7.8%

Performing everyday activities such 

as walking, bathing, or getting in 

and out of a chair

3.3% 9.3% 1.3% 6.3%

Having too few activities or feeling 

bored 3.3% 16.1% 1.8% 13.4%

Between 2008 and 2012, the percentage of respondents choosing major or minor concerns 

increased for every category except affording gasoline. This likely reflects the current economic 

problems throughout the United States. In 2008, the highest financial concern was being able to 

afford gasoline, whereas in the 2012 survey; affording dental care was the highest concern at 

21%. Other necessities that were reported as being difficult to afford were: 16% of respondents 

have not been able to afford eyeglasses compared to 9% in 2008 and 10% are unable to afford 

hearing aids, similar to the 2008 findings. Eleven percent cannot afford insurance, compared to 

8% in 2008. 

Figure 20 illustrates the percentage of respondents who have needed certain necessities like 

dental care, eyeglasses, and insurance and have not been able to afford them. 

Figure 20. Percentage of respondents not able to afford necessities

Idaho Commission on Aging Needs Assessment Survey Results 30
24 

Other Concerns 

Many survey respondents have concerns about their future even though most (85%) consider 

their community a good place to grow old. Those concerns include how they will pay for health 

care or be able to afford other necessities, not having health insurance, and needing help with 

transportation, in-home repairs and caregiving. Numerous respondents also mentioned they are 

unnerved by the state of world affairs. 

Primarily, all the concerns of respondents focused on their financial viability, even more so than 

in 2008. Several respondents from rural areas are concerned about having to leave their 

community when they need help: “I live in a rural area. I am at the point where I can no longer 

adequately take care of my house and yard. I do not need assisted living and do not want to live 

in a city or town.” 

Respondents also worry they will not have enough money to pay for health care and without 

health insurance many noted they will not be able to pay for prescription medications. 

Escalating costs for utilities, rent/mortgages and food make it even more difficult for individuals 

to afford health care. Additionally, some respondents worry about their own declining health in 

the mix of being able to afford to care for others. Some are concerned who will take care of 

them when their spouse dies. There is a need for more services to help care for family members 

(spouse or parents). There are a large percentage of those who care for family members who do 

not know what services are available. 

Summary and Implications 

0% 25%

2008

2012

Idaho Commission on Aging Needs Assessment Survey Results 31
25 

The Idaho Commission on Aging Needs Assessment provides numerous important findings for 

future planning. Respondents provided information about their ability and desire to participate in 

various social activities, their ability to perform varying levels of physical activities and the ways 

they obtain information about services. In addition, respondents were asked about transportation 

options within their communities, the level of support they receive from family, friends or 

community members, and how they will pay for long-term care. The survey closed with an 

opportunity for respondents to share any other issues that might be of concern. 

Key results derived from this study are overall similar to the 2008 findings, with some specific 

changes highlighted below. 

1. Respondents are most concerned about the cost of medical care, health insurance and 

staying in their homes as they age. 

Respondents are most concerned about their ability to afford their homes, health insurance and 

medical care. Numerous respondents noted they were already living on a tight budget. With 

increasing costs for utilities and food, being able to afford dental care, eyeglasses, medications, 

and health care has become increasingly difficult. Individuals who are not able to perform 

physical activities, such as housework or home repairs, or get the assistance they need to perform 

such tasks, will find it increasingly difficult to remain in their own homes. Providing the 

assistance for these physical household chores could impact the ability of many to remain in their 

homes and overall could reduce the cost of their care. 

2. Changes in access to information vary widely by age, and need to be considered when 

targeting specific segments of the over 50 population. 

The method used to reach seniors needs to be carefully considered. Across all age groups, 

respondents lack interest in senior centers. Senior centers, as one respondent put it, need to be 

“cheerful and bright for active intelligent people, not just [a place] to serve cheap meals and play 

Bingo.” While this characterization may not be an accurate representation of many senior 

centers, it illustrates a perception about senior centers that may hinder participation by the 

younger groups or those closer to age 50. In addition, if a proposed service is to be delivered 

across all age groups (50 and older) then newspapers and television will reach the widest 

audiences. However, if the target audience is under 65, the Internet could be an effective way to 

reach a wide audience. Information from friends and family members carry a great deal of 

weight with the oldest group. 

3. The oldest Idahoans have the greatest needs for assistance in finding transportation and 

performing the physical activities necessary to remain in their homes. 

The results provide important information for service delivery planning for older adults. Key to 

this planning will be paying close attention to the oldest group of Idahoans (age 75 and older) as 

this group struggles the most to find transportation options and keep up with the physical 

activities necessary to keep their homes and remain in their communities. This is not to say that 

younger respondents do not also have difficulty; in fact, the results show an increasing 

percentage of individuals in each age group who struggle with these issues. Also key in planning 

is understanding that older adults in Idaho do not receive a significant amount of help from 

sources other than family members, most do not have long-term care insurance and more than 

half plan to pay for long-term care with Medicare. 

Idaho Commission on Aging Needs Assessment Survey Results 32
26 

4. Even with 74% of respondents indicated they have someone to call who lives within 10 

miles, most do not receive a significant amount of help. 

Only 32% of respondents receive a lot of help from family members and 36% receive some or a 

little support from family members. Even less receive any support from friends and neighbors or 

the community. However, the perception is that most have someone they can call who lives close 

by. Despite this perception, about 22% noted that feeling depressed, lonely, sad, or isolated was a 

major or minor problem and respondents overall were having more difficulty affording the 

necessities, including dental care (21%) and being able to afford eyeglasses (16%). 

5. Fewer than 25% of survey respondents have long-term care insurance and most believe 

they can use Medicare or private insurance to pay for long-term care. 

It is imperative that seniors receive more education about long-term care issues. Overall more 

than 50% of individuals plan to use Medicare to pay for their long-term care needs. Medicare 

does not currently cover many of the services that might be needed for long-term care and thus, a 

large percentage of elderly Idahoans are vulnerable should they need long-term care services. 

6. Almost 25% of respondents are caregivers for family or friends and 33% of those 

caregivers provide care for more than one person. 

Respondents who are caregivers for family or friends provide an invaluable service for those that 

depend upon them; however, the burden seems to be quite heavy. More than 33% of those 

respondents who are caregivers are caregivers for more than one person; 22% for two people and 

13% care for three or more people. In addition, they spend an average of $293 per month of their 

own money. The most common care recipients are spouses and parents. Caregivers spend an 

average of 68 hours per week for spouses and 10 hours per week for parents. Of concern is the 

fact that approximately 51% of respondents reported being frequently or sometimes stressed in 

the past two months by their caregiving role. 

Idaho Commission on Aging Needs Assessment Survey Results 33
27 

Appendix A 

Survey Instrument 

Idaho Commission on Aging Needs Assessment Survey Results 34
28 

Dear Fellow Idahoan: 

You have been selected to receive this survey from the Idaho Commission on Aging and the 

Center for the Study of Aging at Boise State University. The survey is part of our effort to 

identify ways to improve the quality of long-term care services for people in Idaho. 

Participation in this survey is completely voluntary. It should take about 20 minutes to 

complete. 

The Idaho Commission on Aging (ICOA) is the sole state agency to administer programs and 

services for Idahoans 60 years of age and older funded by the federal Older Americans Act and 

the Idaho Senior Services Act. If you are an Idahoan age 50 years or older, we would like to ask 

about your opinions. Your responses will provide information for current and future planning 

efforts. Answering this survey gives you a chance to tell us about your values, priorities and 

concerns. We want to know how you feel, and what you know and think about the choices 

available as you age. Your responses will help shape future services provided to older Idahoans. 

Information from the Idaho survey will make it possible to tailor programs to specific needs in 

Idaho and more effectively promote services needed by you and your family. 

If you choose to complete the paper survey, please return it in the pre-paid envelope by 

March 30, 2012. If you would prefer to complete the survey online, please type in the following 

web address. 

https://boisestate.qualtrics.com/SE/?SID=SV_0vK4IZNcib4eLCk

For this research project, we are requesting demographic information. Due to the make-up of 

Idaho’s population, the combined answers to these questions may make an individual person 

identifiable. We will make every effort to protect participants’ confidentiality. However, if you 

are uncomfortable answering any of these questions, you may leave them blank. All survey 

responses will be kept completely confidential and no individual replies will be reported. 

If you have any comments or questions about this survey, please contact Dr. Lee Hannah at (208) 

426-2508, or the Institutional Review Board at Boise State University, Office of Research 

Administration, 1910 University Drive, Boise, ID 83725-1135 or (208) 426-1574. 

We thank you for your time and appreciate your assistance with this important project. 

Sincerely, 

 

Sam Haws, Administrator Lee Hannah, DVM, MS, MPH 

Idaho Commission on Aging Center for the Study of Aging

www.aging.idaho.gov

Idaho Commission on Aging Needs Assessment Survey Results 35
29 

Idaho Commission on Aging Community Needs Assessment

For each survey item below,  check the box that best represents your opinion or 

experience. 

1. My community is a good place to grow old? 

1 Yes

0 No If No, please explain________________________________________ 

 

2. For most of your trips, how do you travel? (select one)

3. In the past 12 months, how much help have you needed getting or arranging 

transportation? 

1 A lot 2 Some 3 None

4. If you selected A lot or Some in Question 3, what would you say were the reason(s)? 

(check all that apply) 

A Have to rely on 

 other(s)

 F Unfamiliar with transportation

 options or systems

 J Weather

B Not available when I 

 need to go

G Car doesn’t work/ problems 

 with vehicle

K Transportation 

does not go where I 

need 

C Can’t afford it H Don’t know who to call L Disability / health 

 related reasons

D Not available in my 

 community

I Too far / Distance related M Other

E Have trouble getting around without someone to help

5. How often has it been difficult for you to arrange transportation for each of the following 

activities? 

Frequently Sometimes Never

a. Medical trips 3 2 1

b. Shopping 3 2 1

c. Personal errands 3 2 1

d. Recreational or social trips 3 2 1

1 Drive myself 5 Take a taxi

2 Ride with a family member or friend 6 Walk

3 Take public transportation

4 Take a senior van, shuttle, or minibus

7 Not applicable – Never leave house

8 Other________________________

Idaho Commission on Aging Needs Assessment Survey Results 36
30 

6. Do you have long-term care insurance (Insurance policies which pay for long-term care 

services such as nursing home and home care)? 

 1 Yes 0 No

7. How do you plan on paying for your long-term care in the future? 

1 Medicare 3 Long-term care insurance policy

2 Medicaid 4 Other please specify_____________________________

8. How often do you use the following services or attend/visit the following locations? 

As often as 

I’d like

Almost as often as 

I’d like

Not nearly as 

often as I’d like

Not 

interested

a. Community events / 

Social clubs

4 3 2 1

b. Degree and non-degree 

courses

4 3 2 1

c. Exercise & Fitness / 

Workouts / Activities

4 3 2 1

d. Family activities 4 3 2 1

e. Library 4 3 2 1

f. Medical/pharmacy visits 4 3 2 1

g. Parks 4 3 2 1

h. Religion / worship 4 3 2 1

i. Senior centers 4 3 2 1

j. Shopping 4 3 2 1

k. Sporting events 4 3 2 1

l. Volunteer work 4 3 2 1

m. Working for pay 4 3 2 1

9. Following is a list of information sources. How often, if at all, do you use each source to 

find out about services and activities available to you?

Frequently Sometimes Never

a. Newspaper 3 2 1

b. Radio 3 2 1

c. Television 3 2 1

d. Library 3 2 1

e. Internet 3 2 1

f. Word of mouth 3 2 1

g. Senior publications 3 2 1

Idaho Commission on Aging Needs Assessment Survey Results 37
31 

10. If you checked Frequently or Sometimes to Question 9e, how often do you use a 

computer to access information from the internet? 

4 Frequently, at least once per week 2 Rarely, less than once per month

3 Often, several times per month 1 Never

11. If you use a computer to access information on the internet, where is the computer 

located? (check all that apply)

1 my home 4 the home of a family member or friend

2 library 5 work

3 senior center 6 other:

12. Please tell me if you can do each of the following activities without any help, with some 

help, or if you cannot do this at all. Can you...

Without any 

help

With some 

help

Cannot 

do this 

at all

a. Prepare your meals 3 2 1

b. Shop for personal items 3 2 1

c. Manage your medications 3 2 1

d. Manage your money 3 2 1

e. Use a telephone 3 2 1

f. Do light housework like dusting or vacuuming 3 2 1

g. Do heavy housework like moving furniture or 

washing windows 3 2 1

h. Do interior or exterior repairs 3 2 1

i. Do yard work and snow shoveling 3 2 1

j. Walk 3 2 1

k. Eat 3 2 1

l. Dress yourself 3 2 1

m. Bathe 3 2 1

n. Use the toilet 3 2 1

o. Get in and out of bed 3 2 1

p. Respond to emergencies 3 2 1

Idaho Commission on Aging Needs Assessment Survey Results 38
32 

13. How much practical support do you receive from the following sources? Examples of 

practical support are: being given a ride, having someone shop for you, or do a home repair 

for you. 

A lot of 

support

Some 

support

A little 

support

No 

support

a. Your family 4 3 2 1

b. Your friends 4 3 2 1

c. Your neighbors 4 3 2 1

d. A church or spiritual group 4 3 2 1

e. A club or social group 4 3 2 1

f. A non-profit community agency 4 3 2 1

14. Thinking back over the last 12 months, how much of a problem has each of the following 

been for you? 

Major 

problem

Minor 

problem

No 

problem

Anticipate 

having a 

problem in the 

future

a. Your physical health 4 3 2 1

b. Having housing suited to your needs 4 3 2 1

c. Getting the health care you need 4 3 2 1

d. Having inadequate transportation 4 3 2 1

e. Feeling lonely, sad or isolated 4 3 2 1

f. Having enough food to eat 4 3 2 1

g. Affording the medications you need 4 3 2 1

h. Having financial problems 4 3 2 1

i. Feeling depressed 4 3 2 1

j. Being physically or emotionally abused 4 3 2 1

k. Being financially exploited 4 3 2 1

l. Being a victim of crime 4 3 2 1

m. Dealing with legal issues 4 3 2 1

n. Performing everyday activities such as 

walking, bathing, or getting in and out of 

a chair

4 3 2 1

o. Having too few activities or feeling bored 4 3 2 1

Idaho Commission on Aging Needs Assessment Survey Results 39
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15. Have you recently needed any of the following, but could not afford them? 

Yes No

a. Eyeglasses 1 0

b. Hearing aids 1 0

c. Walkers/Wheelchairs/Canes 1 0

d. Dental Care 1 0

e. Prescription medications 1 0

f. Rent/Mortgage 1 0

g. Utilities 1 0

h. Taxes 1 0

i. Insurance 1 0

j. Food 1 0

k. Gasoline 1 0

16. If you needed assistance, is there someone you could call for help? (Select one)

0 No 1 Yes, a family member

2 Yes, a friend or neighbor

3 Yes, other

If yes, how far away does this person live?

1 0-9 miles 3 26-50 miles 5 76-100 miles

2 10-25 miles 4 51-75 miles 6 Greater than 100 miles

17. Do you provide care for one or more family members or friends on a regular basis? 

 1 Yes 0 No (Please skip to question 26)

18. For how many family members or friends do you provide care? ___________________ 

19. For whom do you provide care and about how many hours per week do you spend 

providing care for this person or these persons? 

Average number of 

hours per week

Average number 

of hours per week

a. Spouse _____ e. Grandchild _____

b. Parent _____ f. Partner _____

c. Friend/Neighbor _____ g. Other family member _____

d. Adult Child _____ h. Other: ____________ _____

Idaho Commission on Aging Needs Assessment Survey Results 40
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20. Are other family members or friends involved in the care of this person(s)? 

 1 Yes 0 No

If Yes, how are they working together to provide care for this person(s)? 

21. Think of the help you get from all your family and friends in looking after the person(s) 

for whom you provide care. Please identify the one response that most closely identifies your 

situation: (Check only one.) 

1 I receive no help 

2 I receive about what I need in terms of help 

3 I receive somewhat less help than I need

4 I receive far less help than I need 

5 I don’t need any help

22. How much of your money do you spend every month to provide care for this person(s)?

$_________ 

23. How often in the past two months have you felt stressed by your care giving? 

1 Frequently 3 Never

2 Sometimes 4 Don’t know

24. Are you aware of services provided in your community that could help you provide 

care?

If yes, what is offered in your community?

25. What kinds of help could you use more of in your caregiving? (check all that apply)

A Financial support

B Organized support groups

C Formal advice or emotional support (from a therapist, counselor, psychologist, or doctor) 

 on care giving issues

D Services such as adult day services, supervision, benefits, transportation

E Communication tips for people with reduced mental function (i.e. dementia, Alzheimer’s)

F Physical care information (lifting, diapering, transporting, cleaning) for an ill person

G Respite (services that allow me to have free time for myself)

H Legal assistance

I Equipment (such as assistive devices, ramps, rails, etc.)

1 Yes 0 No

Idaho Commission on Aging Needs Assessment Survey Results 41
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26. How many years have you been a resident of your community? 

1 0-5 3 11-15 5 20 or more

2 6-10 4 16-20

27. What is your year of birth? _____________

28. Overall, how do you rate your quality of life? 

1 Very good 2 Good 3 Neither good nor bad 4 Bad 5 Very bad

29. Which of the following kinds of health insurance do you have? (check all that apply)

A Medicaid

B Medicare

C Private insurance 

D Other insurance_________________ 

30. What is your gender? 

0 Male 1 Female

31. Do you consider yourself to be Hispanic or Latino? 

1 Yes 0 No

32. Which one or more of the following would you say is your race? (check all that apply)

 1 White

 2 Black or African American

 3 Native Hawaiian/Pacific Islander

4 American Indian, Alaskan Native

5 Other (Specify)____________________

Idaho Commission on Aging Needs Assessment Survey Results 42
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33. Do you currently rent or own your home? 

1 Rent 2 Own 3 Other_______________________

34. Which of the following best describes where you live? 

1 Single family home 5 Nursing home

2 Townhouse, condo, duplex, or 

apartment

6 Subsidized housing

3 Mobile home 7 

Other__________________________

4 Assisted living residence

35. How many people, including yourself, live in your household? 

1 1 person 4 4 people

2 2 people 5 5 or more people

3 3 people

36. Who lives with you? (check all that apply) 

A Spouse (wife/husband) E Other relative(s)

B Significant other F Unrelated adults/friends

C At least one child G Grandchildren/great-grandchildren

D Child(ren) and his/her/their 

family

H Other__________________________

37. What is your total annual household income? 

1 Less than $10,000 5 $40,000 to under $50,000

2 $10,000 to under $20,000 6 $50,000 to under $60,000

3 $20,000 to under $30,000 7 $60,000 to under $75,000

4 $30,000 to under $40,000 8 $75,000 or more

38. What is your marital status? 

1 Married 4 Single

2 Widowed 5 Partnered

3 Divorced 6 Other ______________________

39. How much formal education have you completed? 

1 0-11 years, no diploma 4 Associate’s degree

2 High school graduate / GED 5 Bachelor’s degree

3 Some college or technical training 6 Graduate or professional degree

Idaho Commission on Aging Needs Assessment Survey Results 43
37 

40. What is your primary occupation? 

1 Retired 5 Homemaker

2 Working full-time 6 Disabled

3 Working part-time 7 Other ______________________________

4 Unemployed, looking for 

work

41. If you are looking for employment, do you need re-training? 

1 Yes 0 No

42. Are there any other issues you are concerned about? 

0 No

1 Yes (specify)______________________________________________ 

Idaho Commission on Aging Needs Assessment Survey Results 44
38 

Appendix B 

Idaho Commission on Aging Areas 

Idaho Commission on Aging Needs Assessment Survey Results 45
39 

Idaho Commission on Aging Needs Assessment Survey Results 46
40 

Appendix C 

Overall Results 

Idaho Commission on Aging Needs Assessment Survey Results 47
41 

Idaho Commission on Aging Community Needs Assessment 

Overall Results – 2012 Survey

1. My community is a good place to grow old? 

85% Yes 15% No 

 

2. For most of your trips, how do you travel? (select one)

3. In the past 12 months, how much help have you needed getting or arranging 

transportation? 

3.5% A lot 12.8 % Some 83.8% None 

4. When you have trouble getting the transportation you need, what would you say are the 

reason(s)? (check all that apply) 

 85.0% Drive myself 0.0% Take a taxi 

 12.4% Ride with a family member or friend 0.4% Walk

 0 .6% Take public transportation 0.0% Not applicable – Never leave house 

 1.4% Take a senior van, shuttle, or minibus 0.2% Other 

6.9 % Have to rely on other(s) 

1.5% Unfamiliar with transportation options or systems 

4.0% Weather 

2.0% Not available when I need to go 

1.8% Car doesn’t work/ problems with vehicle 

2.7% Transportation does not go where I need to go 

2.6% Can’t afford it 

1.5% Don’t know who to call 

5.4% Disability / health related reasons 

2.0% Not available in my community 

2.2% Too far / Distance related 

1.6% Other 

3.4% Have trouble getting around without someone to help 

Idaho Commission on Aging Needs Assessment Survey Results 48
42 

5. How often has it been difficult for you to arrange transportation for each of the following 

activities? 

Frequently Sometimes Never

a. Medical trips 1.2% 16.4% 82.3%

b. Shopping 1.4% 10.4% 88.2%

c. Personal errands 1.4% 9.5% 89.1%

d. Recreational or social trips 2.5% 11.9% 85.7%

6. Do you have long-term care insurance (Insurance policies which pay for long-term care 

services such as nursing home and home care)?

20.9% Yes 79.1% No 

7. How do you plan on paying for your long-term care in the future? 

51.0% Medicare 16.0% Long-term care insurance policy 

6.0% Medicaid 27.0% Other 

8. How often do you use the following services or attend the following locations? 

As often as 

I’d like

Almost as 

often as I’d 

like

Not nearly as 

often as I’d 

like

Not

interested

a. Community events / 

Social clubs

43.1% 15.1% 16.4% 25.5%

b. Degree and nondegree courses

16.1% 4.0% 16.0% 63.9%

c. Exercise & Fitness / 

Workouts / 

Activities

40.1% 11.9% 20.7% 27.3%

d. Family activities 58.2% 19.5% 16.4% 5.9%

e. Library / Internet 48.3% 11.3% 14.3% 26.1%

f. Medical and 

pharmacy visits

76.8% 13.7% 4.0% 5.5%

g. Parks 58.1% 13.2% 13.8% 14.9%

h. Religion / worship 61.7% 8.0% 8.4% 21.9%

i. Senior centers 40.8% 6.8% 6.4% 46.0%

j. Shopping 73.4% 15.6% 7.1% 3.9%

k. Sporting events 42.8% 10.8% 12.8% 33.6%

l. Volunteer work 45.5% 10.8% 15.6% 28.1%

m. Working for pay 35.4% 6.4% 9.8% 48.4%

Idaho Commission on Aging Needs Assessment Survey Results 49
43 

9. Following is a list of information sources. How often, if at all, do you use each source to 

find out about services and activities available to you? 

Frequently Sometimes Never

a. Newspaper 57.0% 31.5% 11.5%

b. Radio 29.6% 39.8% 30.6%

c. Television 54.9% 33.8% 11.4%

d. Library 14.9% 33.2% 51.9%

e. Internet 42.0% 25.5% 32.5%

f. Word of mouth 49.2% 45.9% 4.9%

g. Senior publications 18.1% 40.9% 41.0%

10. If you checked frequently or Sometimes to Question 9e, how often do you use a 

computer to access information from the internet? 

77.9% Frequently, at least once 

per week

 8.2% Rarely, less than once per month

12.6% Often, several times a 

month

 1.2% Never

11. If you use a computer to access information on the internet, where is the computer 

located? (check all that apply) 

79% my home 2% home of friend or family

3% library 11% work

2% senior center 3% other

Idaho Commission on Aging Needs Assessment Survey Results 50
44 

12. Please tell me if you can do each of the following activities without any help, with some 

help or if you cannot do this at all. Can you...

Without 

any help

With 

some help

Cannot do 

this at all

a. Prepare your meals 90.9% 6.9% 2.2%

b. Shop for personal items 91.1% 7.1% 1.9%

c. Manage your medications 93.9% 4.1% 2.0%

d. Manage your money 92.2% 6.7% 1.1%

e. Use a telephone 96.6% 2.4% 1.0%

f. Do light housework like dusting or 

vacuuming 85.3% 9.9% 4.8%

g. Do heavy housework like moving 

furniture or washing windows 57.6% 27.1% 15.3%

h. Do interior or exterior repairs 42.4% 33.8% 23.9%

i. Do yard work and snow shoveling 55.3% 27.0% 17.8%

j. Walk 89.6% 8.2% 2.2%

k. Eat 98.8% 1.0% .2%

l. Dress yourself 97.3% 2.5% .2%

m. Bathe 95.7% 3.6% .7%

n. Use the toilet 98.6% 1.1% .2%

o. Get in and out of bed 98.1% 1.6% .2%

p. Respond to emergencies 90.0% 7.9% 2.1%

13. How much practical support do you receive these days from the following sources? 

Examples of practical support are: being given a ride, having someone shop for you, loan 

you money or do a home repair for you. 

A lot of 

support

Some 

support

A little 

support

No support

a. Your family 31.8%% 18.6% 18.6% 31.0%

b. Your friends 14.8% 21.9% 25.5% 37.8%

c. Your neighbors 8.0% 16.5% 24.8% 50.7%

d. A church or spiritual group 10.5% 13.1% 12.8% 63.6%

e. A club or social group 3.2% 7.1% 10.4% 79.3%

f. A non-profit community 

agency 2.3% 4.9% 7.0% 85.8%

Idaho Commission on Aging Needs Assessment Survey Results 51
45 

14. Thinking back over the last 12 months, how much of a problem has each of the 

following been for you? 

Major 

problem

Minor 

problem

No 

problem

Anticipate 

having a 

problem 

in the 

future

a. Your physical 

health 14.8% 41.0% 40.1% 4.1%

b. Having housing 

suited to your 

needs

2.5% 7.2% 84.8% 5.5%

c. Getting the health 

care you need 6.9% 11.4% 76.4% 5.3%

d. Having inadequate 

transportation 3.7% 7.8% 83.4% 5.1%

e. Feeling lonely, sad 

or isolated 3.3% 18.8% 73.3% 4.6%

f. Having enough 

food to eat 4.5% 5.0% 87.3% 3.2%

g. Affording the 

medications you 

need

6.1% 13.0% 75.2% 5.7%

h. Having financial 

problems 5.5% 20.3% 66.2% 8.0%

i. Feeling depressed 3.8% 20.8% 71.1% 4.2%

j. Being physically or 

emotionally abused 1.4% 3.0% 91.4% 4.2%

k. Being financially 

exploited 1.7% 6.4% 87.9% 4.0%

l. Being a victim of 

crime 1.4% 3.8% 89.9% 4.9%

m. Dealing with legal 

issues 2.6% 10.2% 82.2% 5.0%

n. Performing 

everyday activities 

such as walking, 

bathing, or getting 

in and out of a 

chair

3.3% 9.3% 82.5% 4.9%

o. Having too few 

activities or feeling

bored

3.3% 16.1% 76.5% 4.1%

Idaho Commission on Aging Needs Assessment Survey Results 52
46 

15. Have you recently needed any of the following, but could not afford them? 

Yes No

a. Eyeglasses 16.1% 83.9%

b. Hearing aids 10.4% 89.6%

c. Walkers/Wheelchairs/Canes 2.0% 98.0%

d. Dental Care 21.0% 79.0%

e. Prescription medications 8.8% 91.2%

f. Rent/Mortgage 5.9% 94.1%

g. Utilities 8.0% 92.0%

h. Taxes 7.1% 92.9%

i. Insurance 11.3% 88.7%

j. Food 7.4% 92.6%

k. Gasoline 13.0% 87.0%

16. If you needed assistance, is there someone you could call for help? (Select one) 

6.4% No 74.2%% Yes, a family member 

15.3% Yes, a friend or neighbor 

4.1% Yes, other 

If yes, how far away does this person live? 

79.8% 0-9 miles 3.6% 26-50 miles 1.2% 76-100 miles 

8.6% 10-25 miles .8% 51-75 miles 4.6% Greater than 100 miles 

17. Do you provide care for one or more family members or friends on a regular basis? 

18. For how many family members or friends do you provide care? 

 

 62.4% 1 

 21.8% 2 

 5.9% 3 

 3.0% 4 

 4.0% 5 

 2.0% 6 

 0.2% 10 

19. For whom do you provide care and about how many hours per week do you spend 

providing care for this person or these persons? 

19.1% Yes 80.90% No 

Idaho Commission on Aging Needs Assessment Survey Results 53
47 

Average number of hours per week 

Range Avg. SD

a. Spouse 2-168 68.6 69.9

b. Parent 1-56 9.8 10.2

c. Friend/Neighbor 1-80 10.7 20.1

d. Adult Child 1-168 49.6 64.0 

e. Grandchild 1-168 34.5 45.8

f. Partner 8-60 34.0 36.7

g. Other family member 1-168 20.7 51.9

h. Other 2-80 23.0 29.0

20. Are other family members or friends involved in the care of this person(s)? 

54.0% Yes 46.0% No 

If Yes, how are they working together to provide care for this person(s)? 

21. Think of the help you get from all your family and friends in looking after the person(s) 

for whom you provide care. Please identify the one response that most closely identifies 

your situation: (Check only one.) 

17.3% I receive no help 

44.9% I receive about what I need in terms of help 

8.3% I receive somewhat less help than I need 

3.8% I receive far less help than I need 

22.4% I don’t need any help

22. How much do you spend every month of your money to provide care for this person(s)? 

$0-5,000 Range $293.61 Avg. $579.74 SD: 

23. How often in the past two months have you felt stressed by your care giving? 

12.0% Frequently 42.0% Never 

39.2% Sometimes 6.8% Don’t know 

24. Are you aware of service provided in your community that could help you provide 

care? 

32.1% Yes 67.9% No 

If yes, what is offered in your community? 

Idaho Commission on Aging Needs Assessment Survey Results 54
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25. What kinds of help could you use more of in your caregiving? (check all that apply) 

21% Financial support 

8 % Organized support groups 

17% Formal advice or emotional support (from a therapist, counselor, psychologist, or 

doctor) on issues such as caring for grandchildren and other caregiving issues 

14% Services such as adult day services, supervision, benefits, transportation 

9% Communication tips for people with reduced mental function (i.e. dementia, 

Alzheimer’s)

4% Physical care information (lifting, diapering, transporting, cleaning) for an ill 

person 

7% Respite (services that allow me to have free time for myself) 

8% Legal assistance 

10% Equipment (such as assistive devices, ramps, rails, etc.) 

26. How many years have you been a resident of your community? 

12.4% 0-5 9.2% 11-15 60.7% 20 or more 

9.6% 6-10 5.9% 16-20 

27. What is your age? 34-97 Range 70.36 Avg. 11.2 SD 

28. Overall, how do you rate your quality of life? 

41.0% Very 

good 

44.7%

Good 

11.0% Neither 

good nor bad 

0.7% Bad 0.1% Very bad 

29. Which of the following kinds of health insurance do you have? (check all that apply) 

6% Medicaid 

39% Medicare 

38% Private insurance 

17% Other insurance 

30. What is your gender? 

41.8% Male 58.2% Female 

31. Do you consider yourself to be Hispanic or Latino? 

.9% Yes 99.9% No 

Idaho Commission on Aging Needs Assessment Survey Results 55
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32. Which one or more of the following would you say is your race? 

 94.6% White 

 0.2% Black or African American 

 0.0% Native Hawaiian/Other Pacific Islander 

 0.9% American Indian, Alaskan Native 

 1.8% Other (Specify) 

33. Do you currently rent or own your home? 

14.1% Rent 81.2% Own 4.7% Other 

34. Which of the following best describes where you live? 

77.7% Single family home 0.5% Nursing home 

7.5% Townhouse, condo, duplex, or apartment 3.2% Subsidized housing 

7.5% Mobile home 1.2% Other 

1.0% Assisted living residence

35. How many people, including yourself, live in your household? 

37.3% 1 person 3.2% 4 people 

47.5% 2 people 2.9% 5 or more people 

7.0 % 3 people 

36. Who lives with you? (check all that apply) 

37. What is your household income? 

 8.0% Less than $10,000 8.7% $40,000 to under $50,000 

 20.5% $10,000 to under $20,000 6.5% $50,000 to under $60,000 

 14.0% $20,000 to under $30,000 6.0% $60,000 to under $75,000 

 10.3% $30,000 to under $40,000 12.3% $75,000 or more

38. What is your marital status? 

48.0% Married 6.3% Single 

28.0% Widowed 1.5% Partnered 

 63% Spouse (wife/husband) 1% Other relative(s) 

 4% Significant other 2% Unrelated adults/friends 

 17% At least one child 5% Grandchildren/great-grandchildren 

 2% Child(ren) and his/her/their family 1% Other 

Idaho Commission on Aging Needs Assessment Survey Results 56
50 

14.4% Divorced 0.4% Other 

39. How much formal education have you completed? 

40. What is your employment status? 

54.6% Retired 3.9% Homemaker 

19.1% Working full-time 5.4% Disabled 

9.6% Working part-time 2.3% Other 

2.7% Unemployed, looking for work 

41. If you anticipate looking for employment, would you need re-training? 

6.1% Yes 93.9% No 

42. Are there any other issues you are concerned about? 

25.2% Yes 74.8% No 

6.9% 0-11 years, no diploma 6.7% Associate’s degree 

23.4% High school graduate / GED 16.4% Bachelor’s degree 

33.4% Some college or technical training 11.3% Graduate or professional degree 

Idaho Commission on Aging Needs Assessment Survey Results 57
51 

Appendix D 

Area Agency on Aging Results 

Idaho Commission on Aging Needs Assessment Survey Results 58
52 

Table 10. Demographic information of sample population overall and by AAA area. 

Idaho Population 

over 50 years old 

Sample Sent Survey

N=3,000

Respondents

N=814

(2010) 

Male 50+ 48% 50% 42%

Female 50+ 52% 50% 58%

Congregate Sites

N= 1,000

Respondents

N = 236

Area I 16% 18%

Area II 9% 6%

Area III 40% 25%

Area IV 13% 20 %

Area V 10% 13%

Area VI 11% 18%

Table 11. Survey participant age from surveys, overall and by AAA area. 

Average Standard Deviation Range

2008 66.9 10.8 50-99

2012 Total 70.5 11.1 51-97

2012 Area 76.3 8.7 53-95

Area I 77.1 8.6 58-92

Area II 76.9 8.9 61-91

Area III 75.3 8.6 53-91

Area IV 74.7 9.3 54-92

Area V 78.6 7.5 64-95

Area VI 76.9 9.1 59-92

Social Activities Area Results 

As with the 2008 data, there were very few differences across regions compared to the overall 

results in terms of whether individuals are able to participate in social activities as often, almost 

as often, or not as often as they would like. The one major exception was the interest in senior 

centers. Since the area specific information was collected from congregate meal sites, 

respondents who participate in congregate meals would be more aware of, or interested in, senior 

centers compared to the mail respondents. 

More respondents from Area II indicated they don’t attend senior centers as often as they would 

like (14.3%), compared to the remaining regions at less than 5% each. When asked whether 

respondents were interested in degree or non-degree programs, again, there was little difference 

across area agencies, with the exception of Area IV that had the highest percentage of 

respondents reporting that they do not attend nearly or as often as they would like (26.3%) 

compared to the remaining area agencies (average 17%). 

Idaho Commission on Aging Needs Assessment Survey Results 59
53 

Additionally, Area I was among the highest percentage of not interested in working for pay but 

they are also among the highest of not working nearly as often as they would like (17.6%). 

(Figures 1 and 2) 

Figure 1. Percentage of respondent interest in attending senior centers by AAA area

Figure 2. Percentage of respondents interested in working for pay by AAA area 

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Area I Area II Area III Area IV Area V Area VI

Not interested

Not nearly as often as I'd like

Almost as often as I'd like

As often as I'd like

0%

10%

20%

30%

40%

50%

60%

70%

Area I Area II Area III Area IV Area V Area VI

Not interested

Not nearly as often as I'd like

Almost as often as I'd like

As often as I'd like

Idaho Commission on Aging Needs Assessment Survey Results 60
54 

Physical Activity Area Results 

For most activities, the area results were similar to the overall results. There were some slight 

differences in ability to do light and heavy housework. Respondents in Areas I and VI have the 

greatest need for help with light and heavy housework. Twenty-four percent of respondents in 

Area I and 26% in Area VI can only do light housework like dusting and vacuuming with some 

help and 35% in Area VI need help with heavy housework, like moving furniture or washing 

windows (Figure 3 and 4). Area III and IV were among the highest areas who self-reported 

needing help to do tasks like yard work, 36% and 48% respectively. When asked about yard 

work, 40% of respondents in Area II and 38% in Area V reported they cannot do this at all 

(Figure 5). 

Figure 3. Percentage of responses to ability to do light housework by AAA area.

Figure 4. Percentage of responses to ability to do heavy housework by AAA area. 

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Area I Area II Area III Area IV Area V Area VI

Cannot do this at all

With some help

Without any help

0%

10%

20%

30%

40%

50%

60%

Area I Area II Area III Area IV Area V Area VI

Cannot do this at all

With some help

Without any help

Idaho Commission on Aging Needs Assessment Survey Results 61
55 

Figure 5. Percentage of responses to ability to do yard work by AAA area. 

Sources of Information Area Results 

Regionally, survey respondents were consistent with the sources they use most frequently to find 

information about services or activities. Newspapers remain the most frequently used source in 

all regions except region VI (Error! Reference source not found.). Area IV respondents use the 

internet as a frequently used source of information about services and activities at 46%, but still 

as a secondary source to newspaper. Area V indicated the lowest response to internet usage for 

information sources at 16%. 

Figure 6. Percentage of responses to frequently used sources of information by AAA area. 

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Area I Area II Area III Area IV Area V Area VI

Cannot do this at all

With some help

Without any help

0%

10%

20%

30%

40%

50%

60%

70%

80%

Area I Area II Area III Area IV Area V Area VI

Newspaper

TV

Internt

Senior publication

Idaho Commission on Aging Needs Assessment Survey Results 62
56 

Transportation Area Results 

Areas I and VI had the highest percentage of individuals who indicated they needed a lot of help 

getting or arranging transportation in the past 12 months. In Area I, 10% of respondents 

indicated they need a lot of help and 8% in Area VI indicated this need (Figure 7). However, 

respondents across all regions reported some difficulty in finding transportation for specific 

activities such as medical trips, shopping, personal errands or recreational or social trips. 

Figure 7. Percentage of responses to difficulty in getting or arranging transportation by AAA area. 

The greatest difference in transportation between areas was when respondents self-reported the 

reasons why they had difficulty finding or arranging transportation. 

 illustrates the reasons by region. In all areas, “Having to rely on others” was the top reason for 

having difficulty arranging transportation. The second highest reason for having difficulty 

arranging transportation was “The transportation doesn’t go where I need it to”; Area III was the 

highest at 10.8% followed by Area I at 9.2%. Weather was also a top reason for Area II (13%) 

compared to less than 5 % for other regions. 

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Area I Area II Area III Area IV Area V Area VI

A lot

Some

None

Idaho Commission on Aging Needs Assessment Survey Results 63
57 

Table 3. Reasons for difficulties in finding or arranging transportation by AAA area. 

Region

I II III IV V VI

Have to rely on other(s) 12% 7% 9% 10% 13% 12%

Not available when I need to go 2% 0% 3% 4% 3% 5%

Can't afford it 2% 7% 5% 2% 0% 2%

Not available in my community 10% 0% 2% 2% 3% 0%

Have trouble getting around without someone 

to help 2% 0% 3% 0% 7% 2%

Unfamiliar with transportation options or 

systems 2% 0% 2% 0% 0% 5%

Car doesn't work/problems with vehicle 0% 0% 0% 4% 0% 0%

Don't know who to call 2% 0% 2% 0% 3% 5%

Too far/Distance related 7% 0% 3% 2% 3% 2%

Weather 5% 13% 3% 2% 3% 5%

Transportation doesn't go where I need to go 9.2% 2.4% 10.8% 4.8% 6.7% 6.7%

Disability/health related reasons 5.3% 6.0% 4.9% 3.2% 7.8% 6.7%

Other 3.8% 2.4% 3.5% 4.8% 5.6% 4.8%

Caregiving Area Results 

The distribution of caregivers was similar across the areas (Error! Reference source not 

found.). Area II had a higher percentage of respondents who identified themselves as caregivers 

(40%), however this region had the lowest number of respondents and this finding may not by

representative of the larger population of Area II. 

Figure 8. Percentage of respondents self-reporting being caregivers by AAA area.

0%

5%

10%

15%

20%

25%

30%

35%

40%

Area I Area II Area III Area IV Area V Area VI

Idaho Commission on Aging Needs Assessment Survey Results 64
58 

One key difference in area responses was in the area of awareness of services available for caregivers. 

With the exception of Area V, less than 50% of caregivers were aware of services available in their area 

(Figure 9). Area III and VI respondents indicated that only 30% of care givers were aware of services. 

Area V indicated that all respondents were aware of services, but the sample size of care givers by region 

is too small to allow for statistical comparisons so these results may not represent the area population. 

Figure 9. Percentage of caregiving respondents who are aware of services by AAA area. 

Assistance and Support Area Results 

Across the regions, roughly the same percentage of respondents receive some type of support 

and assistance from family, church or spiritual groups, clubs or social groups, and non-profit 

community agencies. Figure 10 and 11 illustrates the percentage of respondents who receive 

some level of support from family and community agencies, respectively. Area III was highest 

among those that receive no or little support from family and Area II was among the highest in 

receiving some or a lot of support from family. 

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Area I Area II Area III Area IV Area V Area VI

Idaho Commission on Aging Needs Assessment Survey Results 65
59 

Figure 10. Percentage of respondents who reported receiving support from family, by AAA area. 

The number of respondents who indicated they get some support from community agencies is very low 

compared to other areas of support. Area IV respondents indicated they get some or a lot of support at 

28% compared to less than 16% in other regions. 

Figure 11. Percentage of respondents who get support from community agencies by AAA area. 

0%

10%

20%

30%

40%

50%

60%

70%

80%

Area I Area II Area III Area IV Area V Area VI

No Support

Some or a lot of Support

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Area I Area II Area III Area IV Area V Area VI

No support

Some support

Idaho Commission on Aging Needs Assessment Survey Results 66
60 

Respondents in some areas had more difficulty being able to afford needed items such as dental 

care, hearing aids, and utilities. Nineteen percent of respondents in Area I needed hearing aids 

but have been unable to afford them compared to 0% in Area II (Figure 12). Twenty-eight 

percent of respondents have needed dental care and could not afford it in Area III; however, 

consistent with the overall results, affording dental care is a concern across all regions. Thirtythree percent of respondents in Area II indicate they have difficulty affording utilities compared 

to 0% in Area V. 

Figure 12. Percentage of respondents who had trouble affording the top three needed expenses by AAA 

area.

0%

5%

10%

15%

20%

25%

30%

35%

Area I Area II Area III Area IV Area V Area VI

Hearing Aids

Dental

Utilites

Idaho Commission on Aging Needs Assessment Survey Results 67
Idaho Caregiver Needs and Respite 

Capacity Report, 2014

Prepared for the 

Idaho Caregiver Alliance 

. . . advancing the well-being of caregivers by promoting collaboration

that improves access to quality, responsive support services across the state

December 2014

Primary Authors:

Tami Cirerol & Sarah E. Toevs

Center for the Study of Aging

http://hs.boisestate.edu/csa/

Work Group Members: 

Stephanie Bender-Kitz, Friends in Action

Stephen Graci, Idaho Federation of Families for Children’s Mental Health

Stephanie Hoffman, Division of Behavioral Health, Idaho Department of Health and Welfare

Idaho Caregiver Needs and Respite Capacity Report, 2014 68
Table of Contents

Executive Summary 3

Introduction 5

Methods 5

Results 7

Caregiver Demographic Characteristics 7

Caregiver Employment 8

Care Recipient Characteristics 10

Respite Awareness 11

Delivery of Respite Message 11 

Perceived Benefits of Respite Use 12

Perceived Barriers to Respite Use 12 

Anticipated Use of Respite if Available 13 

Patterns of Respite Use 15

Characteristics of Respite Users and Non-Users 15

Discussion and Summary 16

Appendix A 19

Appendix B 25

Idaho Caregiver Needs and Respite Capacity Report, 2014 69
Executive Summary

Prepared for the Idaho Caregiver Alliance (formerly the Idaho Lifespan Respite Coalition) 

In 2014 the Idaho Caregiver Alliance (ICA) conducted a statewide assessment to describe the 

demographic characteristics and needs of primary caregivers and identify available respite 

services. Respite or a “time-out” provides a caregiver with a short-term break from the constant 

responsibilities of caring for a dependent child or adult and can extend the caregivers ability to 

provide home-based care. This in turn, can enhance the quality of life for both the caregiver and 

care recipient and reduce costs associated with facility-based care. For example, in 2012, the 

number of unpaid caregiving hours in Idaho was approximately 8.5 million hours and valued at 

$1,037,881,136.1

 

The assessment provides a snapshot of caregivers and the individuals they care for, experiences 

associated with caregiving, and what role respite support may play in the lives of caregivers. 

This information will be used to identify priority needs and as a baseline for planning and 

evaluation. 

The caregiver assessment findings reported in this document are based on a web-based survey 

distributed to primary caregivers through email distribution lists and web-sites maintained by 

organizations providing services to caregivers and/or recipients of care. In addition, the survey 

and/or postcards announcing the survey were distributed at events designed for caregivers, 

individuals receiving care, and/or representatives from organizations who may have contact with 

caregivers. 

The capacity assessment of available respite providers was conducted using a mixed methods 

strategy of a review of online resources and solicitation of information about resources from key 

informant agencies. The findings were organized by region of the State and coded by whether 

the provider was listed in the Idaho 2-1-1 Careline database and the availability of respite 

services. 

Portrait of an Idaho Caregiver

The caregiver survey was completed by 261 individuals. The majority of participants were 

female (82.5%), over the age of 55 (58%), and had been care for one individual for more than 21 

hours per week (69.7%) for more than four years (63.2%). Approximately two-thirds of the 

respondents were employed on either a full- or part-time basis and an additional 10% were 

looking for employment. Almost all (96%) of the participants had access the internet in their 

homes. 

The most common relationships between caregiver and care recipient were minor or adult child 

(35.5%) and parent or parent-in-law (33.6%). Only 27% of respondents indicated they had used 

respite services in the past six months with use more common among younger caregivers and 

those providing care for a longer period of time. Of the caregivers who had not previously used 

1 Across the States: Profiles of Long-Term Care and Independent Living, Idaho, 2012). Across the States: 

Profiles of Long-Term Care and Independent Living, Idaho, 2012

Idaho Caregiver Needs and Respite Capacity Report, 2014 70
respite, 77% stated they would use the support once a month or more. The most frequently 

identified barriers noted by those who had not used respite were: 1) locating and paying for 

services; 2) concerns related to an outsider caring for their loved one; and 3) the person they 

provided care for would refuse help from others. When asked where they would look for 

information about respite the most common responses were the internet, friends and/or family, or 

a health care provider. 

Identified Priority Needs and Future Action

Caregivers would use respite services if available in their community. Based on the findings 

from this survey, caregivers know the benefits of respite (i.e. rejuvenate, do tasks and chores, 

attend to needs of other family members) although 69.5% did not know where to find respite 

services and 57.7% indicated they would need assistance with making arrangements for respite. 

 Future action should focus on effectively promoting respite and other supports to 

caregivers.

 Use a common language for caregiver supports – make it easy for consumers to 

understand the “who, what, and how” of respite.

Caregivers need assistance overcoming commonly perceived barriers. In addition to needing 

information about available respite services, caregivers need assistance with overcoming 

common barriers. Securing quality respite providers, having an “outsider” come into a person’s 

home, and cost/financing are top-ranking barriers to caregivers. 

 Caregivers need to be empowered to make informed decisions about providers and the 

type of services needed. 

 Consumer and respite provider education is a priority. Respite providers need to be 

supported in their efforts to provide quality services. 

 Future actions should focus on promoting standards of care and development of effective 

consumer-focused feedback mechanisms. 

Access points for information and services are needed. Caregivers who had used respite 

received information from a variety of sources including case managers, social workers, friends 

and family, or by word of mouth. For caregivers who had not received respite information, they 

identified internet, friends and/or family, or a health care provider as preferred sources for 

information. 

 Future actions should focus on consumer-driven access points where caregivers can 

obtain the information they need regarding respite services. 

 Health care providers were identified as a preferred source of information. Access to 

information through this “trusted” source should be expanded.

Many caregivers in Idaho are full-time or part-time employees. Two-thirds of Idaho 

caregivers are employed (outside the home) in full-time (37%) or part-time (20%) positions or 

looking for employment (10%). The impact of caregiving on work ranges from using 

vacation/sick leave, to reducing hours, to leaving paid employment. 

 Engagement of employers and policy makers in efforts to champion the need for and 

access to sustainable, high quality services for caregivers is imperative. 

Idaho Caregiver Needs and Respite Capacity Report, 2014 71
Previous respite use did not meet the needs of most caregivers. Of the caregivers reporting 

the use of respite services, nearly two-thirds (61.7%) indicated services did not cover their needs. 

 Further exploration of the unmet needs of caregivers who have used respite services is 

warranted. 

Introduction

Caregiver respite or the ability to have some “time way” from the responsibility of providing 

care is not always easily accessible. The diversity of caregivers and those receiving care, 

availability of services, ability to pay and/or access to funding, and geographical differences 

make it difficult to establish a statewide comprehensive picture of respite services and those who 

need those services. 

The purpose of this project was two-fold; first, to begin to document the need for respite services 

and secondly, to identify the available respite services in Idaho. These efforts serve as initial 

statewide assessments and provide a baseline for continued evaluation of need, preferences, 

availability and gaps in respite support in Idaho. By identifying needs and the difference 

between needs and available services, these findings will serve as a basis for future program and 

policy development. 

This report is a component of the scope of work of the Idaho Caregiver Alliance (formerly 

known as the Idaho Lifespan Respite Coalition). The mission of the Idaho Caregiver Alliance 

(ICA) is to “advance the well-being of caregivers by promoting collaboration that improves 

access to quality, responsive lifespan support services across the state”. The work of the 

coalition is guided by representatives from state and local governmental and non-profit agencies 

and individuals involved in caregiving. Oversight of the Alliance is provided by the Idaho 

Commission on Aging with funding from a three-year grant from the Administration for 

Community Living.

Methods 

A work group, consisting of members from the Idaho Caregiver Alliance, was formed to develop 

data collection strategies for the needs and capacity assessments. This section of the report 

includes a description of strategies used for the caregiver needs and respite service assessment 

process.

Caregiver Needs Assessment Survey 

An on-line survey was designed to provide information on the characteristics of unpaid 

caregivers and care recipients, awareness of and need for respite services, barriers and patterns of 

use of respite, and impact of caregiving on employment or career, see Appendix A for survey. 

The survey was based on assessment tools used in other states and the following caregiver

assessments conducted in Idaho: 

• Idaho Commission on Aging Needs Assessment Survey (2012)

Idaho Caregiver Needs and Respite Capacity Report, 2014 72
• Idaho Needs Assessment: Alzheimer’s Disease and Related Dementias (2012)

• Respite Care Needs Assessment (2002)

 

Caregivers residing in Idaho who do not receive compensation for the services they provide were 

the population of interest for the survey. Due to the diverse nature of the lifespan caregiver 

population and lack of an established database of caregivers, a purposive recruitment strategy 

was used. This strategy included the distribution of a web address for the on-line survey to 

informal caregivers through email distribution lists and web-sites maintained by organizations 

providing services to caregivers and/or recipients of care. In addition, the survey and/or 

postcards promoting the survey were distributed at events designed for caregivers, individuals 

receiving care, and/or representatives from organizations who may have contact with caregivers, 

see Table 1. All data collection procedures were approved by the Boise State University 

Institutional Review Board, approval #199-SB14-002. 

Table 1. Survey Distribution Strategies 

Websites used to host link to survey

Center for the Study of Aging, Boise State 

University

Justice Alliance for Vulnerable Adults

Homewatch Caregivers of Southwest Idaho Idaho Department of Health and Welfare

Idaho 2-1-1 Careline Idaho Council on Developmental Disabilities

Idaho Commission on Aging Southwestern Idaho Area Agency on Aging

State Independent Living Council

Conferences used to distribute survey recruitment cards

Caregiver Conference, 1/ 2014 Strengthening Families Training Institute, 3/2014

Wrightslaw Conference, 4/2014

Events used to distribute survey recruitment cards

Foster Parent Training Event, 3, 21014 Autism Awareness Walk/Run, 4, 2014

Multiple Sclerosis Walk, 4/2014

The online Caregiver Needs Assessment survey was available from January 10 - August 15, 

2014. Data analysis and compilation of the report were performed by staff with the Center for 

the Study of Aging. All analyses were conducted using SPSS v. 20. 

Respite Provider Assessment

The assessment of available respite providers was conducted using a mixed methods strategy of 

the review of online resources and solicitation of resources from key informant agencies. The 

online information sources used to identify available respite providers included: 

• AARP’s Idaho Price Guide to Long-Term Care Insurances & Services (2013) 

• Idaho 2-1-1 Careline 

• Idaho Department of Health and Welfare

• Idaho Federation of Families for Children’s Mental Health 

• Idaho Senior Blue Book 

Idaho Caregiver Needs and Respite Capacity Report, 2014 73
In addition to a web-based search, key informant agencies, identified by members of the Idaho 

Caregiver Alliance, were contacted and asked to provide information about respite providers. 

The following agencies responded with region-specific provider information: 

• Area Agency on Aging, Area 1

• Area Agency on Aging, Area 2

• Area Agency on Aging, Area 3

• Area Agency on Aging, Area 4

• Area Agency on Aging, Area 5

• Children’s Mental Health, Region 3 

• Children’s Mental Health, Region 7

The findings were organized by region of the State and coded by whether the provider was listed 

in the Idaho 2-1-1 Careline database and identified the delivery of services specific to respite. 

The resulting catalog of respite providers reflects an assessment of capacity as of August 2014

(Appendix B). 

Results 

Between January 10 to August 15, 2014, 261 surveys were started, with an approximate drop-out 

rate of 11%. Three-fourths (75.1%) of the respondents completed 60% or more of the survey. 

Approximately one-third (34.6%) of the surveys were completed by individuals participating in a 

caregiver conference. 

Caregiver Demographic Data and Characteristics 

The typical Idaho caregiver is female (82.5%), 55 years of age or older (58%), has internet 

access in their home (96.3%), provides care for more than 21 hours per week (69.7%), has been 

providing care for four years or more (63.2%), and provides care for one individual (59.5%), see 

Table 2. 

The most common relationships between caregiver and care recipient were minor or adult child 

(35.5%) and parent or parent-in-law (33.6%). Based on postal zip codes, 21% and 79% of 

respondents were found to reside in rural and metropolitan areas, respectively. Zip codes of 

cities with a population of 32,000 or greater, and those within the greater Boise/Treasure Valley

area were classified as metropolitan. 

Table 2. General Caregiver Demographics

Caregiver Demographics

Characteristic n %

Gender 211

Male 37 17.5

Female 174 82.5

Age (mean=55.58, range=24-87) 200

54 years of age or less 84 42.0

Idaho Caregiver Needs and Respite Capacity Report, 2014 74
Caregiver Demographics

55 years of age or more 116 58.0

Residence 202

Metropolitan 160 79.2

Rural 42 20.8

Years Providing Care 223

Less than 1 year 25 11.2

1-3 years 57 25.6

4-6 years 42 18.8

More than 6 years 99 44.4

Number of Current Care Recipients 215

None 5 2.3

One individual 128 59.5

More than one individual 82 38.1

Care Recipient Relationship to Caregiver 214

Parent or Parent-in-law 72 33.6

Minor Child 42 19.6

Spouse or partner 37 17.3

Adult Child 34 15.9

Other relative 15 7.0

Friend or Neighbor 7 3.3

Other (group home individual, local agencies such as 

Friends in Action and Legacy Corp.) 5 2.3 

Grandparent 2 0.9

Hours per Week Providing Care 201

Zero 5 2.5

1-20 hours per week 56 27.9

21-100 hours per week 52 25.9

101-167 hours per week 19 9.5

168 hours per week 69 34.3

Regular Internet Access 215

Yes 207 96.3

No 8 3.7

Caregiver Employment 

Two-thirds of Idaho caregivers are employed either full-time (37%) or part-time (20%). The 

following graphics describe the employment status of Idaho caregivers (Figure 1) and the 

potential effects of caregiving on employment (Table 3). 

Idaho Caregiver Needs and Respite Capacity Report, 2014 75
 Figure 1. Employment Status

Providing care for an individual may influence a caregiver’s schedule and affect employment 

practices. While 40 survey respondents indicated that caregiving had no impact on employment, 

the majority of those in the workforce identified one or more impact on career. The most 

frequently cited impacts of caregiving were using vacation time or sick leave to provide care, 

arriving to work late or leaving early, and having to arrange for flexible work hours. 

Table 3. Affects of Caregiving on Employment 

Affects of Caregiving on Employment

Caregiving has affected my employment or career in the following ways:

(check all that apply) n 

I used vacation time to provide care 61

I arrived late or left work early 60

I used sick leave to provide care 58

I arranged for flexible work hours 56

Caregiving had no impact on my employment or career 40

I changed from full-time to part-time work or reduced my work hours 37

I considered taking early retirement or leaving the labor force 37

I used Family and Medical Leave to provide care 30

I took a leave of absence to provide care 27

I took a less demanding job 25

I quit work, I cannot work, or I choose not work 18

I declined a promotion 16

I quit school to provide care 2

Other (identified below) 14

The following qualitative comments illuminate some of challenges experienced by caregivers

who are in the workforce or would like to work. 

• “Laid off at work became a CFH [certified family home] to care for my brother and 

daughter.” 

37%

33%

20%

10%

Caregiver Employment Status

Employed full time

Retired and not

seeking employment

Employed part time

Not employed, but

seeking employment

Idaho Caregiver Needs and Respite Capacity Report, 2014 76
• “I have stayed at a job for almost 4 years because of the flexibility of schedule. However, 

I have no benefits and have not received an increase in pay for 3 years.”

• “Employment is out of the question given our circumstances, so the result is...I cannot 

work outside the home.” 

• “I very much desire to go back and finish my education (2 yrs left for BA) and find 

employment to help contribute to our income.” 

Care Recipient Characteristics

In addition to caregiver characteristics, information about the individual receiving care was 

gathered. Care recipient ages ranged from 21 months to 102 years of age, with an average age of 

57.9 years. Approximately half (51%) of the care recipients were 65 years of age or older, see 

Figure 2. 

Figure 2. Age of Care Recipient

The primary condition of the care recipients varied, with intellectual, cognitive, or 

developmental disabilities (38.2%) and chronic health conditions (25.6%) as the top-ranking 

conditions. Originally entered in the “other” category, 30 responses were redistributed as either 

an intellectual, cognitive, or developmental disability, chronic health condition, or general aging, 

see Figure 3. 

0-17 years

19%

18-64 

years

30%

65 years 

or older

51%

Care Recipient Age Groups

Idaho Caregiver Needs and Respite Capacity Report, 2014 77
Figure 3. Primary Condition of Care Recipient 

Respite Awareness

Knowledge of the definition of respite and awareness of services are key components to 

understanding the needs of Idaho caregivers. Almost all of the respondents knew what respite 

was (98.2%) and believed it would be beneficial for them (85.9%). 

Respondents were asked a series of questions related to respite use. Nearly half (44.4%) of the 

caregivers were unsure if respite services were available in their community, just over two-thirds 

(69.5%) did not know where to find respite services, and nearly three-quarters (73.1%) would 

need assistance securing respite resources (Table 4). 

One-third of the respondents stated indicated they did not need or were not sure of the need for 

respite services. Further examination of these respondents revealed that 84.5% had not used 

respite services in the past and nearly half (48.4%) had been providing care for three years or 

less. In addition, those providing fewer hours of care or providing care for older individuals and 

being older themselves were more likely to indicate they did not need or were unsure of need for 

respite. 

Table 4. General Caregiver Need for and an Awareness of Respite 

General Awareness of Respite

Yes No Not Sure

Other

2%

General aging

3%

No diagnosis

4%

Prefer not to 

say

4% Physical 

disability

12%

Mental 

illness

12%

Chronic health 

condition

25%

Intellectual, 

cognitive, or 

developmental 

disability

38%

Primary Condition of Care Recipient

Idaho Caregiver Needs and Respite Capacity Report, 2014 78
n % n % n %

I understand what respite is. 232 98.3 0 0.0 4 1.7

I need respite. 150 67.0 50 22.3 24 10.7

I can benefit from respite. 195 85.9 18 7.9 14 6.2

Respite services are available in my 

community.

105 45.3 24 10.3 103 44.4

I know where to find respite services in 

my community.

70 30.6 84 36.7 75 32.8

If I wanted to arrange for respite, I would 

need assistance.

131 57.7 61 26.9 35 15.4

Delivery of Respite Messages

All survey participants were asked if they had ever received information regarding respite 

services in their community. Nearly one-third (31.4%) of the respondents answered in the 

affirmative, with 68.6% reporting they had not received information. 

The caregivers who had received respite information were asked how they learned about the 

services. The three most frequently cited methods were; 1) from a case manager or social 

worker, 2) friend, family member, or word of mouth, and 3) from a social service agency. Other 

methods of locating respite information were a booth at a fair or conference, personal research, 

and employment within the health care field. 

Those caregivers indicating they had not received information were asked where they would 

look for respite materials. The most frequently identified methods were the internet, friends or 

family members, word of mouth, or through a health care provider. Other routes of gaining 

information included the Chamber of Commerce, local nursing home staff, and caregiving 

seminars.

Perceived Benefits of Respite Use 

One outcome of using respite services is that it allows the caregiver a break from providing care 

and “frees up” time for other endeavors. All survey participants were asked to identify perceived 

benefits of respite (Table 5). The most frequently identified benefits of respite were time for the 

caregiver to rejuvenate, run errands, attend personally enjoyable events, give other family 

members a break, and help reduce caregiver stress and burnout. 

Table 5. Perceived Benefits of Respite 

Perceived Benefits of Respite

I feel respite would benefit me in the following ways (check all that apply): n

Time for me to rejuvenate, catch up on sleep, or go on vacation 193

Time for me to run errands 137

Time for me to attend events I like (sports, arts, music, or worship) 131

Time to give family members a break 123

Time for me to seek help for caregiver stress and burnout 122

Idaho Caregiver Needs and Respite Capacity Report, 2014 79
Time for me to build relationships with family members 120

Time for me to pursue hobbies 117

Time for me to go to my own doctor appointments 117

Time to take care of unplanned events or emergency situation 101

Time for me to learn about caregiving techniques and skills 85

Time for me to pursue educational goals 57

Other (all of the above, none of the above, to go to work, for household tasks/chores, 

exercise, to care for my own family, when the caregiver is ill) 17 

I’m not sure of the benefits of respite 5

Perceived Barriers to Respite Use

The respondents who had not used respite (73% of sample) were asked to identify why they had 

not used respite services. The three top-ranking answers were: 1) not knowing where to find 

respite services, 2) inability to afford respite services, and 3) concerns about an outsider caring 

for their loved one (Table 6). Other responses included unfamiliarity with respite, not being able 

to find a qualified caregiver, difficulty in obtaining the service, and it not being available when 

needed. 

Some caregivers indicated they had not sought respite services because they were able to care for 

their loved one without assistance and/or had enough help and did not need respite services. 

Idaho Caregiver Needs and Respite Capacity Report, 2014 80
Table 6. Barriers to Seeking Respite

Barriers to Seeking Respite

I have not used or sought respite services because: 

(check all that apply) n 

I do not know where to find respite services. 69

I cannot afford respite services. 68

I am concerned about outsiders caring for my loved one(s). 45

I think I do not qualify for respite services. 42

The person I care for refuses help from others. 38

I have no family or friends to ask for help. 31

I am able to provide care to my loved one without assistance. 31

I have enough help and do not need respite services. 28

I am embarrassed to ask for help. 23

I cannot find qualified people or agencies who provide respite. 23

Respite service is too difficult to obtain. 22

Respite service is not available when I need it. 13

Other (no need for respite, did not know about respite, care recipient passed, 

another person has custody, in assisted living facility, I am a respite provider) 18 

Anticipated Use of Respite if Available

Respondents indicating they had not used respite services were asked how often they would use 

respite if they could receive it. Figure 4 shows the responses from the caregivers. Just over 

three-fourths of the respondents stated they would use respite, if the service were available, for 

caregiver support outside of emergencies. 

Figure 4. Potential Use of Respite

18%

77%

5%

If I could receive respite,

I would probably use it:

For emergencies

I would use respite (once

a month or more)

I would not use respite

Idaho Caregiver Needs and Respite Capacity Report, 2014 81
Patterns of Respite Use

Approximately one-fourth (27%) of the respondents indicated they had used respite services in 

the past six months with 49.2% reporting they had been able to secure respite services when 

needed. The majority of respite providers were either family members or paid staff from an 

agency with 68.9% of the providers receiving some form of payment for the service (Table 7). 

Caregivers using respite were also asked if the amount of service received met their needs. Of 

the 60 respondents, nearly two-thirds (61.7%) had not received adequate respite services. 

Table 7. Characteristics of Caregivers who had used Respite Services 

Demographics of Caregivers Using Respite Services

Characteristic n %

How often have you received respite in the past 6 months? 62

I have not received any respite services 14 22.6

Once a month or less often 16 25.8

1-2 times per month 7 11.3

3 or more times per month 25 40.3

The amount of respite received in the past 6 months has met respite 

needs. 60

Yes 23 38.3

No 37 61.7

I have been able to get respite when I needed it. 61

Yes 30 49.2

No 24 39.3

Not sure 7 11.5

In general, who has provided you with respite?

(check all that apply)

Family member 33

Paid staff from an agency 29

Friend or neighbor 14

Volunteer 7

Other (paid individual, private caregiver, staff from a 

Developmental Center) 7 

Did the person(s) who provided respite receive financial payment? 61

Yes 42 68.9

No 17 27.9

Not sure 2 3.3

Source of the financial payment 43

My own money 13 30.2

A community social service agency 6 14.0

A government agency 17 39.5

An insurance policy 1 2.3

Other (family member, care recipient’s money) 6 14.0

Idaho Caregiver Needs and Respite Capacity Report, 2014 82
Demographics of Caregivers Using Respite Services

Estimated total amount I paid for respite in the last six months 26

Under $500 13 50.0

$550 to $1,499 3 11.5

$1,500 to $2,999 2 7.7

$3,000 to $4,999 1 3.8

$5,000 and over 4 15.4

Not sure 3 11.5

Why did you seek respite? (check all that apply)

To attend to my own personal needs 47

To relieve emotional stress/prevent burnout 44

To help me continue to provide care 29

To do tasks/chores 26

To attend to the needs of other family members 22

To take care of an urgent or emergency situation 17

To be able to work 16

To participate in caregiver support group/training or self-care 

classes 15 

Other (to provide a variety of visitors for care recipient, to fill in 

time gaps in care) 2 

Characteristics of Respite Users and Non-Users

An analysis of characteristics of respondents reporting the use of respite in the past 6 months and 

those that had not used respite was conducted. This included a comparison of factors such as the 

age, gender, and employment status of the caregiver; years providing care; and the age of the 

care recipient. The characteristics of the respondents who had used respite were similar to nonusers with the exception of age with respite users being younger (χ2

= 5.521, p=0.02) than nonusers. 

Use of respite was also explored based on location of residence (Table 8). Similar patterns of 

use were found between caregivers living in metropolitan and rural areas although while not 

statistically significant, the use of respite was more frequent among respondents living in rural.

Table 8. Respite Use by Location

Have you used respite?

Yes No

n % n %

Metropolitan 44 28 116 73

Rural 14 33 28 67

Idaho Caregiver Needs and Respite Capacity Report, 2014 83
Summary and Identification of Priority Needs and Future Action

The outcome of the needs assessment survey shows that caregivers in Idaho understand the 

benefits of receiving a break from providing care. The desire for respite services is present 

among the population, and caregivers resoundingly state their need of it. Caregivers need 

assistance in overcoming certain barriers to obtain respite services. 

Limitations of the study are primarily related to the relatively low number of respondents. The 

lack of common access points to individuals engaged in unpaid caregiving hampered distribution 

efforts and as the survey was electronic, caregivers who did not have access to the internet may 

have been underrepresented in the survey. 

This effort serves as an initial statewide assessment and provides a baseline for continued 

evaluation of need, preferences, availability and gaps in respite support in Idaho. The findings 

provide valuable insight to the Idaho Caregiver Alliance and other organizations and illuminate 

priority needs and future actions. 

Identified Priority Needs and Future Action

Caregivers would use respite services if available in their community. Based on the findings 

from this survey, caregivers know the benefits of respite (i.e. rejuvenate, do tasks and chores, 

attend to needs of other family members) although 69.5% did not know where to find respite 

services and 57.7% indicated they would need assistance with making arrangements for respite. 

 Future action should focus on effectively promoting respite and other supports to 

caregivers.

 Use a common language for caregiver supports – make it easy for consumers to 

understand the “who, what, and how” of respite.

Caregivers need assistance overcoming commonly perceived barriers. In addition to needing 

information about available respite services, caregivers need assistance with overcoming 

common barriers. Securing quality respite providers, having an “outsider” come into a person’s 

home, and cost/financing are top-ranking barriers to caregivers. 

 Caregivers need to be empowered to make informed decisions about providers and the 

type of services needed. 

 Consumer and respite provider education is a priority. Respite providers need to be 

supported in their efforts to provide quality services. 

 Future actions should focus on promoting standards of care and development of effective 

consumer-focused feedback mechanisms. 

Access points for information and services are needed. Caregivers who had used respite 

received information from a variety of sources including case managers, social workers, friends 

and family, or by word of mouth. For caregivers who had not received respite information, they 

identified internet, friends and/or family, or a health care provider as preferred sources for 

information. 

 Future actions should focus on consumer-driven access points where caregivers can 

obtain the information they need regarding respite services. 

Idaho Caregiver Needs and Respite Capacity Report, 2014 84
 Health care providers were identified as a preferred source of information. Access to 

information through this “trusted” source should be expanded.

Many caregivers in Idaho are full-time or part-time employees. Two-thirds of Idaho 

caregivers are employed (outside the home) in full-time (37%) or part-time (20%) positions or 

looking for employment (10%). The impact of caregiving on work ranges from using 

vacation/sick leave, to reducing hours, to leaving paid employment. 

 Engagement of employers and policy makers in efforts to champion the need for and 

access to sustainable, high quality services for caregivers is imperative. 

Previous respite use did not meet the needs of most caregivers. Of the caregivers reporting 

the use of respite services, nearly two-thirds (61.7%) indicated services did not cover their needs. 

 Further exploration of the unmet needs of caregivers who have used respite services is 

warranted. 

Idaho Caregiver Needs and Respite Capacity Report, 2014 85
Appendix A - Caregiver Survey 

Idaho Lifespan Respite Needs Assessment Survey

We invite you to take our survey! The Idaho Commission on Aging has received a three-year 

grant from the Administration for Community Living to enhance the support available to people 

who care for others. A first step in this project is to conduct a statewide survey of informal 

(unpaid) caregivers. 

If you are an informal (unpaid) caregiver we encourage YOU to complete this survey. If you 

know of other informal caregivers we encourage you to send this survey to them (a message and 

link to the survey has been included at the end of the survey for this purpose). 

The information you provide will be used to guide the actions of the Idaho Lifespan Respite 

Coalition as it works to enhance the network of support available to people who care for others. 

This survey will take an estimated 10 minutes to complete. Please complete the survey only 

once. 

Your responses will not affect any services or benefits you receive because we will not know 

who answered this questionnaire. You are not required to complete this survey and you do not 

need to answer any question you don’t want to answer. 

Your individual responses are anonymous and confidential. Responses will only be reported after 

they are combined with the responses from everyone who took the survey. 

Please read each question carefully. If you have any questions please contact Sarah Toevs, 

Center for the Study of Aging (208-426-2452, stoevs@boisestate.edu) or Pam Catt-Oliason, 

Commission on Aging (208-577-2852, Pam.Catt-Oliason@aging.idaho.gov).

If you have questions about your rights as a research participant, you may contact the Boise State 

University Institutional Review Board (IRB), which is concerned with the protection of 

volunteers in research projects. You may reach the board office by calling (208) 426-5401 or 

emailing humansubjects@boisestate.edu.

Thank you. 

Members of the Idaho Lifespan Respite Coalition 

Please read the definition of respite below and answer the questions that follow. 

Respite simply means having some “time away” from the responsibility of providing 

care. It is an opportunity for you to have a break from providing care while someone else 

helps the person you care for. That “someone else” can be a family member, friend, 

acquaintance, volunteer, or a paid worker. Respite can be provided in-home, or in 

different places out-of-the-home. You can receive respite from a few hours a month to 

several days and/or nights a week. The benefits of respite include reduced feelings of 

stress and improved well-being. Respite can also benefit the care receiver’s well-being 

and quality of care. 

Idaho Caregiver Needs and Respite Capacity Report, 2014 86
1. Before you read the definition above, did you know what respite was?

☐Yes 

☐ No 

2. I feel respite would benefit me in the following ways (please check all that apply): 

☐ Time for me to rejuvenate, catch up on sleep, or go on vacation 

☐ Time for me to build relationships with family members 

☐ Time for me to attend events I like (sports, arts, music, or worship) 

☐ Time for me to run errands 

☐ Time for me to go to my own doctor appointments 

☐ Time for me to pursue educational goals 

☐ Time for me to pursue hobbies 

☐ Time for me to learn about caregiving techniques and skills 

☐ Time for me to seek help for caregiver stress and burnout (attend self-care classes, join a 

support group, talk with a counselor) 

☐ Time to give family members a break 

☐ Time to take care of unplanned events or emergency situations 

☐ Other (please specify) 

☐ I’m not sure of the benefits of respite 

3. Please select the response that best describes your opinion on the following statements 

about respite. 

Yes No Not Sure

I understand what respite is.

I need respite.

I can benefit from respite.

Respite services (volunteer or paid) are available in my 

community.

I know where to find respite services in my community.

If I wanted to arrange for respite, I would need assistance.

4. Have you ever received information about respite services in your community?

____Yes _____No <skip to # 6> 

5. How did you learn about respite services? (Check all that apply) 

☐ Friend, family, or word of mouth 

☐ Member of my church or religious group 

☐ Health care provider

☐ Case Manager, Service Coordinator, or Social Worker 

Idaho Caregiver Needs and Respite Capacity Report, 2014 87
☐ My child’s school 

☐ Idaho’s 211 Careline 

☐ Social Service Agency (Area Aging on Aging, Center for Independent Living)

☐ Internet 

☐ Newspaper article or pamphlet

☐ Other (please specify) 

☐ I don’t remember. 

☐ I have never received information about respite services. 

<skip to # 7> 

6. If you wanted information about respite services in your community where would you 

look? (Check all that apply) 

☐ Friend, family, or word of mouth 

☐ Member of my church or religious group 

☐ Health care provider

☐ Case Manager, Service Coordinator, or Social Worker 

☐ My child’s school 

☐ Idaho’s 211 Careline 

☐ Social Service Agency (Area Aging on Aging, Centers for Independent Living) 

☐ Internet 

☐ Newspaper article or pamphlet

☐ Other (please specify) 

☐ I don’t know. 

☐ I have never tried to find information about respite services. 

7. Have you used respite? 

____Yes _____No <skip to # 16> 

8. Why did you seek respite? (Check all that apply.)

☐ To be able to work 

☐ To relieve emotional stress/prevent burnout 

☐ To attend to the needs of other family members

☐ To attend to my own personal needs (social/business/recreation/medical)

☐ To help me continue to provide care 

☐ To do tasks/chores

☐ To take care of an urgent/emergency situation

☐ To participate in caregiver support group/training or self-care classes

Idaho Caregiver Needs and Respite Capacity Report, 2014 88
☐ Other (please specify)

9. How often have you received respite in the past 6 months? 

☐ I have not received any respite services. 

☐ Once a month or less often 

☐ 1 to 2 times per month 

☐ 3 or more times per month 

10. The amount of respite I received in the past 6 months has met my respite needs. 

☐Yes 

☐ No 

☐ Not sure 

11. I have been able to get respite when I needed it.

☐Yes 

☐ No 

☐Not sure 

12. In general, who has provided you with respite? (Check all that apply.)

☐ Family member

☐ Friend/neighbor 

☐ Volunteer 

☐ Paid staff from an agency 

☐ Other (please describe)

13. Did the person(s) who provided you respite receive financial payment?

☐Yes 

☐ No 

☐ Not sure 

<Respondents who select “No” and “Not sure” will skip to # 18> 

14. What was the source of that financial payment? 

☐ My own money 

☐ A community social service agency

☐ A government agency (federal, state or local)

☐ An insurance policy 

☐ Other (please describe)

<Respondents who select “My own money” will go to # 15. All others will skip to # 18> 

Idaho Caregiver Needs and Respite Capacity Report, 2014 89
15. I estimate the total amount I paid for respite in the last six months as:

☐ Under $500 

☐ $500 to $1,499 

☐ $1,500 to $2,999 

☐ $3,000 to $4,999 

☐ $5,000 and over 

☐ Not sure 

<Respondents answering this question will go to # 18> 

16. I have not used or sought respite services because: (Check all that apply.)

☐ I am able to provide care to my loved one without assistance. 

☐ I have enough help and do not need respite services. 

☐ I have no family or friends to ask for help. 

☐ I am embarrassed to ask for help. 

☐ The person I care for refuses help from others.

☐ I am concerned about outsiders caring for my loved one(s). 

☐ I do not know where to find respite services.

☐ I cannot afford respite services.

☐ I think I do not qualify for respite services. 

☐ Respite service is too difficult to obtain.

☐ I cannot find qualified people or agencies who provide respite. 

☐ Respite service is not available when I need it. 

☐ Other (please describe) 

17. If I could receive respite, I would probably use it:

☐ For emergencies

☐ Once a month or less 

☐ 1-2 times a month

☐ 3 or more times a month

☐ I would not use respite 

18. I am currently:

☐ Employed full time

☐ Employed part time

☐ Not employed, but seeking work 

☐ Retired and not seeking work 

Idaho Caregiver Needs and Respite Capacity Report, 2014 90
19. Caregiving has affected my employment or career in the following ways. (Check all that 

apply.)

☐ Caregiving had no impact on my employment or career

☐ I arrived late or left work early

☐ I used sick leave to provide care 

☐ I used vacation time to provide care 

☐ I used Family and Medical Leave to provide care

☐ I arranged for flexible work hours 

☐ I changed from full-time to part-time work or reduced my work hours 

☐ I took a leave of absence to provide care 

☐ I took a less demanding job 

☐ I declined a promotion 

☐ I considered taking early retirement or leaving the labor force 

☐ Other (please describe) 

20. How long have you been providing care? 

☐ Less than one year 

☐ 1-3 years 

☐ 4-6 years 

☐ more than 6 years 

21. How many family members or friends do you provide care for? 

If you provide care or assistance for more than one person, please think about the person for 

whom you provide the most care and answer the following questions for that person. 

22. What age is the person you care for? (Enter a whole number, e.g. 45) 

23. The person I care for is a: 

 spouse or partner 

 parent or parent-in-law

 adult child 

 Minor child

 Grandparent 

 Other relative 

 Friend or neighbor 

 other: ___________________ 

Idaho Caregiver Needs and Respite Capacity Report, 2014 91
24. What is the primary condition of the person you care for? 

 Intellectual, cognitive, or developmental disability 

 Physical disability 

 Mental Illness 

 Chronic health condition 

 No diagnosis 

 Other (please describe) 

 I prefer not to say. 

25. How many hours per week do you provide care for this person? 

26. Do you have regular access to the Internet?

☐ Yes, I have regular access to the Internet at home, work or another place. 

☐ No, I do not have regular access to the Internet. 

27. What is the ZIP Code of your home address? _____________ 

28. What year were you born? 

29. What is your gender? 

 Female 

 Male 

Please provide additional feedback. 

Thank you for completing this survey. Please help us in getting this survey to other caregivers 

by sending them the following message and survey link. (This can be done by copying and 

pasting the message and link in to an email message.) 

Greetings from members of the Idaho Lifespan Respite Coalition. The Idaho Commission on 

Aging has received a three-year grant from the Administration for Community Living to enhance

the support available to people who care for others. The purpose of this message is to invite you 

to participate in a statewide survey of informal (unpaid) caregivers, see below for link to survey. 

The survey is designed to gather information about the needs of caregivers and the results will be 

used to guide the actions of the Coalition. 

Your responses will not affect any services or benefits you receive because we will not know 

who answered this questionnaire. Your responses are anonymous and confidential and you do 

not need to answer any question you don’t want to answer. 

If you have any questions please contact Dr Sarah Toevs, Center for the Study of Aging (208-

426-2452, stoevs@boisestate.edu) or Pam Catt-Oliason, Commission on Aging (208-577-2852, 

Pam.Catt-Oliason@aging.idaho.gov

Idaho Caregiver Needs and Respite Capacity Report, 2014 92
Appendix B

The following key explains the color-coding system for the list of respite providers: 

• YELLOW = company or organization not listed on Idaho 2-1-1 Careline 

• TEAL = company or organization listed on Idaho 2-1-1 Careline, but not associated with respite specifically

• NO COLOR = listed as a respite provider on Idaho 2-1-1 Careline

District 1 – Boundary, Bonner, Kootenai, Benewah, and Shoshone Counties

Organization Website/Contact Number Services Notes

AAging Better In-Home Care 208-777-0308

866-464-2344

In-Home Respite Post Falls

5 northern counties

A Better Personal Care choskins@pcareinc.com In-Home Respite

ACE Elder Care 208-267-1481 Adult Day Care &

Facility Respite

Bonners Ferry

Boundary County

Addus HealthCare 208-667-2309

www.addus.com

In-Home Respite Coeur d’Alene

5 northern counties

Aging and Long Term Care of 

Eastern Washington – Spokane

www.altcew.org

All Valley Home Care 208-664-2764

www.allvalleyhomecare.com

In-Home Respite Coeur d’Alene

5 northern counties

Alzheimer’s Association www.alz.org/inlandnorthwest

Area Agency on Aging of North 

Idaho

208-667-3179

www.aaani.org

Adult Respite Coeur d’Alene

5 northern counties

August Home Health 208-664-0858

800-664-0838

In-Home Respite Coeur d’Alene

5 northern counties

Bennett House 208-651-9060

www.bennetthouse.org

Adult Day Care Coeur d’Alene

5 northern counties

Bestland of Coeur d’Alene 208-665-1600 Adult In-Home Respite

The Bridge Assisted Living at 

Sandpoint 

208-263-1524

www.thebridgeatsandpoint.com

Facility Respite Bonner County

Bristol Heights Assisted Living 208-661-6173

www.bristolheightscda.com

Adult Day Care &

Facility Respite

Coeur d’Alene

Kootenai

Boundary County Nursing 208-267-4847 Adult Day Care & Bonners Ferry

Idaho Caregiver Needs and Respite Capacity Report, 2014 93
District 1 – Boundary, Bonner, Kootenai, Benewah, and Shoshone Counties

Home www.bcch.org Facility Respite Boundary County

Children’s Village 208-667-1189

www.thechildrensvillage.org

Children’s Respite Coeur d’Alene

Greater Northwest

Comfort Keepers 208-765-9511 In-Home Respite Coeur d’Alene

5 northern counties

Community Restorium 208-267-2453

www.boundarycountyid.org

Adult Day Care Bonners Ferry

Boundary County

Coeur d’Alene Health Care & 

Rehabilitation

208-664-8128 Facility Respite Coeur d’Alene

Kootenai County

The Courtyard 208-765-9264

www.courtyardsatcoeurdalene.com

Facility Respite Coeur d’Alene

Kootenai County

Creekside Inn 208-665-2444

www.koelschseniorcommunities.com

Adult Day Care &

Facility Respite

Coeur d’Alene

5 northern counties

DayBreak Center 208-265-8127 Adult Day Care Sandpoint

Bonner County

Developmental Disabilities 

Program, H & W

healthandwelfare.idaho.gov

Emeritus at Coeur d’Alene 208-765-4352

www.emeritus.com

Facility Respite Coeur d’Alene

Kootenai County

Evergreen Assisted Living 208-265-2354

www.evergreenhealthcare.com

Facility Respite Sandpoint

Bonner County

Good Samaritan Silver Wood 

Village Assisted Living 

208-556-1147

www.good-sam.com

Facility Respite Silverton

Shoshone County

Guardian Angel Homes 208-777-7797

www.guardianangelhomes.com

Facility Respite Post Falls

5 northern counties

Hayden Valley Assisted Living 208-762-9292 Facility Respite Hayden

Kootenai County

Hayden View Cottage LLC Aspensprings.us/Hayden_View_Cottage

.html

Hearthstone Village 208-255-4849

www. hearthstonevillage.net

Facility Respite Kootenai

Bonner County

Hearthstone Village Post Falls 208-777-4179

www. hearthstonevillage.net

Facility Respite Post Falls

Kootenai County

Hospice House 208-772-7994

www.honi.org 

Facility Respite

End-of-Life

Coeur d’Alene 

5 northern counties 

Idaho Caregiver Needs and Respite Capacity Report, 2014 94
District 1 – Boundary, Bonner, Kootenai, Benewah, and Shoshone Counties

Home Instead 

Senior Care

208-415-0366

www.homeinstead.com/764 

In-Home Respite Coeur d’Alene

Kootenai, Bonner, Boundary 

Counties

Huckleberry Retirement Homes 

II 

208-255-7248 Facility Respite Sandpoint

Bonner County

Huckleberry Retirement Homes 

IV 

208-255-5333 Facility Respite Sandpoint

Bonner County

Ivy Court 208-667-6486

www.extendedcare.com

Facility Respite Coeur d’Alene

Kootenai County

Kindred Nursing & Rehab 

Center – Mountain Valley

208-784-1283 Facility Respite Kellogg

5 northern counties

Kootenai Health

Senior Care Program

208-625-5354

www.kh.org

Adult Day Care Coeur d’Alene

Kootenai County

LaCrosse Health & 

Rehabilitation Center

208-664-2185

www.lacrosse skillednursing.com

Facility Respite Coeur d’Alene

Kootenai County

Legends Park Assisted Living 

Community

208-666-9900

www.prestigecare.com

Facility Respite Coeur d’Alene

Kootenai County

Life Care of Coeur d’Alene 208-762-1122

www.lcca.com

Facility Respite Coeur d’Alene

Kootenai County

Life Care of Post Falls 208-777-0318

www.lcca.com

Facility Respite Post Falls

Kootenai County

Life Care of Sandpoint 208-265-9299

www.lcca.com

Facility Respite Sandpoint

Bonner County

Living Springs 208-773-6145

www.livingspringshome.com

Facility Respite Post Falls

Kootenai County

The Lodge at 

Fairway Forest & Riverside 

Harbor

208-457-3403

www.lodgeliving.net

Adult Day Care &

Facility Respite

Post Falls

Kootenai County 

Loving Care & More 208-752-1019 In-Home Respite Silverton

5 northern counties

Luther Park At Sandpoint, LLC www.luther-park.org

Mental Health Services, H & W healthandwelfare.idaho.gov

North Idaho Children’s Mental 

Health 

Nicmh.com

Idaho Caregiver Needs and Respite Capacity Report, 2014 95
District 1 – Boundary, Bonner, Kootenai, Benewah, and Shoshone Counties

North Star Assisted Living 208-765-5505

www.stellarliving.com

Facility Respite Coeur d’Alene

Kootenai County

Pacifica Senior Living – Coeur 

d’Alene

208-665-2100

www.pacificiacoeurdalene.com

Facility Respite Coeur d’Alene

Kootenai County

Pacifica Senior Living 208-556-1147

www.pacificaseniorliving.com

Facility Respite Pinehurst

Shoshone County

Panhandle Home Health, Senior 

Companion Respite Program

208-415-5177

www.panhandlehomehealth.org

In-Home Adult Respite Hayden

5 northern counties

The Renaissance at Coeur 

d’Alene Assisted Living

208-664-6116

www.assistedlivingcda.com

Facility Respite Coeur d’Alene

Kootenai County

ResCare Home Care 208-665-5579

888-390-6730 

www.rescare.com

In-Home Respite Coeur d’Alene

5 northern counties 

Rose Terrace Cottages 208-665-0580

www.roseterrace.org

Adult Day Care &

Facility Respite

Coeur d’Alene

Kootenai County

Rose Terrace Country Homes 208-623-6154

www.roseterrace.org

Adult Day Care &

Facility Respite

Spirit Lake

Kootenai County

Sandpoint Assisted Living 208-265-2354

www.sandpointassistedliving.com

Facility Respite Sandpoint

Bonner County

Sylvan House www.alcco.com

Tesh, Inc. 208-765-5105

www.teshinc.com

Day Care Respite

School age on up

Coeur d’Alene

5 northern counties

Valley Vista Care Center of 

Sandpoint

208-265-4514

www.valleyvista.org

Facility Respite Sandpoint

Bonner County

Veterans Affairs Medical 

Center

509-434-7000 Spokane, Washington

Visiting Angels of Coeur 

d’Alene

www.visitingangels.com/coeurdalene

Wellspring Meadows 208-762-9001

www.wellspringmeadows.com 

Adult Day Care,

In-Home &

Facility Respite

5 northern counties

Idaho Caregiver Needs and Respite Capacity Report, 2014 96
District 2 – Latah, Clearwater, Nez Perce, Lewis, and Idaho Counties

Organization Website/Contact Number Services Notes

Addus HealthCare www.addus.com Adult Day Health

Alternative Nursing 

Services

208-746-5487 or 

208-746-3050

Adult Day Health Nez Perce County

Area Agency on 

Aging of North Idaho

208-798-4197

www.aaani.org

Adult Respite Lewiston and Region

Circles of Caring 

Adult Day Health 

Foundation Inc.

208-883-6483

www.circlesofcaring.org

Adult Day Health Latah County

Compassionate Care 208-476-3714 Adult Respite Clearwater County

Developmental 

Disabilities Program, 

H & W

healthandwelfare.idaho.gov

Devin’s Home Care 208-983-1237 Adult Respite Grangeville and 

Surrounding Area

Mental Health 

Services, Adult and 

Children, Lewiston

208-799-4440

healthandwelfare.idaho.gov 

Children’s Respite Lewiston

Mental Health 

Services, Adult and 

Children, Moscow

208-882-0562

healthandwelfare.idaho.gov 

Children’s Respite Moscow

Seubert’s Quality 

Home Care

208-743-1818

800-597-6620

Adult Respite 5 North Idaho 

Counties

Sundance Services 208-983-0041 Adult Respite Grangeville

Wedgewood Terrace 208-743-4545 Adult Day Health Lewiston

Idaho Caregiver Needs and Respite Capacity Report, 2014 97
District 3 – Adams, Washington, Payette, Gem, Canyon, and Owyhee Counties

Organization Website/Contact Number Services Notes

24-7 Idaho Home 

Care

208-908-6080

services@247idahomecare.com

Respite In-home or facility

Addus HealthCare www.addus.com Adult Day Health

Advocates for 

Inclusion

Area Agency on 

Aging, Caldwell

208-908-4990

seniors.idahocog.com

Respite Caldwell and 

Region

Assisting Angels 208-344-7979 Respite Nights and 

weekends, no 

holidays

A Tender Heart 208-442-2978 Respite

Care at Home 208-642-1838, 208-453-2659 Respite

CCOA 208-459-0063 Respite

Developmental 

Disabilities Program, 

H & W

healthandwelfare.idaho.gov

Havenwood 208-327-1011 Respite

Horizon Healthcare 208-884-5051

Idaho Federation of 

Families for 

Children’s Mental 

Health

Idahofederation.org

208-433-8845 

Referrals to Respite Care providers 

Johnson, Edrie 208-602-8157 Respite Caldwell

Mental Health 

Services, Adult and 

Children, Caldwell

For children’s respite care contact 

Jose Valle at 208-459-0092 

healthandwelfare.idaho.gov

Children’s Respite Caldwell

Mental Health 

Services, Adult and 

Children, Payette

208-642-6416

healthandwelfare.idaho.gov 

Children’s Respite Payette

Idaho Caregiver Needs and Respite Capacity Report, 2014 98
MultiCare Home 

Health & Personal 

Care Services

www.multicareinc.com Respite

Sara Care of Boise 208-375-2273 Adult Day Health Serves District 3

Villegas, Cecilia 208-275-9753 Respite Caldwell

WICAP 208-549-2066 Respite

WITCO (Western 

Idaho Training Co.)

208-454-3051 Adult In-Home Respite

Idaho Caregiver Needs and Respite Capacity Report, 2014 99
District 4 – Ada, Valley, Boise, and Elmore Counties

Organization Website/Contact Number Services Notes

A & R Case 

Management

www.arcasemanagement.com Adult Day Health 

(mentally disabled), 

respite care (children)

At facility for adults, in 

home or at facility for 

children

A Place for Mom 208-344-1375 Adult Respite Boise

A Tender Heart 

Home Care

www.atenderheart.net Respite

Addus Health Care www.addus.com Adult Day Health

Area Agency on 

Aging, Boise

208-908-4990

seniors.idahocog.com

Respite Boise and region

Ashley Manor 208-376-7298 Adult Day Health

Assisting Angels 

Home Care – 

Boise, Emmett, Mt 

Home, Nampa

assistingangels.biz Respite In home

Assisting Hands 

Home Care

www.assistinghands.com Respite, companion 

services

In home services, 

Seniors

Brightstar www.brightstarcare.com/boise Respite Care

Children and 

Families Service 

Program, H & W

healthandwelfare.idaho.gov

Comfort Keepers comfortkeepers.com Respite Seniors

Community 

Partnerships of 

Idaho

www.mycpid.com

The Cottages of 

Boise

www.assistedlivingidaho.com Respite, Adult Day 

Health

At facility

Developmental 

Disabilities 

Program, H & W

healthandwelfare.idaho.gov

Dillon, Christine 208-639-1663 Respite

Everyday Angels 

Home Health Care

www.everydayangelshomehealth.com Respite Private pay and 

Medicaid

Frazier, Robin 208-866-1035 Respite Boise

Friends in Action 208-333-1363 Adult Respite Senior Advocacy, Boise

Idaho Caregiver Needs and Respite Capacity Report, 2014 100
District 4 – Ada, Valley, Boise, and Elmore Counties

Havenwood 

Caregiver Services

havenwoodhomecare.com Respite In home, Boise and 

Treasure Valley (Nampa 

phone number)

Hays Shelter Home 208-322-6687 Respite Boise

Henderson, Dan 

and Mary

208-866-8782 Respite Eagle

Home Instead 

Senior Care

www.homeinstead.com Respite In home, Seniors

Idaho Commission 

on Aging

208-334-3833 Adult Respite Boise

Idaho Federation of 

Families

208-433-8845 Respite resources Boise

Kiser, Jana 208-287-1038 Respite Meridian

Mental Health 

Services, Adult and 

Child

208-334-0808

healthandwelfare.idaho.gov 

Children’s Respite Boise

Mental Health 

Services, Adult and 

Child

208-587-9061

healthandwelfare.idaho.gov 

Children’s Respite Mt. Home

MultiCare Home 

Health & Personal 

Care Services

www.multicareinc.com Respite

Phillips, Amanda 208-515-6497 Respite Meridian

Progressive 

Nursing Staff prn, 

Inc.

www.progressivenursingprn.com Respite Specialists in vent, trach, 

wound, quad care and 

and IV infusion for ALL 

AGES, incl. infants

Shepherd’s Home www.shephers-home.org

Synergy Home 

Care

www.synergyhomecare.com Respite

Vida Inc, Senior 

Resource

www.vidaseniorresource.com Respite Grants Compiles resource 

information

Visiting Angels www.visitingangels.com Respite

Idaho Caregiver Needs and Respite Capacity Report, 2014 101
District 5 – Camas, Blaine, Gooding, Lincoln, Jerome, Minidoka, Twin Falls, and Cassia Counties

Organization Website/Contact Number Services Notes

A Caring Hand 208-736-4903 Respite Twin Falls, Jerome and Gooding 

Counties

A-1 Home Care 208-404-7524 Respite Gooding County, cities of Twin 

Falls, Burley and Jerome

Accomplishments InHome Services208-324-8409 Respite Cassia, Gooding, Jerome, Lincoln, 

Minidoka and Twin Falls Counties

Addus HealthCare 208-733-9100

www.addus.com

Adult Day Health Cassia, Gooding, Jerome, Lincoln, 

Minidoka and Twin Falls Counties

Alliance Home Health 

& Hospice

208-733-2234 Respite Gooding, Jerome, Lincoln and Twin 

Falls Counties

Alpine Manor I 208-734-1794 Adult Day Health

Facility Respite

Twin Falls

Alpine Manor II 208-423-5417 Adult Day Health

Facility Respite

Twin Falls

An Angel’s Touch InHome Care208-324-5605 Respite Gooding, Jerome and Twin Falls 

Counties

Applegate Retirement 

Center

208-543-4020

www.applegateassistedliving.com

Adult Day Health

Facility Respite

Buhl

Area Agency on 

Aging, Twin Falls & 

Burley offices

208-736-2122

officeonaging.csi.edu 

Respite Blaine, Camas, Cassia, Gooding, 

Jerome, Lincoln, Minidoka and 

Twin Falls Counties

Ashley Manor –

Buttercup Trail

208-423-5971

www.ashleycares.com

Adult Day Health

Facility Respite

Kimberly

Ashley Manor –

Lincoln

208-423-5971

www.ashleycares.com

Adult Day Health

Facility Respite

Jerome

Assisting Angel’s 208-733-2550 Respite Jerome, Lincoln, Minidoka and 

Twin Falls Counties

Autumn Haven, Inc 208-436-3200 Adult Day Health

Facility Respite

Rupert

Birchwood Retirement 

Estates

208-734-4445 Adult Day Health

Facility Respite

Twin Falls

Blaine County Senior 

Connection

208-788-3468 Respite Blaine & Camas Counties

Idaho Caregiver Needs and Respite Capacity Report, 2014 102
District 5 – Camas, Blaine, Gooding, Lincoln, Jerome, Minidoka, Twin Falls, and Cassia Counties

Bridgeview Estates 208-736-3933

www.lcca.com/bridgeview

Facility Respite Twin Falls

Cedar Draw Living 

Center

208-326-3342 Adult Day Health

Facility Respite

Twin Falls

Cenoma House 208-735-9796

cenomahouse.com

Adult Day Health

Facility Respite

Twin Falls

Chardonnay Assisted 

Living

208-736-4808

www.chardonnaytwinfalls.com

Adult Day Health

Facility Respite

Twin Falls

Children and Family 

Services Program

208-678-0974

healthandwelfare.idaho.gov

Children’s Respite Burley

Comfort Keepers 208-733-8988 Respite Cassia, Jerome, Minidoka and Twin 

Falls Counties

Country Cottage 

Assisted Living

208-736-1856 Facility Respite 

(disabilities)

Twin Falls

Country Living 208-326-6560

www.countrylivingretirementhomes.com

Adult Day Health

Facility Respite

Twin Falls, Jerome, Gooding, 

Blaine, Lincoln Counties

Creekside Care Center 208-324-4941 Adult Day Health

Facility Respite

Jerome

DeSano Place Suites 208-934-4623

www.desanoplace.com

Adult Day Health

Facility Respite

Gooding

DeSano Place LLC 208-886-7665

www.desanoplace.com

Adult Day Health

Facility Respite

Shoshone

DeSano Village 208-595-1589 Adult Day Health

Facility Respite

Jerome

Desert Rose 

Retirement

208-734-1866 Adult Day Health

Facility Respite

Twin Falls

Developmental 

Disabilities Program, 

H & W

healthandwelfare.idaho.gov

Devine Living Centers 

at Curry Retirement 

Estates

208-734-0626 Adult Day Health

Facility Respite

Twin Falls

Encompass Home 

Health

208-733-8600 Respite Camas, Cassia, Gooding, Jerome, 

Lincoln, Minidoka and Twin Falls 

Counties

Idaho Caregiver Needs and Respite Capacity Report, 2014 103
District 5 – Camas, Blaine, Gooding, Lincoln, Jerome, Minidoka, Twin Falls, and Cassia Counties

Havenwood Home 

Care

208-358-4772 Respite Blaine, Camas, Cassia, Gooding, 

Jerome, Lincoln, Minidoka and 

Twin Falls Counties

Heritage/Woodstone 

Retirement

208-733-9064

heritagewoodstone.com

Adult Day Health

Facility Respite

Twin Falls

Highland Estates 208-678-4411

www.highlandretirement.com

Adult Day Health

Facility Respite

Cassia & Minidoka Counties

Interfaith Volunteer 

Caregivers

Ivcmagicvalley.com Homemaker services

Jewel’s Home Care 208-733-6849 www.jewelshomecare.com Respite Blaine, Camas, Cassia, Gooding, 

Jerome, Lincoln, Minidoka and 

Twin Falls Counties

Julie’s Premier Home 

Care

208-280-0327 Respite Cassia, Gooding, Jerome, Lincoln, 

Minidoka and Twin Falls Counties

Koehn, Nancy 208-406-6268 Respite Buhl

Living Independent 

Network Corporation 

(LINC)

208-733-1712

www.lincidaho.org 

Respite Blaine, Camas, Cassia, Elmore, 

Gooding, Jerome, Lincoln, Minidoka 

and Twin Falls Counties

Loving Hands 208-734-3001 Respite Jerome and Twin Falls Counties

Mental Health 

Services, Adult and 

Children

208-677-5390

healthandwelfare.idaho.gov 

Children’s Respite Burley

Mental Health 

Services, Adult and 

Children

208-736-2177

healthandwelfare.idaho.gov 

Children’s Respite Twin Falls

Minidoka Memorial 

Home Health

208-436-9019 Respite Cassia and Minidoka Counties

MJ Home Care 208-420-6202 Respite Jerome and Twin Falls Counties

Personal Connections 208-543-8222 Respite Buhl and Castleford

Rosetta Assisted 

Living - Hiland

208-677-5451

www.rosettahomes.com

Facility Respite Burley

Rosetta Assisted 

Living – Eastridge

208-734-9422

www.rosettahomes.com

Adult Day Health

Facility Respite

Twin Falls

Safe Haven Homes of 

Bellevue

208-788-9698

www.safehavenhealthcare.org

Adult Day Health

Facility Respite

Bellevue

Idaho Caregiver Needs and Respite Capacity Report, 2014 104
District 5 – Camas, Blaine, Gooding, Lincoln, Jerome, Minidoka, Twin Falls, and Cassia Counties

Safe Haven Homes of 

Burley

208-678-2955

www.safehavenhealthcare.org

Adult Day Health

Facility Respite

Burley

Safe Haven Homes of 

Wendell

208-536-6623

www.safehavenhealthcare.org

Adult Day Health

Facility Respite

Wendell

Senior Companion 

Program

208-736-2122

flewis@ooa.csi.edu 

Adult Respite Blaine, Camas, Cassia, Gooding, 

Jerome, Lincoln, Minidoka and 

Twin Falls Counties

Stonebridge Assisted 

Living

208-837-4153 Adult Day Health

Facility Respite

Gooding

Tasks Unlimited 208-733-0497 Respite Cassia (partial), Minidoka and Twin 

Falls Counties

Visions Home Care 208-732-8100 Respite Gooding, Jerome and Twin Falls 

Counties

Vista Assisted Living 

Community

208-436-3332 Adult Day Health

Facility Respite

Rupert

Warren House 208-677-8212

www.alcco.com

Facility Respite Burley

Willowbrook Assisted 

Living

208-736-3727

www.willowbrookassistedliving.com

Adult Day Health

Facility Respite

Twin Falls

Woodland Retirement 

Estates

208-543-9050 Adult Day Health

Facility Respite

Buhl

Wynwood at Twin 

Falls

208-735-0700 Facility Respite Twin Falls

Zions In-Home Health 

Care

208-319-4587 Respite Gooding, Jerome and Twin Falls 

Counties

Idaho Caregiver Needs and Respite Capacity Report, 2014 105
District 6 – Butte, Bingham, Power, Bannock, Caribou, Oneida, Franklin, and Bear Lake Counties

Organization Website/Contact Number Services Notes

Area Agency on Aging of 

Pocatello

208-233-4032 x 16

www.sicog.org

Respite Pocatello and region

Bear Lake Home Care 208-847-4454

www.blmhospital.com/elderly-services/homehealth

Adult Respite Montpelier

Bingham Memorial Extended 

Care

208-785-4100

www.binghammemorial.org

Adult Day Health Bingham County

Caring Hearts 208-269-7150

caringheartsassist.com

Adult Respite Bannock, Bingham, Caribou, 

Power

Children and Family Services 

Program

208-785-5826

healthandwelfare.idaho.gov

Children’s Respite Blackfoot

Dawn Enterprises, Inc. 208-785-5890 Adult Day Health Bingham County

Developmental Disabilities 

Program, H & W

healthandwelfare.idaho.gov

Developmental Options, Inc. 208-233-6833

developmentaloptions.com

Adult Day Health Bannock & 

Bingham County

Franklin County Medical 

Center/PCS

208-852-1937

www.fcmc.org

Adult Day Health Franklin County

Friends and Family 208-244-4136

www.homecaresoutheastidaho.net

Adult Respite Bannock, Bingham, Power

Heartworks Connection 208-782-1088 Adult Respite Bannock, Bingham, Caribou, 

Oneida, Power

Helping Hands 208-232-2009

www.helpinghandshomehealth.net

Adult Respite Bannock, Bingham, Caribou, 

Franklin

Home Helpers 208-406-2380

homehelpershomecare.com

Adult Respite Bannock, Bear Lake, 

Bingham, Power

Mental Health Services, 

Adult and Children

208-785-5871

healthandwelfare.idaho.gov

Children’s Respite Blackfoot

Mental Health Services, 

Adult and Children

208-234-7900

healthandwelfare.idaho.gov

Children’s Respite Pocatello

Mental Health Services, 

Adult and Children

208-852-0634

healthandwelfare.idaho.gov

Children’s Respite Preston

Miner, Steve 208-406-6268 Respite Pocatello

Idaho Caregiver Needs and Respite Capacity Report, 2014 106
District 6 – Butte, Bingham, Power, Bannock, Caribou, Oneida, Franklin, and Bear Lake Counties

Oneida County Hospital 

Home Care

208-766-1054

www.oneidahospital.com

Adult Day Health Oneida County

SE Idaho Developmental 

Center

208-782-1301 Adult Day Health All Counties

Idaho Caregiver Needs and Respite Capacity Report, 2014 107
District 7 – Duster, Lemhi, Clark, Fremont, Jefferson, Madisen, Teton, and Bonneville Counties

Organization Website/Contact Number Services Notes

Affiliates, Inc.

dba The Adventure 

Center

208-403-6420

theadventurecenter.org 

Adult Day Health Bonneville, Butte, Clark, 

Custer, Fremont, Jefferson, 

Lemhi, Madison, Teton 

Counties

Area Agency on 

Aging/EICAP

208-522-5391

www.eicap.org

Respite Idaho Falls and region

Catanese, Debbi 208-881-9212 Respite Idaho Falls

Children With 

Disabilities Foundation

208-520-823 Children’s Respite Idaho Falls

Developmental 

Disabilities Program, H 

& W

healthandwelfare.idaho.gov

Joshua D. Smith 

Foundation 

208-403-6420 Adult Day Health Bonneville, Butte, Clark, 

Custer, Fremont, Jefferson, 

Lemhi, Madison, Teton 

Counties

Mental Health Services, 

H & W

healthandwelfare.idaho.gov

Northfork

Developmental Services

208- 624-7781 Adult Day Health Bonneville, Butte, Clark, 

Custer, Fremont, Jefferson, 

Lemhi, Madison, Teton 

Counties

Villarreal, Robin 208-552-2115 Respite Idaho Falls

Wilcox, Darcie 804-731-4214 Respite Rexberg

Wright, Melanie 208-201-8167 Respite Idaho Falls

Idaho Caregiver Needs and Respite Capacity Report, 2014 108
34

ATTACHMENT H 

MICHIGAN OFFICE OF SERVICES TO THE AGING 

NEEDS ASSESSMENT SUMMARY 

Introduction

The Michigan Office of Services to the Aging (OSA) has recognized the value of garnering 

feedback from the population it serves since its formation in 1973. This understanding was the 

driving force behind the decision to conduct a new needs assessment to aid in statewide 

planning and program activities for the future. 

The last needs assessment was completed by OSA in 1987 and focused exclusively on 

Michigan residents age 60 and over, the population that OSA serves. However, it was 

determined that with the addition of a new program set to launch in 2014, the Michigan Aging 

and Disability Resource Collaboration, additional data should be collected from the disability 

community. 

Further, the Older Americans Act – the federal law establishing most aging services in the U.S. 

– outlines lesbian, gay, bisexual and transgender (LGBT) older adults as a group for whom 

special efforts should be made to address the specific challenges they face. Therefore, it was 

also determined that the needs assessment should focus on LGBT residents as well. This 

decision made Michigan one of the first states in the country to conduct a statewide needs 

assessment specifically for LGBT residents. The expansion to a broader demographic makes 

this the most comprehensive statewide assessment ever conducted by OSA. 

Efforts to develop this needs assessment began in January 2011. It was supported by an 

advisory group, comprised of individuals and organizations across Michigan’s aging, disability 

and LGBT communities. More than 5,000 Michigan residents participated. The assessment 

itself began in May 2012 and concluded in October 2012. The needs assessment is broken into 

three data sets: 

1) 60 and over; 

2) 60 and under with disabilities; 

3) Lesbian, gay, bisexual and transgendered residents over 50, or under 50 with 

disabilities. 

Data highlights of each set are included in this document, which includes information on 

demographics, housing, employment and finances, transportation, health care, social 

connections, end of life and legal issues, caregiving, and information. To request the tables from 

any data set, please contact OSA. 

Helping older adults maintain their quality of life and independence is OSA’s continued focus. In 

the coming months we will be working with our partners to utilize each data set to improve the 

effectiveness, efficiency, and quality of services provided throughout the aging network. 

We are honored to have been able to conduct this unprecedented effort to give a voice to those 

who have concerns and needs in the state. We also look forward to developing partnerships 

and new and innovative ways to help meet those needs. 

Michigan Office of Services to the Aging Needs Assessment Summary 109
35

Giving and Receiving Care 

 Twelve-point-six percent (12.6%) are providing care for others. Of those, 38.8% are 

caring for a spouse, 23.2% for a parent and 15.6% are caring for a child. 

 Nearly four-out-of-five (77.8%) caregivers are caring for one person, and 12.9% are 

caring for two people. 

 Of those surveyed, 26.7% indicated that they are providing care because services are 

not available. 

 Caregivers report that caregiving causes them to make adjustments in their lives; 42.3% 

indicated there were emotional adjustments, 37.6% indicated there were personal 

adjustments, and 33.6% have feelings of stress or illness. 

 Of those surveyed, 64.1% of caregivers provide companionship, 61.2% provide 

transportation, and 59.7% help with shopping. 

 Almost half of caregivers (48.9%) indicated that there are services available that would 

make things easier for them, but 42.6% indicated that they won’t use the services 

because the person they are caring for does not like other people to help with their care. 

More than thirty percent (33.5%) mentioned that they do not have money to pay for 

services. 

 Twenty-point-three percent (20.3%) of respondents indicated that they need someone to 

help them with daily activities such as preparing meals, bathing or housekeeping. 

 Family and friends help in the areas of housecleaning (62.1%), transportation (51.4%), 

shopping (46.9%) and yard work or house maintenance (40.9%). 

 Paid workers help with house cleaning (67.7%), meal preparation (24.3%), yard work or 

house maintenance (23.7%) and transportation (22.8%). 

 Most paid workers are paid out-of-pocket only (45.2%). 

 Most respondents (68.8%) are paying $50 or less a week out-of-pocket for services in 

their home. 

Methodology 

The 60 and over needs assessment was developed in partnership with an advisory group, 

which was a workgroup of individuals representing agencies and organizations working with 

older adults, and individuals with disabilities. 

Other people with specialized knowledge were also consulted during the planning and 

implementation of the assessment. The development process took more than a year as 

domains were identified, questions from past needs assessments were reviewed, and new 

questions were developed to meet identified information gaps. 

Michigan Office of Services to the Aging Needs Assessment Summary 110
36

A convenience sample was used rather than a random sample for several reasons related to 

our information goals, sampling frames, costs, and expected returns. 

The Michigan Office of Services to the Aging (OSA) wanted to support participation by people 

who are normally excluded from survey sampling. Traditionally, samples may be chosen from 

lists of people who have drivers’ licenses, state IDs, are on voting rolls, or have received 

services from the agency or agencies undertaking a survey. Sampling can also be done 

through random digit dialing of landlines and cell phones. 

OSA’s goal was to also reach people who would be served by a new state program called the 

Aging and Disability Resource Collaboration. This target population is anyone who needs 

information and counseling about all aspects of life related to aging or living with a disability. 

Had OSA used voting lists, drivers’ licenses, state IDs, or service roles it would have omitted 

people in nursing homes, young adults with disabilities who do not have drivers’ licenses or 

voting records, and people who do not have access to a permanent phone number. For that 

reason a convenience sample was used. 

 

The advisory group reviewed sampling approaches and supported the decision to use a 

convenience sample with an emphasis on outreach. This decision meant that while OSA was 

able to collect a large number of responses, the sample was open to bias. Therefore, the 

findings cannot be generalized to all Michigan residents. Still, the information collected provides 

insights into the breadth of needs identified by respondents. 

The needs assessment survey was available in three formats: online, hard copy and interview. 

The online version of the survey held several advantages for those taking the survey and those 

working with the data. It was shorter since the survey skipped through questions that did not 

apply to the respondent. The data was accurately collected behind the scenes, avoiding the 

cost, time, and errors associated with data entry. It was pre-tested and modified in three rounds 

by more than one hundred people. The average time to take the online version ranged from 10-

20 minutes. 

The same online survey was used to conduct interviews. One experienced interviewer 

administered the 80 interviews requested by participants. The average time for the interview 

was 15-20 minutes. 

The hard copy version of the survey was constructed and pre-tested in two rounds by 78 

people. The survey was adjusted to read clearly, especially where respondents were asked to 

skip sections of questions. There was more variation in the amount of time needed to fill out the 

hard copy of the survey. Some could do it fairly quickly in about 20 minutes and others took as 

long as one hour. 

A lesbian, gay, bisexual, and transgender (LGBT) version of the survey was also created that 

contained the same questions with additional questions to learn about additional financial, legal, 

family and social challenges faced by LGBT residents. 

Outreach 

A website (www.needsmichigan.com) was set up as the hub for much of the activity for the 

needs assessment. The website served as the access point for the online version of the 

assessment and the place for agencies to connect with PDF versions of the hard copy of the 

Michigan Office of Services to the Aging Needs Assessment Summary 111
37

survey. It was also a source for informational sheets, webinar links, and helped field questions. 

Finally, it served as a contact point for survey participants to connect with project coordinators to 

find distribution sites for the hard copy version or public computer sites to take the online 

version of the assessment. 

An email address (needsmichigan@gmail.com) and a phone line were set up for people to ask 

questions or to request an interview or hard copy. Agencies or people could call to get hard 

copies of the survey sent to them. Return postage was provided if requested. 

Social media was also used in outreach with the use of a Facebook page. A total of 21 people 

responded that they heard about the survey through Facebook. 

 

A needs assessment information packet was created to send to all potential community partners 

informing them of the assessment and asking for their assistance. Postcards with the web 

address of the assessment, the number for the project coordinator and a short explanation of 

the survey were created as well. Nearly 30,000 were distributed to people through various 

community partners including senior centers, area agencies on aging, service providers, centers 

for independent living, and other disability organizations. More than 40 percent of respondents 

indicated they had heard about the survey through senior centers or area agencies on aging. 

More than 11 percent indicated they had heard of the survey through word of mouth from 

friends or family members. 

Data Analysis 

There were 3,805 useable responses in the 60 and over needs assessment. 

Demographic statistics were compared to 2010 Michigan census data. The use of a 

convenience sample produced a sample with demographic characteristics that were similar to 

those of Michigan, with a few differences. 

The largest difference was in the gender of respondents. The proportion of women in the 60 and 

over assessment is significantly higher than the proportion seen in the Michigan population, 

70.3% in the sample compared to 55.3% in the actual population. 

To review other differences, contact OSA to request a copy of the 60 and over tables. 

In the coming months, OSA will be working alongside Michigan’s aging and disability 

communities to examine the findings in the 60 and over assessment and develop 

recommendations if necessary. 

The 60 and over assessment will be critical for OSA as it works to develop its fiscal year 2014 

state plan and better understand and predict more accurately the services that will be required 

in the coming years for the population it serves. 

Data Highlights – 60 and Under with Disabilities 

There were 417 respondents who participated in the 60 and under with disabilities needs 

assessment. Data highlights of the assessment are broken out and listed below. 

Demographics 

 Females comprised 68.1% of the respondents, males 28.5%, transgender 2.9% and 

0.5% preferred not to answer. 

Michigan Office of Services to the Aging Needs Assessment Summary 112
38

 Of those surveyed, 36.7% were single, 26.3% were married, 15.5% were divorced, 9.7% 

have a long-term partner, 6.3% were widowed, 2.4% were separated and 3.1% listed 

other. 

 Most of the respondents were white (86.7%), 7.4% were black or African American, 

2.7% American Indian, Eskimo or Aleut, 2.5% other, 0.5% Asian American and 0.2% 

multi-racial. 

 Two-point-six percent (2.6%) of the respondents were of Hispanic origin (Hispanic was 

considered an ethnic group as opposed to a race). 

 Most of the respondents (38.8%) were age 55-59, 32.1% were age 18-49 and 29% were 

age 50-54. 

 Most of the respondents have had some college level education (31.8%), 23.2% were 

college graduates and 21.7% have completed grade 12. 

 Of those surveyed, 37.6% have two people in the household, 32.2% has one person, 

and 17.5% have three people. 

 Most of the respondents (29.9%) make between $1,000 and $2,000 household monthly 

income. Another 27.9% make between $600 and $1,000, 21.5% make more than 

$3,000, 14.3% make between $2,001 and $3,000 and 6.4% make less than $600. 

 Fifteen-point-four percent (15.4%) are blind or have serious difficulty seeing and 

10.7% are deaf or have serious difficulty hearing. 

 Over half (55.1%) had serious difficulty walking or climbing stairs. 

 Of those surveyed, 22.3% had difficulty dressing or bathing. 

 Of those surveyed, 44.5% have difficulty doing errands alone because of a physical, 

mental, or emotional condition. 

 Most of the respondents (62.9%) have difficulty concentrating or remembering 

because of a physical, mental, or emotional condition. 

Housing 

 Of those surveyed, 61.4% were living “where they want to be.” 

 Most of the respondents (58.5%) live in a house, 27.6% in an apartment, 5.6% a mobile 

home, 2.4% a condominium, 1.5% assisted living, 0.7% home for the aged and 3.7% 

indicated other. 

 Fifty-point-six percent (50.6%) of respondents rent and 49.4% own where they live. 

Twenty-seven percent (27%) have paid off their mortgage. 

 The costs that have been the biggest problem for respondents include utilities (56.3%), 

maintenance (44.7%) and mortgage/rental payments (39.8%). 

Michigan Office of Services to the Aging Needs Assessment Summary 113
39

 Over half (51.7%) were aware of utility assistance programs. 

 Sixty-four percent (64%) live in a home they rate as in good or excellent condition, and 

6.5% are in homes rated as poor. 

 Of those surveyed, 35.7% live in homes that can be used by people who use 

wheelchairs or cannot climb stairs. 

 Over half (56.5%) of the sample sees them moving in the future. Of those respondents, 

44.6% want a place they can stay as they get older and 42.4% want a place that is more 

affordable. 

 Seventeen-point-two percent (17.2%) of respondents have been a victim or had 

someone in their household be a victim of a crime in their neighborhood in the last year. 

Employment and Finances 

 Forty-point-one percent (40.1%) of respondents had income from disability payments, 

37.3% from Social Security and 33.2% from salary and wages. 

 Of those surveyed, 25.5% of respondents were not working due to a disability. Another 

21.8% were working full-time, 10% were working part-time and 10.7% were looking for 

work. 

 Of those working, 52.7% would rather be retired but need to work to support themselves 

or their family (38.9%), or pay for healthcare (13.8%). 

 Forty-two percent (42%) report it is hard to find or keep a job because of they have a 

disability. 

 Forty-four percent (44%) report they do not have enough money for their basic needs, 

and 40.3% use a bridge card. 

 Most of the respondents (78.2%) are worried their money will run out. 

 Twenty-five percent (25%) are helping to support other people. 

 Thirty-seven percent (37%) report that other people help pay for things they need, with 

parents (38.5%) helping most often. 

Transportation 

 Of those surveyed, 65.6% drive a car to get around the community, and 64.7% drive 

daily. 

 Over half (52.3%) of people surveyed indicated that they have trouble getting to places 

they want to go at least sometimes. The most common reason for lack of transportation 

is that it is too expensive (46.3%). 

Michigan Office of Services to the Aging Needs Assessment Summary 114
40

 Most frequently mentioned reasons for not using public transportation include the bus 

not taking them where they want (36.8%) or need (31.7%) to go, and length of time it 

takes to ride the bus (32%). 

 Fifty-one percent (51%) responded there were special bus programs to provide 

transportation for older people or those with disabilities in their area and 44.7% use 

those programs. 

Health Care 

 Most of the respondents (88.5%) indicated they have a personal primary care 

physician, and 44.1% have had a physical in the last six months. 

 Most of the respondents (94.3%) indicated they can get emergency medical care 

when they need it. 

 Most of the respondents (81.9%) indicated they have access to mental health care. 

The most often used sites for mental health services are a private practice office 

(42.3%) and community mental health (40.5%) for mental health services. 

 Nearly one-third (31.4%) reported that they have had problems getting medical care. 

Not having enough money for payment or co-payment (55.5%) was the most 

frequently mentioned reason for not getting care. 

 Of those surveyed, 54.8% did not go to the dentist during the past two years when 

they should have. 

 Not having enough money (68.3%) was the main reason respondents did not go to 

the dentist. 

Social Connections 

 Forty-point-eight percent (40.8%) of those surveyed live with a spouse or partner, 33.8% 

live alone, and 10.1% live with parents. 

 Sixty-point-three percent (60.3%) report they connect with family members by phone or 

internet every day. Another 25.9% connect at least once a week. 

 Nearly half (46.8%) reported visiting with family and friends at least once a week. 

Another 22.9% visit at least once a month. 

 Over half (54.9%) of respondents consider their close friends to be part of their family. 

Fifty-nine percent (59%) consult with their friends for advice first, followed by other family 

members (48.2%) and their spouse/partner (40%). 

End of Life and Legal Issues 

 Over half (54.6%) have discussed end of life issues with someone else. 

 Of those answering yes, 53.6% have spoken to their spouse/partner, 36.4% a friend, 

33.6% a child, and 33.2% a sibling. 

Michigan Office of Services to the Aging Needs Assessment Summary 115
41

 Over one-third (35.2%) have legal documents related to end of life issues, with the most 

common being a power of attorney for health care decisions (57.7%). 

Giving and Receiving Care 

 Of those surveyed, 18.3% of respondents are providing care for others. Of those, 33.8% 

are caring for a parent, 24.3% for a spouse or partner and 23% for a son or daughter. 

 Three-quarters (75.7%) of caregivers are caring for one person and 15.7% are caring for 

two people. 

 Of those surveyed, 42.3% indicated they are providing care because services are not 

available. 

 Caregivers report that caregiving causes them to make adjustments in their lives. Of 

those, 64.9% indicated there were emotional adjustments, 52.7% indicated stress or 

illness and 48.6% indicated there were personal adjustments. 

 Most of the caregivers (67.6%) were providing companionship, 64.9% were helping with 

housekeeping and laundry, 62.2% were providing transportation and 56.8% were 

helping with food preparation. 

 Sixty-point-nine percent (60.9%) indicated that there were services available that would 

make things easier for them, but 61.9% responded that lack of money keeps them from 

using those services. 

 Of those surveyed, 43.7% indicated that they need someone to help them with daily 

activities such as preparing meals, bathing or housekeeping. 

 Family and friends tend to provide help in the areas of transportation (61.7%), shopping 

(60.2%), house cleaning (56.3%) and yard work or house maintenance (45.3%). 

 Paid workers help with house cleaning (51.1%), transportation (43.2%), meal 

preparation (42%) and shopping (39.8%). 

 Forty-five percent (45%) are paying $50 or less a week out-of-pocket for services. 

Information 

 Fifty-eight percent (58%) go to the Internet for information, 57.3% get their information 

from friends and family and 20.9% from the Michigan Medicare/Medicaid Assistance 

Program (20.9%). 

Methodology 

The 60 and under with disabilities needs assessment was developed in partnership with an 

advisory group, which was a workgroup of individuals representing agencies and organizations 

working with older adults, and individuals with disabilities. 

Other people with specialized knowledge were also consulted during the planning and 

implementation of the assessment. The development process took more than a year as 

domains were identified, questions from past needs assessments were reviewed, and new 

questions were developed to meet identified information gaps. 

Michigan Office of Services to the Aging Needs Assessment Summary 116
42

A convenience sample was used rather than a random sample for several reasons related to 

our information goals, sampling frames, costs, and expected returns. 

The Michigan Office of Services to the Aging (OSA) wanted to support participation by people 

who are normally excluded from survey sampling. Traditionally, samples may be chosen from 

lists of people who have drivers’ licenses, state IDs, are on voting rolls, or have received 

services from the agency or agencies undertaking a survey. Sampling can also be done 

through random digit dialing of landlines and cell phones. 

OSA’s goal was to also reach people who would be served by a new state program called the 

Aging and Disability Resource Collaboration. This target population is anyone who needs 

information and counseling about all aspects of life related to aging or living with a disability. 

Had OSA used voting lists, drivers’ licenses, state IDs, or service roles it would have omitted 

people in nursing homes, young adults with disabilities who do not have drivers’ licenses or 

voting records, and people who do not have access to a permanent phone number. For that 

reason a convenience sample was used. 

 

The advisory group reviewed sampling approaches and supported the decision to use a 

convenience sample with an emphasis on outreach. This decision meant that while OSA was 

able to collect a large number of responses, the sample was open to bias. Therefore, the 

findings cannot be generalized to all Michigan residents. Still, the information collected provides 

insights into the breadth of needs identified by respondents. 

The needs assessment survey was available in three formats: online, hard copy and interview. 

The online version of the survey held several advantages for those taking the survey and those 

working with the data. It was shorter since the survey skipped through questions that did not 

apply to the respondent. The data was accurately collected behind the scenes, avoiding the 

cost, time, and errors associated with data entry. It was pre-tested and modified in three rounds 

by more than one hundred people. The average time to take the online version ranged from 10-

20 minutes. 

The same online survey was used to conduct interviews. One experienced interviewer 

administered the 80 interviews requested by participants. The average time for the interview 

was 15-20 minutes. 

The hard copy version of the survey was constructed and pre-tested in two rounds by 78 

people. The survey was adjusted to read clearly, especially where respondents were asked to 

skip sections of questions. There was more variation in the amount of time needed to fill out the 

hard copy of the survey. Some could do it fairly quickly in about 20 minutes and others took as 

long as one hour. 

A lesbian, gay, bisexual, and transgender (LGBT) version of the survey was also created that 

contained the same questions with additional questions to learn more about the financial, legal, 

family and social challenges faced by LGBT residents. 

Outreach 

A website (www.needsmichigan.com) was set up as the hub for much of the activity for the 

needs assessment. The website served as the access point for the online version of the 

Michigan Office of Services to the Aging Needs Assessment Summary 117
43

assessment and the place for agencies to connect with PDF versions of the hard copy of the 

survey. It was also a source for informational sheets, webinar links, and helped field questions. 

Finally, it served as a contact point for survey participants to connect with project coordinators to 

find distribution sites for the hard copy version or public computer sites to take the online 

version of the assessment. 

An email address (needsmichigan@gmail.com) and a phone line were set up for people to ask 

questions or to request an interview or hard copy. Agencies or people could call to get hard 

copies of the survey sent to them. Return postage was provided if requested. Social media was 

also used in outreach with the use of a Facebook page. A total of 21 people responded that 

they heard about the survey through Facebook. 

 

A needs assessment information packet was created to send to all potential community partners 

informing them of the assessment and asking for their assistance. Postcards with the web 

address of the assessment, the number for the project coordinator and a short explanation of 

the survey were created as well. Nearly 30,000 were distributed to people through various 

community partners including senior centers, Area Agencies on Aging, service providers, 

Centers for Independent Living, and other disability organizations. More than 20 percent of 

respondents indicated they had heard about the survey through friends or family members. 

More than 14 percent indicated they had heard of the survey through other sources. 

Michigan Office of Services to the Aging Needs Assessment Summary 118
44

Data Analysis 

There were 417 useable responses in the 60 and under with disabilities needs assessment. 

Comparisons between census 2010 Michigan census data and the 60 and under with 

disabilities needs assessment are not possible due to the use of a convenience sample. 

Those wanting to review all of the data related to the 60 and under with disabilities needs 

assessment may request a copy of the tables by contacting OSA. 

In the coming months, OSA will be working alongside Michigan’s aging and disability 

communities to examine the findings in the 60 and over assessment and develop 

recommendations if necessary. 

The 60 and under with disabilities assessment will be critical for OSA to better understand and 

predict more accurately the services that will be required in the coming years. 

Data Highlights – Lesbian, Gay, Bisexual and Transgendered Residents Over 50, or 

Under 50 with Disabilities

There were 753 respondents who participated in the lesbian, gay, bisexual and transgendered 

residents over 50, or under 50 with disabilities needs assessment. Data highlights of the 

assessment are broken out and listed below. 

Demographics 

 Females comprised 51.5% of the respondents, males 42.5%, transgender 5.1% and 

0.9% preferred not to answer. 

 Most of the respondents were white (90.8%), 4.7% were black or African American, 

2.4% other, 1.2% American Indian, or Eskimo or Aleut, 0.4% Asian American, 0.3% 

multi-racial and 0.1% Native Hawaiian or other Pacific Islander. 

 Three percent (3%) of the respondents were of Hispanic origin (Hispanic was considered 

an ethnic group as opposed to a race). 

 Most of the respondents (17.5%) were age 55-60, 17% were age 50-54, 15.2% were 

age 60-64, 8.7% were age 65-70, 4.7% were age 70-74, 3.5% were age 18-50, and 

30.1% were simply identified as 60 or older. 

 Most of the respondents (43.8%) have a graduate degree, 30.7% were a college 

graduate, 20.7% have had some college level education, and 3.1% have completed 

grade 12. 

 Of those surveyed, 46.8% have two people in the household, 40.1% have one person 

and 8.4% have three people. 

 Nearly half (46.9%) are single, 23.7% have a long-term partner, 13.9% listed other, and 

1.6% are married. 

 Of those surveyed, 31.2% had a disability. 

Michigan Office of Services to the Aging Needs Assessment Summary 119
45

 Fourteen-point-six percent (14.6%) of respondents had serious difficulty walking or 

climbing stairs. 

 Twenty-point-eight percent (20.8%) had difficulty concentrating or remembering 

things because of a physical, mental, or emotional condition. 

 Most of the respondents (87.4%) considered themselves to be gay or lesbian, and 

9% considered themselves to be bisexual. 

Housing

 Three-quarters (75.3%) were living “where they want to be.” 

 Of those surveyed, 74.9% live in a house, 11.4% in a condominium, 9.7% in an 

apartment, 1.8% a mobile home, and 1.7% indicated other. 

 Most respondents own their home (82.4%) and 27.1% have paid off their mortgage. 

 Nearly half (45.5%) can comfortably afford their housing costs. 

 Over half (51.3%) had lived at their current address for more than 10 years. 

 Of those surveyed, 84.8% rate the physical condition of their home/residence as being 

good (49.2%) or excellent (35.6%). 

 Over half (59.4%) of respondents sees themselves moving in the future. Of those, 50.6% 

want to be in a place where they can stay as they get older, and 45.9% want a place 

with less upkeep. 

 One-third (33.6%) of respondents indicated that finding housing in a LGBT-friendly 

community is difficult when finding a new home. 

 Fifteen-point-four percent (15.4%) of respondents were a victim or had someone in their 

household be a victim of a crime in their neighborhood in the last year. 

Employment and Finances 

 Of those surveyed, 38.7% were working full-time, 29% were retired, 9.6% were working 

part-time and 3.9% were looking for work. 

 Of those working, 34.8% need a job to care for themselves or their family, and 11.4% 

need their job for health care. 

 Nearly one-quarter (23.3%) report it is hard to find or keep a job because of their age, 

and 8.8% report it is hard to find or keep a job because of their sexual orientation. 

 Most of the respondents (84.4%) have enough money to meet basic needs (including 

food, clothing, housing, utilities). 

 Salary and wages (56%), pensions and annuities (32.4%) and Social Security (32.3%) 

are the main sources of income for respondents. 

Michigan Office of Services to the Aging Needs Assessment Summary 120
46

 Eight-point-six percent (8.6%) use a bridge card or food stamps. 

 Of those surveyed, 64.4% were worried their money will run out. 

 Eighteen-point-two percent (18.2%) were financially supporting adult children, 

grandchildren or others. 

Transportation 

 Most of the respondents (94.6%) drive a car to get around the community, and 86% 

drive daily. 

 Over half (55.4%) feel unsafe driving a car at night. 

 Fourteen-point-eight percent (14.8%) of people surveyed indicated that they have 

trouble getting to places they want to go often or sometimes. 

 The most frequently mentioned reasons for not using public transportation are that it 

does not take me where I want to go (38.8%), and it takes too long (35.5%). 

Health Care 

 Most of the respondents (91.7%) indicated they have a primary care physician, and 

46.9% have had a physical in the last six months. 

 Most of the respondents (96.9%) indicated they can get emergency medical care 

when they need it. 

 Most of the respondents (87.7%) indicated they have access to mental health care. 

The most often used sites for mental health services are a private practice office 

(73.2%), and a large group practice (15.2%). 

 Fourteen-point-five percent (14.5%) reported problems getting medical care. 

 Of those surveyed, 29.1% did not go to the dentist during the past two years when 

they thought they should have. 

 Not having enough money (61.2%) was the main reason respondents did not go to 

the dentist. 

 Most of the respondents (92.7%) have health insurance. 

 Nearly three-quarters (74.3%) have self-identified as LGBT to their health care 

provider. 

 Over three-quarters (76.2%) believe they are not treated differently by their health 

care provider because of their LGBT status. 

 Of those surveyed, 26.4% were victimized or had someone in their household 

victimized because of sexual orientation or gender identity in the last 10 years. 

Social Connections 

 Nearly half (48.8%) live with a spouse or partner and 40% of respondents live alone. 

Michigan Office of Services to the Aging Needs Assessment Summary 121
47

 Of those surveyed, 38.6% report they connect with family members by phone every day, 

and 43.1% connect at least once a week. 

 Fifty-point-five percent (50.5%) report they connect with family members through the 

Internet every day, and 33.9% connect at least once a week. 

 Of those surveyed, 43.5% reported visiting with family and friends at least once a week. 

Another 32% visit at least once a month. 

 Most of the respondents (68.6%) consider their close friends to be part of their family. 

 Respondents report that they consult their friends (79.9%) and spouse/partner (54.6%) 

the most when they need advice. 

End of Life and Legal Issues 

 Most of the respondents (78.7%) have discussed end of life issues with someone else. 

 Of those who have discussed end of life issues, 64.9% have spoken to their 

spouse/partner, 45.8% have spoken to a friend, 36.9% a sibling, and 35.1% have 

spoken to a lawyer. 

 Of those surveyed, 64.5% have legal documents related to end of life issues, with the 

most common being a power of attorney for health care decisions (78.5%). 

Giving and Receiving Care 

 Fifteen-point-nine percent (15.9%) of respondents are providing care for others. Of 

those, 46.7% care for a parent, 25.2% care for a spouse or partner, and 12.1% care for 

a friend or neighbor. 

 Nearly three-quarters (74.8%) of caregivers care for one person, and 18.4% care for two 

people. 

 Thirty-point-five percent (30.5%) indicated they are providing care because services are 

not available. 

 Caregivers report that caregiving causes them to make adjustments in their lives. Of 

those, 63.6% indicated there were personal adjustments, 59.8% indicated emotional 

adjustments, 49.5% indicated it takes a lot of time, and 40.2% indicated it causes 

stress/illness. 

 Most caregivers (77.6%) provide companionship, 70.1% help with transportation, 54.2% 

help with shopping, and 52.3% help with paperwork/paying bills. 

 Fifty percent (50%) indicated that there were services available that would make things 

easier for them, but 49% responded that a lack of money keeps them from using those 

services. 

 Ten-point-six percent (10.6%) indicated that they need someone to help them with daily 

activities such as preparing meals, bathing or housekeeping. 

Michigan Office of Services to the Aging Needs Assessment Summary 122
48

Information

 Trusted sources of information mentioned most frequently include the Internet (68.4), 

friends and family (55%) and the library (18.8%). 

 

 Of those surveyed, 21.2% would go to the Internet if they had questions. 

Methodology 

The lesbian, gay, bisexual and transgendered (LGBT) 50 and over or under 50 with disabilities 

needs assessment was developed in partnership with an advisory group, which was a 

workgroup of individuals representing agencies and organizations working with older adults and 

individuals with disabilities, and members from organizations serving the LGBT community. 

Other people with specialized knowledge were also consulted during the planning and 

implementation of the assessment. The development process took more than a year as 

domains were identified, questions from past needs assessments were reviewed, and new 

questions were developed to meet identified information gaps. 

Questions were identified to explore financial, legal, and social dimensions of aging related to 

LGBT identity, as well as questions related to LGBT identity and disclosure of LGBT identity 

with family members, friends and co-workers. 

An LGBT sub-group was instrumental in developing the outreach necessary to inform Michigan 

residents about the LGBT needs assessment. 

The advisory group reviewed sampling approaches and supported the decision to use a 

convenience sample with an emphasis on outreach. This decision meant that while OSA was 

able to collect a large number of responses, the sample was open to bias. Therefore, the 

findings cannot be generalized to all Michigan residents. Still, the information collected provides 

insights into the breadth of needs identified by respondents. 

The LGBT needs assessment was available in online and interview format. 

The online version of the survey held several advantages for those taking the survey and those 

working with the data. It was shorter since the survey skipped through questions that did not 

apply to the respondent. The data was accurately collected behind the scenes, avoiding the 

cost, time, and errors associated with data entry. 

It was pre-tested and modified in three rounds by more than one hundred people. The average 

time to take the online version ranged from 10-20 minutes. The online survey was used to 

conduct interviews but only four individuals requested an interview. 

Outreach 

A website (www.needsmichigan.com) was set up as the hub for much of the activity for the 

needs assessment. The website served as the access point for the online version of the 

assessment and the place for agencies to connect with PDF versions of the hard copy of the 

survey. It was also a source for informational sheets, webinar links, and helped field questions. 

Finally, it served as a contact point for survey participants to connect with project coordinators to 

find distribution sites for the hard copy version or public computer sites to take the online 

version of the assessment. 

Michigan Office of Services to the Aging Needs Assessment Summary 123
49

An email address (needsmichigan@gmail.com) and a phone line were set up for people to ask 

questions or to request an interview or hard copy. Agencies or people could call to get hard 

copies of the survey sent to them. Return postage was provided if requested. 

The survey was implemented on August 3, 2012 and ended on September 18, 2012. 

More than half of respondents heard about the needs assessment through an LGBT 

organization and another 33 percent heard of it through friends or family members. Social 

media was also utilized through the use of a Facebook page and about 8 percent of 

respondents heard of the assessment through that page. 

Data Analysis 

There were 753 useable responses from the LGBT residents over 50, or under 50 with 

disabilities needs assessment. 

 

To review the tables for the assessment, contact OSA to request a copy. 

In the coming months, OSA will be working alongside Michigan’s aging, disability and LGBT 

communities to examine the findings and develop recommendations if necessary. 

The LGBT residents over 50, or under 50 with disabilities needs assessment will be critical for 

OSA to better understand and predict more accurately the services that may be required in the 

coming years. 

Michigan Office of Services to the Aging Needs Assessment Summary 124
50

ATTACHMENT I

MICHIGAN OFFICE OF SERVICES TO THE AGING 

NEEDS ASSESSMENT RECOMMENDATIONS 

Michigan Aging and Disability Needs Assessment Workgroup: 

Caregiving-Receiving 

The Michigan Office of Services to the Aging (OSA) staff, designated as champions for this 

workgroup, reviewed and studied the results and trends of the 2012 OSA Needs Assessment. 

The data from the assessment was fairly consistent across the three target population groups; 

residents age 60 and over, residents under 60 with disabilities and LGBT residents 50 and over, 

and under 50 with disabilities. 

The workgroup focused on four primary areas as trends identified from the OSA Assessment 

Surveys; 

A) The importance of family caregiving 

B) The stress of caregiving 

C) Service utilization by caregivers 

D) Service Utilization by care receivers 

While the discussion, review and recommendations centered on family caregivers and those 

receiving care from family members, the workgroup did note some similar issues, challenges 

and recommendations with respect to paid caregivers. One in four households in the nation is 

involved in caregiving for a loved one. 

It is estimated that family caregivers provide 80% of all in-home care. Paid caregivers through 

private and public agencies, provide the remaining 20% of care. 

National and State Background Data and Issues in Caregiving and Care Receiving: 

The Importance of Family Caregiving 

The definition of the informal or family caregiver is an unpaid individual (spouse, partner, family 

member, friend or neighbor) involved in assisting others with activities typically not part of the 

relationship; this may include instrumental activities, such as driving a person to appointments, 

helping or doing weekly shopping, etc. It may also include daily activities, such as cooking, 

eating, and personal grooming. A growing trend is the delivery of medical assistance by family 

members, such as medication monitoring, and other in-home medical tasks. 

Informal caregiving of older adults among families had not attracted much attention until an 

article in 1985 proposed that caregiving for aging parents was becoming so common, it would 

become a normative experience.1 Since then, families became heavily engaged in caregiving, 

shifting providers’ perspective to include the needs of caregivers. Studies of caregiving and 

organizations supporting caregivers have proliferated.

Nationally, informal caregivers are estimated at 65.7 million or 29% of the adult U.S. population. 

This equates to more than one in four households engaged in caregiving for an adult over age 

50 (1.5 million in Michigan). Fifty two million caregivers provide care for adults age 18 and over 

 

1

 Brody, E.M, Parent Care as a Normative Family Stress, The Gerontologist (1985) 25 (1): 19-29.

Michigan Office of Services to the Aging Needs Assessment Summary 125
51

and 43.5 million of adult family caregivers are caring for someone age 50 and over. Fourteenpoint-nine million people care for someone who has Alzheimer’s disease or some form of 

dementia. 

A majority of caregivers (86%) care for a relative and most (36%) of those care for a parent. 

Twenty-six percent (26%) care for their mother and 10% care for their father. Only 14% care for 

a friend, neighbor or another non-relative. Twenty one percent of LGBT respondents provided 

care for an adult friend. One in seven (14%) caregivers assists their child (children) as well.2

 

Nationally, the value of unpaid family caregiving is estimated at more than $450 billion. In 

Michigan, the value is estimated at $15.5 billion3

The average age of a caregiver is 48, with 51% of caregivers being between the age of 18 and 

49. Rates of caregiving vary somewhat by ethnicity. Of the U.S. adult population age 18 and 

over, approximately 72% are white; 13% are African-American, 12% are Hispanic and 2% are 

Asian-American. Ethnic differences are also found with regard to the need of the care recipient. 

African-American caregivers (41%) were more likely to provide help with more than three of the 

core adult daily living activities (ADL’s; e.g. getting in/out of bed, dressing, feeding, managing 

incontinence or getting to and from the toilet). White caregivers are around 28% and AsianAmericans around 23%.4

 

The percentage of caregivers caring for individuals over 85 years of age has increased based 

on national surveys of informal caregivers conducted by National Alliance for Caregiving. 

Parent care continues to be the primary caregiving situation for mid-life caregivers with 70% of 

the caregivers between the age of 50 and 64. 

Interestingly, most care recipients live in their own home (58%) and 1 in 5 (20%) live in their 

caregiver’s home.5

The Stress of Caregiving 

The experience of caregiving produces varying levels of stress. The amount of stress 

experienced by family members varies as well. Some people report stress while providing brief 

or minimal care, while others don’t experience stress when spending 20 plus hours per week 

engaging in caregiving. Caregiving situations often develop based on a close relationship 

between the caregiver and care recipient; but there are family members who become caregivers 

purely from a sense of duty. 

Caregivers who care for a person with dementia, cognitive, or emotional issues are more likely 

to report stress. The unexpected behaviors and/or need for constant supervision can be 

exhausting. Some additional factors that contribute to stress are described below. 

Work life: Of Americans working full or part time, More than 1 in 6 reports assisting in the care 

of an elderly or disabled family member, relative, or friend. Caregivers who work at least 15 

hours per week said it “significantly affected their work life.” About 69% of working caregivers 

report having to rearrange their work schedule, decrease their hours, or take an unpaid leave in 

 

2

FCA (Family Care giving Alliance) and NCA (National Alliance on Caregiving) 2012 data

3

 AARP Public Policy Institute; Valuing the Invaluable: 20122 Update The Economic Value of Family Caregiving 

in 

 2009 (based on $11.23 per hour). 

4

FCA (Family Care giving Alliance) and NCA (National Alliance on Caregiving) 2012 data

5

FCA (Family Care giving Alliance) and NCA (National Alliance on Caregiving) 2012 data

Michigan Office of Services to the Aging Needs Assessment Summary 126
52

order to meet their caregiving responsibilities. Ten million caregivers over the age of 50 who 

care for their parents suffer loss of wages, health insurance and other job benefits, retirement 

saving/investing, and Social Security benefits to the tune of $3 trillion. 6

 

Working women caregivers: Women are the original source of concern in caregiving situations, 

due in part to their “being in the middle.” Middle age women may be active with children or 

grandchildren, while increasing their assistance to aging parents. Women also may suffer a 

particularly high level of economic hardship due to their caregiving. Female caregivers are 

more likely to make alternate work arrangements, take a less demanding job, give up work 

entirely and lose job related benefits. Single women caring for their elderly parents are 2.5 

times more likely than non-caregivers to live in poverty in their old age.7

 

The 2008 the economic downturn had a hard effect on the working family caregiver. A study 

found that 6 in 10 caregivers expressed they are less comfortable with risking time off from work 

to care for a family member or friend, which resulted in more than half feeling more stress 

because of the need to accommodate for care for a loved one and work. Of the employed 

caregivers, half sought additional jobs to cover their own living needs and 33% sought additional 

employment to cover the caregiving costs of a loved one.8

Travel distance: The majority of caregivers (72%) live within 20 minutes of the care recipient. 

Thirteen percent live within an hour of the care recipient. As the age of the caregiver increases, 

they are more likely to report living with their care recipient. More than one-third (37%) of older 

caregivers live with their recipient compared to 1 in 5 (20%) of middle aged and about one in six 

for (14%) of younger caregivers. 

The proportion of caregivers reporting living less than 20 minutes from the recipient has 

increased in the last 5 years from 44% to 51% and some attribute this to the 2008 economic 

downturn. Long distance caregivers had the highest annual expenses (average just under 

$8,800/yr.) compared to co-resident caregivers (average just under $5900/yr.) while those who 

cared for a loved one nearby (average $4800/yr.).9

Of those providing care, 24% say caring for a family member, relative, or friend has a direct 

impact on their work performance, and it keeps them working more hours. Caregivers miss an 

average of 6.6 workdays per year. Approximately 17% of full time workers missed 126 million 

workdays per year. Thirty six percent of caregivers missed 1-5 days per year while 30% missed 

6 or more days per year. One third of working caregivers are working professionals and another 

12% are in service or management roles. Seventy one percent indicate their employers know of 

their caregiving status with 28% reporting their employers were unaware. 

When surveyed about workplace programs, one-quarter or less stated they have access to 

employer sponsored support groups (e.g. support group discussions, ask-a-nurse type services, 

financial or legal consultation and assisted living counselors).10

The time spent caregiving, on average, is 20.4 hours per week. Those who live with their care 

recipient spend 39.3 hours per week for that person. Those caring for a child under the age of 

 

6

 Ibid

7

 Ibid

8

FCA (Family Care giving Alliance) and NCA (National Alliance on Caregiving) 2012 data 

9

 Ibid

10 Ibid

Michigan Office of Services to the Aging Needs Assessment Summary 127
53

18 spend 29.7 hours per week. Older caregivers who are 65 plus provide 31 hours per week on 

average while middle aged caregivers report spending approximately 19 hours per week. Older 

caregivers are more likely than younger caregivers to bathe and shower their care recipient 

(33% vs. 22%).11

 

Caregiving for person with Alzheimer’s disease: In 2010, 14.9 million families and other unpaid 

caregivers of people with Alzheimer’s disease and other dementias provided 17 billion hours of 

unpaid care. This represents an average of 21.9 hours of care giving/week or 1,139 hrs. of care 

per caregiver valued annually at $11.93/hr. for an estimated $202.6 billion in 2010 alone. 

Measured by duration of care, Alzheimer’s and dementia caregivers provide care on average of 

1-4 yrs. longer than a caregiver providing care for someone with a other illness (43% vs. 33%). 

The average duration of a caregiver’s role is 4.6 yrs. Only 3 in 10 caregivers provide care for 

less than a year. Similarly, caregivers for a loved one is 1-4 yrs. and 3 in 10 caregivers cared 

for 5 yrs. or more with 15% reporting caring for 10+yrs.12

Caregiving for Veterans: Ninety-six percent (96%) of caregivers of veterans are female and 

70% provide care to their spouse or partner. Thirty percent (30%) of veterans’ caregivers care 

for 10 years or more as compared to 15% of caregivers nationally. Eighty-eight percent (88%) 

report increased stress or anxiety as a result of caregiving and 77% state sleep deprivation as 

an issue. Veterans suffer more frequently from traumatic brain injuries, post-traumatic stress 

disorder, diabetes; and paralysis or spinal cord injury.13

 

Other Caregiver and Care Receiver Trends: Caregivers, regardless of employment status, 

report that positive activities in their life is reduced by 27.2% as a result of caregiving 

responsibilities, and the effect on their personal life is three times more than the effect on their 

employment.14

Care recipients/Caregiver Service Utilization: 

 Forty-nine percent of caregivers reported use of at least three specific types of help on 

behalf of their care recipient. Most commonly used was an outside transportation 

service (29%) followed by requesting resources for financial assistance (28%). Only 

12% have used respite services. Caregivers of adults aged 18-49 are more likely to 

have sought financial help (44%), than those caring for older (25%) or younger (32%) 

recipients.15

 One in five caregivers report having had training (19%) but seek additional resources. 

Seventy-eight percent report needing more help and information with at least 14 specific 

topics related to caregiving. Caregivers in high burden situations are more likely to seek 

help (83% vs. 73% of low burden caregivers).16

 

The Top Three Topics of Concern to Caregivers are: 

Keeping their loved one safe (37%); managing their own stress (34%); finding easy activities to 

do with their care recipients (34%); and finding time for them. The demand for information by 

 

11 Ibid

12 FCA (Family Care giving Alliance) and NCA (National Alliance on Caregiving) 2012 data

13 National Alliance for Care giving/United Health Foundation, Caregivers of Veterans: Serving on the Home Front (2010)

14 FCA (Family Care giving Alliance) and NCA (National Alliance on Caregiving) 2012 data

15 Ibid

16 Ibid

Michigan Office of Services to the Aging Needs Assessment Summary 128
54

caregivers has increased in the last 5 years to 77% vs. 67%. Transportation is a vital 

component provided by the family caregiver and family or friends provide transportation for 1.4 

billion medical visits a year for older relatives (70+ who no longer are able to drive 

themselves).17

Additional Caregiver and Care-Receiver Issues/Trends: 

 Caregivers are getting younger 

 Caregivers are increasingly asking for stipends – to get paid for caregiving tasks 

 There is usually one primary person who serves in the caregiver role 

 “Being in the middle” stress is greater for parents with children at home 

 It takes an army to do the caregiving, so it helps to get help from others 

 Some caregivers are not aware of available services 

 The caregiving experience is often unexpected – or stops unexpectedly 

 Prior relationship (or lack thereof) impacts ability/willingness to engage in caregiver role 

 Ethnicity, cultural concerns are factors in accessibility to services 

 Caregiver and care receivers have concerns about quality of care 

 Caregivers may need training to do caregiving tasks well 

 The workforce of those who provide care are a really difficult population to reach and 

maintain 

*Information above, in aggregate, based on information and input from FCA (Family Caregiving 

Alliance) and National Alliance on Caregiving (2012 data), as well as experienced case 

management input and work group members personal experience as caregivers, as well as 

work experiences with persons in the role of caregivers and care receivers. 

Workgroup members felt that the results of the OSA Needs Assessment were consistent with 

national studies and with participants’ experiences of working with caregivers and care receivers 

and other surveys and evaluations of caregiver needs in their regions. 

Barriers to Support Caregivers and Care Receivers, Reduce Caregiver Stress and 

Increase effective Service Utilization: 

The needs assessment found that the number one reason people don’t use services is that the 

care recipient doesn’t want a formal caregiver. The workgroup looked at some of the possible 

factors that contribute to that perspective, on both sides of the equation: caregiver and care 

recipient. 

The workgroup concluded that trust and quality of care were often important underlying factors 

to not using available services. People are wary of allowing strangers in their homes, care 

recipients may be uneasy about receiving personal care from a stranger, and for some 

individuals there is concern about acceptance of personal attributes, e.g., race, ethnicity, gender 

orientation, etc. The care recipient is relatively vulnerable in a caregiving situation. The list: 

 Caregivers think they provide services best, “Only I can take good care of...” 

 Care recipients/care givers are in denial about the needs 

 

17 FCA (Family Care giving Alliance) and NCA (National Alliance on Caregiving) 2012 data

Michigan Office of Services to the Aging Needs Assessment Summary 129
55

 Nobody has confirmed the actual cost of services 

 There is concern that receiving services is like being on welfare 

 Privacy is a big issue for both, letting someone into the home 

 Ethnicity and cultural concerns: will they be respected and treated with dignity? 

 How do you achieve a comfortable match between the professional aide and the care 

recipient? 

 Quality of care concerns 

 Training issues: staff knowledge and training 

 Risk assessment: possible abuse, theft, inappropriate acts, etc. 

 Guilt: if family members allow professional services, they look “neglectful” to others or 

unable to do the task. 

Survey respondents also indicated being unable to locate services or people to perform services 

that they needed, ranging from house cleaning to assistance eating. The top reason they didn’t 

use services is inability to pay. The workgroup generated a list of concerns for this group: 

 Lack of knowledge of where to seek service and don’t know who to call 

 Respite and other service designations seem arcane, specialized, or not easily 

understood, examples: 

o Adult day services 

o Aging Disability Resource Collaborations 

o Area Agencies on Aging 

o Personal Care Services 

o Congregate meals 

 Need for greater public education about the aging network, services, and eligibility 

Finally, the workgroup generated a list of various supportive programs, initiatives and resources. 

While certainly not conclusive, the list demonstrates the types of programs that are known and 

valued. This was part of the recognition that it takes “an army of friends, colleagues, 

information, supports, and resources” to navigate caregiving. 

 Lotsa Helping Hands website - https://www.lotsahelpinghands.com/

 Villages - 

http://vtvnetwork.clubexpress.com/content.aspx?page_id=0&club_id=691012

 Faith in Action (example) - http://www.faithinaction1.org/

 Time Banks - http://www.mitimebanks.org/

 Parish Nursing (example) - http://www.allnursingschools.com/nursingcareers/career/parish-nurse

Michigan Office of Services to the Aging Needs Assessment Summary 130
56

 Block Nurses Program (example) - http://www.elderberry.org/

 NORC: naturally occurring retirement communities - http://www.norcs.org/

The workgroup also cited the importance of coordination between home service providers and 

health care and inpatient settings. The continuum of care includes hospitals, rehabilitation 

facilities and often the lynchpin is a discharge planner. The Aging and Disability Resource 

Collaboration can help bridge the service gap. Factors noted include: 

 Specialized delivery of healthcare services and overall lack of coordination of care 

between providers (systems don’t always talk to one another) 

 HIPAA rules preclude effective communication between providers and supportive 

service agencies 

 Continuum of care in home/community based settings are more labor intensive for the 

discharge planners after an acute care episode 

 Penalty of readmissions are causing a shift towards skilled nursing care and often have 

the “pendulum affect” of providing care on a continuum based on admitting diagnosis 

 Qualifications for Medicare Skilled Home services 

 Time limits on most services: less than typical work week. 

Recommendations to Support Caregivers and Care Receivers, Reduce Caregiver Stress 

and Increase effective Service Utilization: 

Overall Recommendations: 

1. Provide solid professional information and support to caregivers (OSA and ADRCs) 

2. Continue to provide and enhance evidence-based programs, such as Creating Confident 

Caregivers® and TCARE®. Multi-functional caregiver programs e.g., programs 

providing information, respite/support, and skill building, are more effective than respite 

care or education alone, according to the AoA, 2013. 

Primary Opportunities: 

There were several opportunities cited by the workgroup that OSA should consider. 

 Increase cultural competency, including the LGBT population, in service practices and 

policies 

 Recognize the importance of quality of care and personal trust between service 

providers and service recipients. 

 Create collaborative connections with health care facilities, residential care and other 

settings to improve personal care aides’ and nursing aides’ skills 

 Recognize and support the variety of caregiving and support networks developed by 

non-governmental entities and encourage collaboration. 

 

Michigan Office of Services to the Aging Needs Assessment Summary 131
57

Recommended Activities:

1. Provide families accurate information and effective support services to facilitate them 

being proactively engaged in addressing issues/problems as they arise. 

2. Explore how the service system can take a broader look at “extended family” to better 

support LGBT caregivers. 

3. Encourage staff training t to increase their cultural competency with ethnic, diverse 

participants, including LGBT. 

4. Explore how caregivers can receive more training and education and how to best 

facilitate a family meeting process. 

5. Promote the use of case management and case coordination and support services 

agencies as a source of information for caregivers and care receivers. 

6. Use ADRC’s to get information out to caregivers and care receivers. 

7. Collaborate with recognized entities for a state registry of direct care workers; a 

mandated state approved curriculum for direct care workers; a mandated licensure for 

direct care workers; and bonding home care providers. 

8. Encourage the utilization of BTBQ Training Grant pilot programs and based on positive 

outcomes, consider expanding. 

9. Provide care managers more training and expertise in gerontology. 

10. Increase and improve the geriatric knowledge and resource knowledge of hospital 

discharge planners. 

11. Provide more information to baby boomers and others so they can proactively plan 

ahead to avoid crisis. 

12. Advocate for the inclusion of caregiving processes and planning in retirement planning 

packages. 

13. Continue to expand the utilization of Creating Confident Caregiver® (CCC) and Tailored 

Caregiver Assessment and Referral® (TCARE) Programs. 

14. Include partner – inclusiveness in planning for care receiver. 

15. Provide more public education about the aging network services and eligibility. 

16. Get information out about Lotsa Helping Hands. 

17. Get information out about Faith in Action and Parish Nurse Programs. 

18. Get information out about Villages and Time Banks. 

19. Get information out about Buddy Programs. 

20. Provide information and education about Hospice at home and palliative care. 

21. Promote with consumers that COAs and Senior Centers are sources of information as 

well. 

22. Promote more education about buying LTC insurance and understanding the associated 

cost/benefits. 

23. For home care agency staff explore bonding for staff as it increase the perception of 

safety and trust on the part of families and caregivers. 

24. Provide more information for consumers regarding what private individuals can do for 

checks background checks. 

25. Share this information with AAA Directors and ask for their input. 

Michigan Office of Services to the Aging Needs Assessment Summary 132
58

The Office of Services will consider the range of recommendations above in developing the 

OSA State Plan and in exploring, shaping and expanding policy and program initiatives for 

caregivers and care receivers in 2014-2016. 

When taking the recommendations of the workgroup as a whole, it is interesting to note that 

they are quite consistent with recommendations made by the 2012 AARP Public Policy Institute 

Paper, “A Call to Action: What Experts Say Needs to Be Done to Meet the Challenges of Family 

Caregiving.” In that paper, the four primary themes stated in which public policies and 

communities best can respond to the needs of family caregivers are: 

 Greater Public awareness and education 

 Better communication, coordination, and collaboration with health care professionals 

 Heightened recognition of and support for family caregivers in policy initiatives 

 More financial relief 

Michigan Office of Services to the Aging Needs Assessment Summary 133
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 1 of 41

2012 County Long-Term Services and Supports

Gaps Analysis Survey 

Aging and Adult Services

Full Report 

Department of Human Services 

Continuing Care Administration 

Aging and Adult Services Division 

August 2013 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 134
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 2 of 41

Contents 

Introduction.............................................................................................................. 3

Background ........................................................................................................... 3

2012 Long-Term Services and Supports Gaps Analysis ................................................ 3

Results .................................................................................................................. 4

Home and Community-Based Services ........................................................................ 4

Current Service Capacity ........................................................................................ 6

Strong Service Capacity ......................................................................................... 6

Service capacity exceeds demand ........................................................................... 7

Changes in Reported Gaps for Aging Services 2003-2013 ..........................................10

Impact of Community Service/Services Development (CS/SD) Grants .........................10

Cultural Competence ...............................................................................................11

Overall HCBS System Improvements ........................................................................12

Barriers for HCBS Development for 2013-2014 ......................................................13

Highest Priority for HCBS Development 2013-2014 ....................................................14

Housing ..................................................................................................................14

New Housing Developments .................................................................................15

Resources for Accessible Housing .............................................................................16

Housing Options .....................................................................................................17

Issues and Barriers for appropriate supply of housing options ....................................19

Highest Priority for Housing Development in County for 2013-2015 ............................21

Demand for Shared or Co-housing Developments ..................................................21

Nursing Facility Specialty Beds/Services and Relocation .............................................21

Barriers for Nursing Facility Specialty Beds and Services ............................................22

Nursing Facility Relocation .......................................................................................23

Conclusion ..............................................................................................................27

Appendix A: Table of Survey Results ........................................................................29

Table 1a: County reports of changes in service capacity, 2011-2012 .......................29

Table 1b: County reports of changes in related service capacity, 2011-2012 ...........30

Table 2a: County reports of current general service capacity ..................................31

Table 2b: County reports of current related service capacity ...................................32

Table 3: County report of service gaps*, by ranking . Error! Bookmark not defined.

Table 4: Capacity to serve culturally diverse communities ....... Error! Bookmark not 

defined.

Table 5: Overall HCBS system improvements ........................................................33

Table 6: Resources for accessible housing .............................................................34

Table 7: Capacity of subsidized housing options ....................................................34

Table 8: Capacity of market rate housing options ..................................................35

Table 9: Capacity of long-term care nursing facility specialty beds and services .......35

Appendix B: Description of Limitations for Top 10 Service Gaps ................................. 36

Appendix C: Changes in Aging Services Capacity 2003-2012 ......................................39

Table C1: Top gaps in service capacity, 2003-2012 ................................................40

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 135
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 3 of 41

Introduction 

Every two years, the Minnesota Department of Human Services (DHS) gathers local 

information about the current capacity and gaps in services and housing needs to

support older adults in Minnesota. Since 2001, all counties in Minnesota have been 

requested to respond to a survey of local capacity to meet long-term services and 

supports (LTSS) needs of current residents, including any significant “gaps” in services 

or supports. This information is submitted to DHS through a County Gaps Analysis 

Survey. 

This report provides a statewide summary of the 2012 Gaps Analysis for Aging and 

Adult Services. These results will provide an overview of statewide trends in home and 

community-based services (HCBS) needs, capacity and development as it relates to 

services for older adults. Individual county profiles are also available at

www.dhs.state.mn.us/GapsAnalysis/aasd. 

Background

In 2001, in order to re-balance Minnesota’s long-term services and supports system, the 

Minnesota Legislature approved a set of reform measures to develop and provide a 

wider range of home and community-based service options to better meet the 

preferences and needs of older adults and their families. To launch this effort, the 

Legislature provided funding for counties to prepare an analysis of the long-term 

services and supports system, including the current availability of - and projected need 

for - additional services and supports, housing and service arrangements and facilitybased long-term services. 

In 2002, the Legislature eliminated state funding for the Gaps Analysis. However, DHS 

has continued to be required by statute1

to report to the Legislature on the status of

the full range of LTSS for older adults in Minnesota, including an update on the state’s

efforts toward balancing its LTSS system. 

2012 Long-Term Services and Supports Gaps Analysis

Over the years, the Gaps Analysis has primarily collected information about service 

capacity to meet the needs of older adults. In 2013, additional surveys were sent 

to the counties to gauge the capacity of services for people with disabilities, 

children and youth with mental health conditions and adults living with 

mental illnesses. 

A bulletin was issued in March 2013 requesting counties to complete the Gaps Analysis 

survey based on data for 2012. There were 84 total replies, which represent all of 

 

1

https://www.revisor.leg.state.mn.us/statutes/?id=144A.351 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 136
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 4 of 41

Minnesota's 87 counties (five of which are part of multi-county agencies2). For the 

purposes of calculating our percentages, each multi-county agency is counted as one 

response. Within this report, the term county will refer to both individual counties and 

multi-county agencies. 

Results 

The results presented in this report are based on county self-reports of capacity in their 

county. Counties were asked to report on their county’s capacity to meet the long-term 

service and support needs of older adults in their community through (1) home and 

community-based services (2) housing and (3) nursing facility specialty beds/services 

along with relocation assistance. This survey consisted of two specific categories of 

questions: change in capacity of home and community-based services since January 

2011; and current HCBS capacity as of December 2012. 

Unless otherwise noted, any percentages provided in parentheses throughout this 

report indicate the percentage of counties that reported the finding under discussion. 

Home and Community-Based Services 

Counties were asked to report on any recent changes in home and community-based 

service (HCBS) capacity as well as current service capacity in their county. Counties also 

reported on local capacity to provide culturally competent services, issues or barriers 

related to HCBS capacity along with their county’s priorities for HCBS development. 

Changes in Service Capacity 

Counties were asked to report on any changes in capacity since January 2011 across 30

services that support older adults in the community. For each service, counties could

indicate whether the service is more available, less available or there was no change in

the service. 

Counties have experienced a combination of increases and decreases in their local 

service capacity between 2011 and 2012. This maintains a trend that was first seen in 

the 2009 survey. In the Gaps Analysis surveys conducted before 2009, counties tended 

to report service capacity as maintained or sometimes even increased. In the 2012 

survey, all but one county reported an increase in at least one service area. Figure 1 on

the next page shows the services that counties most commonly reported as more 

available. The services most commonly reported as more available were: health 

promotion activities (with 43% of counties reporting this service as more available), 

customized living (35%), technology (33%), end-of-life/hospice/palliative care (31%), 

personal care assistance (23%) and insurance counseling/forms assistance (23%). 

 

2

 The following counties submitted a single survey because they operate as multi-county human service agencies: Human 

Services of Faribault and Martin counties; and Southwest Health and Human Services (Lincoln, Lyon, and Murray counties) 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 137
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 5 of 41

Figure 1: Top ten services reported as more available, 2011-2012

*Related service 

Decrease in services 

Nearly half of counties (48%) reported a decrease across two or more services since 

2011. This is fairly consistent with the 2009 Gaps Analysis survey, where 55% of 

counties reported that two or more services became less available between 2007 and 

2009. As shown in Appendix A – Table 1, many services that were reported by counties 

as less available were also reported as not meeting the demands of the service 

population (i.e., a gap) for 2012: transportation (20% reported that this service was 

less available), chore service (18%), companion service (17%), non-medical 

transportation (15%), and homemaker service (14%). 

Figure 2: Top ten services reported by counties as less available, 2011-2012 (see next 

page) 

43%

35%

33%

31%

23%

23%

21%

20%

20%

20%

0% 20% 40% 60%

Health Promotion Activities*

Customized Living

Technology*

End-of-life, Hospice, Palliative Care*

Personal Care Assistance

Insurance Counseling/Forms Assistance*

Adult Day Care

Companion Service

Home Delivered Meals

Non-County Information/Ref & Assistance*

Top Services Reported By Counties As More Available, 2011-2012

Percent of counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 138
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 6 of 41

*Related service 

Current Service Capacity

Counties were given a list of 17 Home and community-based services and 13 related services 

that support older adults in the community and were asked to determine if the service was

not available, available but limited, meets demand or exceeds demand as of December 2012. 

Strong Service Capacity 

Figure 3 displays the top ten services with capacity reported as sufficient for their jurisdiction3. 

Long Term Care Consultation/ community assessment (98%), End-of-life / hospice / palliative 

care (96%), relocation service coordination (93%), supplies and equipment (90%), and skilled 

home nursing care (89%) were at the top of the list. 

 

3

 Sufficient capacity includes any county that reported a service “meets demand” or “exceeds demand”.

20%

18%

17%

15%

14%

10%

10%

10%

10%

8%

0% 20% 40%

Transportation

Chore Service

Companion Service

Transportation, non-medical*

Homemaker Service

Adult Day Care

Customized Living

Home Health Aide

Prevention/Early Interv (Beh/Cog Health)*

Personal Care Assistance

Top Services Reported By Counties As Less Available, 2011-2012

Percent of counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 139
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 7 of 41

Figure 3: Top ten services reported as meeting or exceeding demand, 2011-2012 

*Related service 

Service capacity exceeds demand 

Several services were reported as exceeding demand by counties. Most commonly, 

10% of counties report that the availability of customized living currently exceeds 

demand. Other services most reported as exceeding demand were: adult day care, 

personal care assistance, and health promotion activities (all at 6%); and home health 

aide (5%). 

98%

96%

93%

90%

89%

88%

88%

88%

88%

87%

70% 80% 90% 100%

LTC Consultation/Community Assessment*

End-of-life, Hospice, Palliative Care*

Relocation Service Coordination*

Supplies and Equipment

Skilled Home Nursing Care

Fiscal Support Entities (CDCS)

Home Delivered Meals

Home Health Aide

Technology*

Adult Protection*

Top services reported as meeting or exceeding demand, 2011-2012

Percent of counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 140
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 8 of 41

Figure 4: Top ten services reported as exceeding demand, 2011-2012 

Most Common Service Gaps 

Figure 5 below summarizes the top ten services where counties reported insufficient 

capacity. These rankings were calculated by combining the percent of counties who 

reported a service as not available with those that reported the service as available but 

limited. The service most frequently reported as a gap was chore service, with 65% of 

counties reporting as such. Gaps were also found in companion service (63%), 

transportation, non-medical (61%), transportation, medical (58%), and adult day care

(57%). In a review of the county aging gaps analysis results, health plan 

representatives noted strong agreement with these gaps and added personal care 

assistance, forms assistance and guardianship. 

10%

6%

6%

6%

5%

4%

2%

1%

1%

1%

0% 5% 10% 15%

Customized Living

Adult Day Care

Personal Care Assistance

Health Promotion Activities*

Home Health Aide

Fiscal Support Entities (CDCS)

Homemaker Service

Caregiver Training & Support

Home Delivered Meals

Home Modifications and Adaptations

Top ten services reported as exceeding demand, 2011-2012

Percent of counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 141
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 9 of 41

Figure 5: Top ten service gaps 

*Related service 

Many of the top ten gaps are services that support informal caregivers (companion 

service, respite care, adult day care, caregiver training and support). Figure 6 shows 

the top ten services that were reported as not at all available by counties, many of 

which also support informal caregivers (adult day care – 25% unavailable - and 

caregiver training and supports – 11% unavailable - placing 2nd and 5th, respectively). 

Table 2 in Appendix A provides a complete summary of county reports of capacity for 

each service. Appendix B of this report includes a summary of the barriers reported by 

counties and health plans to developing and maintaining capacity for these ten services. 

65%

63%

61%

58%

57%

56%

50%

45%

45%

44%

0% 20% 40% 60% 80% 100%

Chore Service

Companion Service

Transportation, non-medical*

Transportation (medical)

Adult Day Care

Respite Care, In Home

Respite Care, Out of Home

Non-County Case Management*

Prevention/Early Interv (Beh/Cog Health)*

Caregiver Training & Support

Top ten services reported as gaps, 2011-2012

Percent of counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 142
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 10 of 41

Figure 6: Top services reported as not available 

*Related service 

Changes in Reported Gaps for Aging Services 2003-2012 

The top service gaps from the 2012 survey were compared to the top gaps reported by 

counties in the four previous Gaps Analysis surveys (for a year-by-year comparison of 

the previous Gaps Analysis results, see Appendix C).The top service gaps for 2012 are 

consistent with previous years, though the percentage of counties reporting gaps for 

particular services has increased over the years. For example, 28% of counties reported 

a gap in the area of chore services in 2003 which has increased to 65% of counties 

reporting this gap in 2012. The same three services – chore, companion and 

transportation (specified as non-medical transportation in 2009 and 2012) – have been 

identified as the top three gaps statewide since 2007 and by a similar proportion of 

counties. 

Impact of Community Service/Services Development (CS/SD) Grants 

In order to aid in the development of a new service or the enhancement of an existing 

service, providers and other community organizations can utilize Community 

Service/Services Development (CS/SD) grants. While the impact of this funding source 

is not known to a majority of counties (52% of counties reported don't know / unsure), 

nearly one in four reported that CS/SD grants either had some impact (21%) or a lot of 

impact (2%). Counties reported that CS/SD grants allowed an expansion of existing 

services to a larger portion of the county or the addition of a new service. Some 

counties reported that the grants have facilitated the development of self-sustaining 

programs that continue to assist older adults in their county. 

30%

25%

12%

12%

11%

7%

7%

7%

6%

5%

0% 10% 20% 30% 40%

Non-County Case Management*

Adult Day Care

Chore Service

Companion Service

Caregiver Training & Support

Respite Care, In Home

Transitional Services

Prevention/Early Interv (Beh/Cog Health)*

Other service

Customized Living

Top Ten Services Listed as Not Available, 2011-2012

Percent of counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 143
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 11 of 41

Figure 7. Impact of Community Service/Service Development Grants, 2011-2012, 

percent of counties

Cultural Competence 

As Minnesota’s population continues to become more culturally diverse, it is important 

to assess the capacity of the State’s LTSS system to provide services to older adults 

from diverse cultural communities. The 2012 Gaps Analysis survey asked counties how 

prepared they believe their provider network is to work with three different 

communities. 

As summarized in Figure 8 below, only a small percentage of counties believe that their 

providers are “very prepared” to deliver care that is culturally competent to racial and 

ethnic minority communities (15%), new American, immigrant and refugee 

communities (7%) and gay, lesbian, bisexual and transgender (GLBT) communities 

(12%). Most notably, 23% of counties report their provider network is not at all 

prepared to deliver care that is culturally competent to new American, immigrant and 

refugee communities. 

Figure 8: Cultural Competence: how prepared they believe their provider network is to 

work with three different communities 

Very 

prepared

Somewhat

prepared

Not at all 

prepared

Racial/ethnic minority communities 15% 81% 4%

New American / immigrant / refugee communities 7% 70% 23%

Gay, lesbian, bisexual and transgender communities 12% 76% 12%

Other cultural community 5% 18% 7%

Counties were also given an opportunity to provide an explanation of the rating they 

gave for each community. Although some counties reported experiences working with 

many of these communities, many counties reported that they do not have much 

52%

18%

6%

21%

2%

Impact of CS/SD Grants

Don't know/unsure

No impact

very little impact

Some impact

A lot of impact

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 144
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 12 of 41

diversity in their area and therefore have not had a reason to become prepared to work 

with some of these. The counties that have experience working in this area discussed 

their collaborations with other counties, tribal agencies, educational institutions and 

community-based culturally specific providers in order to provide culturally competent 

service to individuals. Some counties have experienced recent demographic shifts in 

their population which has led them to address cultural diversity needs. The most 

common barrier noted by counties, particularly outside of the Metro area, is the lack of 

qualified interpreters and bilingual workforce. 

Counties tended to respond differently in their description of preparedness to work with 

the GLBT community. Older adults that are GLBT continue to be invisible in many 

communities. Although counties tended to be aware of providers with bilingual staff or 

culturally specific providers, no counties reported that they were aware of culturally 

specific providers for this community. Several counties reported a need for more 

training for provider staff to increase their capacity to provide culturally competent 

services. 

Even though many counties do not have much experience with many of these 

communities, most reported optimism that if a need arose they and their providers will 

seek out the assistance and resources they need to meet the needs of individuals. 

These results indicate that additional supports are needed in order to help prepare the 

aging services network to provide culturally competent services to these various 

communities. 

Overall HCBS System Improvements 

Counties were asked to rate their county’s improvement across a number of factors that 

support local HCBS systems with a one-to-five scale, where one equals no improvement

and five equals significant improvement. The average county rating for each area is 

summarized in Figure 9 below. Further detail on the results of this section can be found 

in Table 4 in Appendix A. On average, counties rated themselves at the mid-point or

higher across all items. While two areas averaged a score of 3.3, no areas saw an 

increase since 2009. 

Figure 9: Average rating of HCBS system improvements for 2009 vs. 2012

2009 2012 Change

Allowed for consumer choice/direction via range of options & 

service flexibility. 3.3 3.2 -0.1

Actively promoted CDCS as viable consumer-driven model. 3.4 3.3 -0.1

Supported family/informal caregivers 3.4 3.1 -0.3

Ensured service quality, met program standards & consumer 

expectations 3.6 3.3 -0.3

Strengthened to monitor/ensure consumer health & safety in 

private homes/apts 3.1 2.9 -0.2

Actively developed/recruited 1+ service providers to meet needs 

of seniors 

* 2.9 -

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 145
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 13 of 41

Actively recruited/developed culturally competent providers * 2.4 -

All persons, regardless of income, able to access info to make 

informed choices about LTC 3.4 3.1 -0.3

All persons, regardless of income, able to access in-person 

assistance to make informed choices about LTC 3.3 3.1 -0.2

All persons, regardless of income, able to participate in a LTC

Consult, as needed 3.4 3.1 -0.3

Health/support service systems were culturally competent to 

adequately meet needs of 65+ from diverse cultural backgrounds 2.9 2.6 -0.3

Communication patterns/referral protocols between HC & LTC 

providers allowing for maximized care coordination 3.4 3.1 -0.3

Sufficient local workforce to meet health/LTC industry & market 

needs 2.8 2.4 -0.4

*Not included in 2009 survey 

All counties reporting that no improvement or very little improvement occurred in a 

category listed above were asked to offer details regarding that assessment. The issues 

and barriers to improvement included reduced funding, workforce shortages, provider 

shortages and limited access to culturally competent services. In many cases, the 

counties reported that the current practice in their county was meeting the needs of 

their community and achieving the goal statements, thus no improvement was deemed 

necessary. 

Barriers to HCBS Development 

In the previous Gaps Analysis surveys, counties were asked within an open-ended 

format to discuss any issues or barriers they believe are currently most critical to 

overcome in their county in order to ensure older adults have home and communitybased support options. Due to the uniformity within the responses across the 2007 and 

2009 editions of the Gaps Analysis, a drop-down box was added to the 2012 survey, 

which featured the eight most prominent barriers found in the previous analyses. In 

order to assure that counties were still able to report a barrier if it was not on the list, 

the open-ended option was retained. For the most part, the issues reported are 

consistent with ones that were reported in the 2009 Gaps Analysis survey. In a review 

of the county aging gaps analysis results, health plan representatives noted strong 

agreement with these barriers and added low reimbursement rates, uncompensated 

travel time and training requirements as barriers experienced by providers. 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 146
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 14 of 41

Figure 10: Issues/barriers currently most critical to overcome to ensure home and 

community-based options, percent of counties 

Highest Priority for HCBS Development 2013-2014 

Counties were asked about their highest priority for HCBS development for the next two 

years. Some counties plan to expand their available service network in the areas of 

chore, non-medical transportation; affordable housing with service options and 

Medicare certified home care agencies. However, most counties report that their focus 

is on maintaining their current network and preventing the loss of providers or services. 

These counties also plan to focus on anticipating and navigating any changes from the 

state and health plans in the areas of eligibility, programs and procedures. The 

implementation of the MnCHOICES assessment tool was noted by many counties. 

Housing 

Counties were asked to report on the availability of affordable and accessible housing 

along with resources for providing accessible housing to older adults in their 

70%

64%

58%

54%

43%

42%

40%

29%

24%

18%

12%

0% 20% 40% 60% 80% 100%

Support services not convenient for ruralbased older adult population

Shortage of HWS for individuals with complex

physical/mental health needs

Seniors not wanting to relocate to areas

where services are more accessible

Cost of services

Consistency of options throughout county

Lack of memory care housing

Availability of CL / AL for all incomes

Shortage of smaller housing options for older

adults wanting such settings

Diversity in housing to meet needs of aging

population

Accessibility in design of new constructions

Excessive paperwork / red tape slowing

development of new resources

Most Critical Issues / Barriers Preventing Appropriate 

Supply of Housing Options

Percent of counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 147
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 15 of 41

community. They also reported on any major barriers to ensuring an appropriate supply 

of housing, as well as their local priorities for housing development. 

New Housing Developments 

Counties were asked to report their new developments of housing or housing/service 

arrangements. Half had no new developments. The 44% of counties with at least one 

new development averaged 1.4 new buildings and 39.9 new units. Ramsey County, with 

4 new buildings and 300 new units, rated highest in both categories. 

Figure 11: New housing developments, 2011-2012 

Yes % No %

Don't 

know/

unsure

%

Any new development of 

Housing and/ or Housing/ 

Service Arrangements?

37 44% 42 50% 5 6%

Total Average

Number of NEW Buildings 51 1.4

Number of NEW Units 1477 39.9

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 148
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Resources for Accessible Housing 

Counties rated the availability of a variety of resources which either support or promote 

accessible housing for older adults. Figure 12 below shows the percentage of counties 

reporting each resource type as not available, available but limited, meets demand or 

exceeds demand. Counties reported the greatest capacity in the area of adequate 

reimbursement under the waiver program for needed modifications, with 72% reporting 

this met demand (no counties indicated that either resource area exceeded demand). 

In addition, three of the remaining seven measurements of accessibility were reported 

as meeting demand by at least 60% of the responding counties: local county staff are 

experienced in promoting accessibility modifications (72%); local builders/contractors 

with accessibility remodeling/new construction expertise (68%); and 

builders/contractors willing to take on accessibility modifications (63%). In contrast, 

more than half of counties reported a gap in the area of available resources used to 

track available accessible and affordable units (52% stating that such resource was 

either available but limited or not available), and nearly two-thirds reported the same 

for subsidies for low-income persons who need home modifications (68%). Table 5 in 

Appendix A provides a complete summary of county responses in this area. 

Figure 12: Resources for accessible housing*

*No resources were reported by counties as exceeding demand

7%

2%

13%

1%

28%

32%

37%

21%

23%

55%

37%

24%

68%

63%

72%

74%

33%

62%

48%

0% 20% 40% 60% 80% 100%

Local builders/contractors with accessibility

remodeling/new construction expertise

Builders/contractors willing to take on

accessibility modifications

Local county/tribal staff with experience in

promoting accessibility modifications

Adequate reimbursement under the waiver

program for needed modifications

Subsidies for low-income persons who need

home modifications

Landlords willing to allow accessibility

modifications on their property

Available resources used to track available

accessible and affordable units

Availability of Resources to Modify Current Housing Stock, Percent 

of Counties

not available available but limited meets demand

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 149
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Housing Options 

Counties were also asked to report on general capacity across a number of types of

both subsidized and market rate housing options. Figure 13 below summarizes the 

percentages of counties reporting a gap4

 for each housing type. The largest gaps were 

reported in the area of subsidized housing with services, both rental apartments with

support services only (73%) and with supervision and/or health care services (70%). As 

summarized in Figure 14, some housing types were unavailable in many counties. 

Overall, fewer gaps are reported in the availability of market rate housing, with 2% of 

counties even reporting a surplus of both market rate apartments with no services and 

with supervision / health care services. In a review of county aging gaps analysis 

results, health plans indicated agreement with the assessment by the counties of 

housing capacity and barriers. Tables 6 and 7 in Appendix A provide a complete 

summary of county responses in this area. 

 

4

A gap was determined if the county reported that the housing type was “not available” or “available but limited”.

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 150
2012 County Long-Term Services and Supports Gaps Analysis Survey Page 18 of 41

Figure 13: Percent of counties reporting gaps by housing options, 2011-2012 

Figure 14: Percentage of counties reporting housing type is not available, 2011-2012 

44%

73%

70%

58%

46%

51%

30%

51%

51%

49%

48%

40%

0% 20% 40% 60% 80%

Rental apartments with no services

Rental apartments with support services only

Rental apartments with supervision/health

care services

Adult Family Foster Care

Corporate Adult Foster Care

Other housing options (e.g. Board & Lodging,

Board & Care, Residential Care)

Percent of Counties Reporting Gaps in Housing Options, By Type

Subsidized Market-Rate

0%

30%

26%

20%

14%

24%

0%

20%

25%

23%

25%

20%

0% 20% 40%

Rental apartments with no services

Rental apartments with support services only

Rental apartments with supervision/health

care services

Adult Family Foster Care

Corporate Adult Foster Care

Other housing options (e.g. Board & Lodging,

Board & Care, Residential Care)

Percent of Counties Reporting Housing Type is Not Available

Subsidized Market-Rate

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 151
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Issues and Barriers for appropriate supply of housing options 

In the previous Gaps Analysis surveys, counties were asked to identify the issues or 

barriers that are most critical to overcome in order to ensure an appropriate supply of 

housing options. Due to the uniformity within the responses across the 2007 and 2009 

surveys, a drop-down box was added to the 2012 survey, which featured the eleven 

most prominent barriers found in the previous analyses. The open-ended option was 

retained to assure that counties were still able to report a barrier if it was not on the 

list, however no county indicated such a need. Support services not convenient for 

rural-based older adult population (70%) and Shortage of HWS for individuals with 

complex physical/mental health needs (64%) were the most commonly selected 

barriers. Older adults not wanting to relocate to areas where services are more 

accessible (58%), cost of services (54%) and consistency of options throughout county

(43%) round out the top five. 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 152
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Figure 15. Most critical issues and barriers preventing appropriate supply of housing 

options

70%

64%

58%

54%

43%

42%

40%

29%

24%

18%

12%

0% 20% 40% 60% 80% 100%

Support services not convenient for ruralbased older adult population

Shortage of HWS for individuals with complex

physical/mental health needs

Seniors not wanting to relocate to areas

where services are more accessible

Cost of services

Consistency of options throughout county

Lack of memory care housing

Availability of CL / AL for all incomes

Shortage of smaller housing options for older

adults wanting such settings

Diversity in housing to meet needs of aging

population

Accessibility in design of new constructions

Excessive paperwork / red tape slowing

development of new resources

Most Critical Issues / Barriers Preventing Appropriate 

Supply of Housing Options

Percent of counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 153
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Highest Priority for Housing Development in County for 2013-2014 

Affordable and accessible housing is the most common priority area, both in the 

increased availability of subsidized housing and affordable market rate housing. Many 

counties discussed the need for housing with services that can support people with 

complex physical, mental health and/or chemical health needs. In addition, many 

counties identified a need for a range of housing options to support older adults as their 

needs and situation changes and want to remain in their community. Some counties 

discussed customized living and prioritized maintaining or increasing the supply of 

affordable assisted living that will take Elderly Waiver participants. Some specifically 

mentioned the need for more memory care and behavioral units. 

Demand for Shared or Co-housing Developments 

Counties were asked to offer their comments regarding demand for shared or cohousing arrangements in their jurisdiction. Most counties reported that there has been 

no demand for these types of living arrangements. Some of these counties attribute 

this to a preference among older adults for their own private living space possibly with 

shared space for dining or other purposes. 

Nursing Facility Specialty Beds/Services and Relocation 

The survey also asked about the need for “specialty” nursing facility beds or services to

meet the unique LTSS needs in their service area. Figure 16 below summarizes the 

percentage of counties that reported a gap5

in the availability of three types of nursing 

facility specialty beds or services. The largest gap reported was in the availability of

dementia care specialty beds, where 61% of counties reported a gap. In addition, over 

half (51%) of counties reported a gap in heavy care/complex medical management 

specialty beds or services. Counties were slightly more likely to report a gap in postacute and rehabilitation beds (15%) compared to the 2009 survey, where 7% of 

counties reported a gap in this area. Table 8 in Appendix A provides a summary of

reported capacity regarding nursing facility specialty beds and services. 

Figure 46: Gaps in nursing facility specialty beds and services 

 

5

A gap was determined if the county reported that the nursing facility specialty bed or service was “not available” or “available 

but limited”.

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 154
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Barriers for Nursing Facility Specialty Beds and Services 

In the previous Gaps Analysis surveys, counties were asked to identify the issues or 

barriers that are most critical to overcome in order to ensure an appropriate supply of 

nursing facility specialty beds and services. Due to the uniformity within the responses 

across the 2007 and 2009 surveys, a drop-down box was added to the 2012 survey, 

which features the twelve most prominent barriers found in the previous analyses. The 

open-ended option was retained to assure that counties were still able to report a 

barrier if it was not on the list, however no county indicated such a need. Appropriate 

facility/staffing for clients w/ complex needs (74%) and Reimbursement: MA rate too 

low for most specialty care (60%) were the most commonly selected barriers. Staffing: 

geographical and availability issues (48%), financial viability of the long-term care 

industry (45%), and cost of services (43%) complete the top five. 

Figure 17. Barriers and issues ensuring appropriate supply of nursing home specialty 

beds 

61%

51%

15%

8%

0% 10% 20% 30% 40% 50% 60% 70%

Dementia care

Heavy care, complex medical management

Post-acute/rehabilitation

Other

Percentage of Counties Reporting Gaps on Nursing Facility 

Specialty Beds/Services

Percent of Counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 155
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Nursing Facility Relocation 

Nearly three of every seven (42%) counties reported that there are persons in their 

county who could move to the community if supports were available. More than three 

of every eight counties (38%) indicated they did not know if they had persons who fit 

this description. 

74%

60%

48%

45%

43%

37%

29%

25%

23%

20%

12%

2%

0%

0% 20% 40% 60% 80% 100%

Appropriate facility/staffing for clients w/

complex needs

Reimbursement: MA rate too low for most

specialty care

Staffing: geographical and availability issues

Financial viability of the LTC industry

Cost of services

Cost of specialty equipment

Population base too small to support specialty

beds

Waiting lists for memory care units

Nursing facilities in need of remodeling

Regulatory requirements

Isolation

Shortage of nursing facilities

Other

Issues/Barriers That Must Be Overcome To Ensure Supply of 

Nursing Home Specialty Beds and Services

Percent

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 156
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Figure 18. Are there any persons 65+ who could move to a community setting from a 

nursing home if adequate supports are available? 

Barriers to Relocation to Community 

In the previous Gaps Analysis surveys, counties were asked to identify the issues or 

barriers that are most critical to overcome in order to relocate an individual from a 

nursing facility to the community. Due to the uniformity within the responses across the 

2007 and 2009 surveys, a drop-down box was added to the 2012 survey, which 

featured the ten most prominent barriers found in these previous analyses. In order to 

assure that counties were still able to report a barrier if it was not on the list, the openended option was retained. Over three-fourths (77%) of counties reported that most 

often the consumer or their family chooses to have the consumer remain in a nursing 

facility. The family worries about the older adult’s health and safety. The caregiver 

might be exhausted and unable to continue to provide the necessary level of support. 

Other informal caregivers are not available. Counties report that a lack of assisted living 

prevents some consumers from leaving the nursing home. A handful of counties 

mentioned that it is often difficult to move consumers out of the nursing home because 

they have given up or sold their home and other affordable housing may not be 

available. 

42%

20%

38%

Are there any persons 65+ who could move to a 

community setting from a nursing home if adequate 

supports are available?

Yes

No

Don't know/unsure

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 157
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Figure 19. Top ten issues and barriers to relocation of persons from nursing homes into 

the community

77%

68%

62%

57%

57%

51%

38%

37%

36%

31%

0% 20% 40% 60% 80% 100%

Personal choice

Vulnerable situation

Health status declined

Caregiver exhaustion/issues

Family refused

Financial

Access to transportation

Lack of housing

Services not available

Caregiver temporarily unavailable

Top ten issues/barriers to relocation of persons from nursing 

homes into the community

Percent of Counties

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 158
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Over three-fifths (62%) of counties reported that they have a systematic strategy in

place for relocating persons to the community from nursing facility settings, an increase 

of six percentage points in comparison with the 2009 results, where 55% of responding 

counties reported this strategy was in place. When asked to describe their strategy, 

these counties most often described the role of the Long-Term Care Consultation 

(LTCC) and relocation service coordination in providing assistance to individual 

consumers who are interested in moving back to the community. Many counties also 

discussed their relationships and ongoing communication with nursing facilities and 

hospital discharge planners and with the Area Agencies on Aging through the Return to 

Community initiative. The role of health plans in providing care coordination to nursing 

facility residents has also helped in the facilitation of relocation efforts. 

Figure 20. Systematic strategy to relocate persons to the community 

62% 15%

23%

Is there a systematic strategy for relocating persons 

65+ from nursing homes into the community?

Yes

No

Don't know/unsure

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 159
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Conclusion 

Results from the 2012 Gaps Analysis survey indicate that counties have generally 

maintained their capacity for home and community-based services between 2009 and 

2012. Many counties reported increases in capacity in some services, but more 

decreases in service capacity were reported than in previous surveys. Although many 

counties have not experienced a substantial loss in services, most counties continue to 

report gaps across a number of HCBS services, housing options and nursing facility 

specialty beds and services. Counties also tend to report that their provider networks 

are only somewhat prepared to provide culturally competent services to Minnesota’s 

diverse senior communities. Some counties report plans to increase HCBS or housing 

capacity, but many will be focusing on maintaining their current networks and 

preventing the loss of services and providers. 

Based on the findings from the 2012 Gaps Analysis, a number of recommendations 

should be considered by the state, lead agencies, regional development and planning 

organizations and the broader home and community-based services network. 

Leverage existing models to address gaps in service availability and 

workforce. 

Many of the gaps reported by counties are influenced by limited workforce availability 

and large geographic distances in rural areas of the state. In these areas it is 

challenging for providers to achieve enough economies of scale in service provision to 

sustain services. Strategies to address these barriers could include building on existing 

housing and service provider capacity to add critically needed services and extend the 

geographic reach of services. One example of this is the use of the family foster care 

model where homes also offer out-of-home respite and family adult day care services. 

The consumer directed model can also be used to allow consumers to hire their own 

staff in light of workforce shortages. In addition, existing providers should be 

encouraged to maximize their use of volunteers to deliver services, where appropriate, 

in order to reduce costs and increase reach. 

Housing Development 

Counties reported gaps in the area of housing, particularly subsidized housing with 

services. Development efforts should focus on placing services and service coordination 

in existing subsidized housing and ensuring that any assisted living development offers 

apartment settings, charges affordable rent and has flexible service options. 

Service Development and Planning 

Planning for and developing home and community-based services should be a joint 

venture across many parties, including lead agencies (counties, tribes and health 

plans), Area Agencies on Aging and Eldercare Development Partnerships, along with 

providers and the broader community. Some less formal services, such as companion 

services, do exist in some communities but are not accessible to public pay consumers. 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 160
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Lead agencies should promote and contract for these existing services. Alternative and 

innovative models of service delivery should be explored at the local level that focus on 

the following elements: supporting community living, engaging informal caregivers and 

cost effective and efficient housing and service options. Rural areas are particularly 

impacted by service capacity issues and face unique barriers to supporting community 

life. 

Cultural Competency 

Survey results indicate that the home and community-based services network in many 

communities are not generally prepared to provide culturally competent services to 

diverse communities. In addition to the need for culturally competent care planning on 

behalf of individuals and development of culturally competent services, it is important to 

identify and address any system-wide barriers that exist for developing and accessing 

culturally competent services.

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 161
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Appendix A: Table of Survey Results 

Table 1 (page 1 of 2): County reports of changes in service capacity, percent of counties (n=84) 

less available no change more available

Adult Day Care 10% 64% 21%

Caregiver Training & Support 7% 73% 15%

Chore Service 18% 68% 13%

Companion Service 17% 58% 20%

Customized Living 10% 54% 35%

Fiscal Support Entities (CDCS) 1% 86% 12%

Home Delivered Meals 5% 75% 20%

Home Health Aide 10% 77% 13%

Homemaker Service 14% 73% 13%

Home Modifications and Adaptations 4% 86% 11%

Personal Care Assistance 8% 69% 23%

Respite Care, In Home 8% 88% 2%

Respite Care, Out of Home 5% 83% 10%

Skilled Home Nursing Care 8% 79% 13%

Supplies and Equipment 7% 80% 13%

Transitional Services 0% 81% 12%

Transportation 20% 67% 13%

Other service 1% 2% 2%

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 162
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Table 2 (page 2 of 2): County reports of changes in related service capacity, percent of counties (n=84) 

less available no change more available

Adult Protection 4% 76% 19%

End-of-life, Hospice, Palliative Care 2% 65% 31%

Guardianship/Conservatorship 8% 77% 13%

Health Promotion Activities 6% 50% 43%

Prevention/Early Intervention

(Behavioral/Cognitive Health) 10% 76% 12%

Insurance Counseling/Forms Assistance 4% 71% 23%

LTC Consultation/Community 

Assessment 1% 89% 10%

Relocation Service Coordination 86% 13%

Non-County Information/Ref & 

Assistance 1% 75% 20%

Non-County Case Management 2% 68% 11%

Transportation, non-medical 15% 71% 11%

Medication Management 4% 76% 19%

Technology 1% 63% 33%

Other Related 0% 4% 0%

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 163
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Table 3 (page 1 of 2): County reports of current general service capacity, percent of counties (n=84) 

not available available but 

limited

meets 

demand

exceeds 

demand

Adult Day Care 25% 32% 37% 6%

Caregiver Training & Support 11% 33% 54% 1%

Chore Service 12% 54% 35% 0%

Companion Service 12% 51% 37% 0%

Customized Living 5% 20% 65% 10%

Fiscal Support Entities (CDCS) 0% 12% 85% 4%

Home Delivered Meals 0% 12% 87% 1%

Home Health Aide 0% 10% 83% 5%

Homemaker Service 0% 19% 79% 2%

Home Modifications and 

Adaptations

0% 20% 79% 1%

Personal Care Assistance 0% 24% 70% 6%

Respite Care, In Home 7% 49% 44% 0%

Respite Care, Out of Home 4% 46% 50% 0%

Skilled Home Nursing Care 0% 10% 88% 1%

Supplies and Equipment 0% 10% 90% 0%

Transitional Services 7% 15% 76% 1%

Transportation 0% 58% 42% 0%

Other service 6% 0% 0% 0%

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 164
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Table 4 (page 2 of 2): County reports of current related service capacity, percent of counties (n=84) 

not available available but 

limited

meets 

demand

exceeds 

demand

Adult Protection 0% 13% 87% 0%

End-of-life, Hospice, Palliative 

Care 0% 4% 95% 1%

Guardianship/Conservatorship 0% 37% 63% 0%

Health Promotion Activities 0% 31% 63% 6%

Prevention/Early Intervention

(Behavioral/Cognitive Health) 7% 38% 55% 0%

Insurance Counseling/Forms 

Assistance 1% 25% 71% 1%

LTC Consultation/Community 

Assessment 0% 2% 96% 1%

Relocation Service Coordination 2% 5% 92% 1%

Non-County Information/Referral

and Assistance 5% 8% 86% 1%

Non-County Case Management 30% 15% 52% 1%

Transportation, non-medical 2% 58% 37% 0%

Medication Management 2% 27% 69% 0%

Technology 2% 10% 88% 0%

Other Related 1% 0% 1% 0%

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Table 3: Overall HCBS system improvements, percent of counties (n=84) 

Average 1 2 3 4 5

Allowed for consumer choice/direction via range of 

options & service flexibility. 3.3 6% 4% 50% 23% 14%

Actively promoted CDCS as viable consumer-driven 

model. 3.3 6% 4% 52% 23% 13%

Supported family/informal caregivers 3.1 5% 7% 50% 23% 11%

Ensured service quality, met program standards & 

consumer expectations 3.3 5% 4% 50% 27% 11%

Strengthened to monitor/ensure consumer health & 

safety in private homes/apts 2.9 4% 4% 54% 19% 8%

Actively developed/recruited 1+ service providers to 

meet needs of seniors 2.9 5% 8% 51% 15% 11%

Actively recruited/developed culturally competent 

providers 

2.4 23% 8% 46% 12% 2%

All persons, regardless of income, able to access info to 

make informed choices about LTC 3.1 8% 6% 40% 24% 15%

All persons, regardless of income, able to access inperson assistance to make informed choices about LTC 3.1 10% 5% 43% 21% 15%

All persons, regardless of income, able to participate in 

a LTC Consult, as needed 3.1 10% 6% 40% 19% 18%

Health/support service systems were culturally 

competent to adequately meet needs of 65+ from 

diverse cultural backgrounds 

2.6 14% 6% 52% 14% 5%

Communication patterns/referral protocols between 

HC & LTC providers allowing for maximized care 

coordination 

3.1 7% 4% 37% 31% 13%

Sufficient local workforce to meet health/LTC industry 

& market needs 2.4 14% 21% 39% 14% 2%

*Level of improvement county’s HCBS system has achieved around the following statements (1= No improvement, 2=Very little 

improvement, 3=Some improvement, 4=Medium amount of improvement, and 5= Significant improvement) 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 166
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Table 5: Resources for accessible housing, percent of counties (n=84)

not

available

available 

but limited

meets 

demand

exceeds 

demand

Local builders/contractors with 

accessibility remodeling/new 

construction expertise

0% 32% 68% 0%

Builders/contractors willing to take on 

accessibility modifications 0% 37% 63% 0%

Local county/tribal staff with 

experience in promoting accessibility 

modifications 

7% 21% 72% 0%

Adequate reimbursement under the 

waiver program for needed 

modifications 

2% 23% 74% 0%

Subsidies for low-income persons who 

need home modifications 13% 55% 33% 0%

Landlords willing to allow accessibility 

modifications on their property 1% 37% 62% 0%

Available resources used to track 

available accessible and affordable 

units

28% 24% 48% 0%

Other 1% 0% 1% 0%

Table 6: Capacity of subsidized housing options, percent of counties (n=83)

not

available

available 

but limited

meets 

demand

exceeds 

demand

Subsidized rental apartments with no 

services 0% 44% 49% 4%

Subsidized rental apartments with 

support services only 30% 43% 24% 0%

Subsidized rental apartments with 

supervision/health care services 26% 44% 25% 0%

Subsidized Adult Family Foster Care 20% 38% 38% 0%

Corporate Adult Foster Care 14% 32% 48% 1%

Other subsidized housing options (e.g. 

Board & Lodging, Board & Care, 

Residential Care) 

24% 27% 42% 1%

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Table 7: Capacity of market rate housing options, percent of counties (n=84)

not

available

available 

but limited

meets 

demand

exceeds 

demand

Market rate rental apartments with no 

services 0% 30% 64% 2%

Market rate rental apartments with 

support services only 20% 31% 45% 0%

Market rate rental apartments with 

supervision/health care services 25% 26% 43% 2%

Market rate Adult Family Foster Care 23% 26% 46% 0%

Market rate Corporate Adult Foster 

Care

25% 23% 45% 1%

Other market rate housing options (e.g. 

Board & Lodging, Board & Care, 

Residential Care) 

20% 20% 50% 1%

Table 8: Capacity of long-term care nursing facility specialty beds and 

services, percent of counties (n=84)

not

available

available 

but limited

meets 

demand

exceeds 

demand

Post-acute/rehabilitation 0% 15% 81% 4%

Dementia care 6% 55% 37% 2%

Heavy care, complex medical 

management 7% 44% 45% 2%

Other 1% 7% 1% 0%

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 168
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Appendix B: Description of Limitations for Top 10 Service Gaps 

1. Chore service- Counties most often reported that the reimbursement for this type 

of service is too low for providers to have an incentive for developing this service. 

Counties particularly face gaps in providing this service in remote areas and for specific 

types of chores, such as shoveling, that may have an irregular and infrequent demand. 

Other barriers reported include a lack of funding for private pay consumers and 

provider difficulty with state or health plan billing systems for reimbursement under the 

Elderly Waiver. Some counties report that this need is somewhat met through volunteer 

programs and Sentence to Serve programs or through limited services contracting on 

an individual basis with private market vendors. 

2. Companion service- The most common barrier reported to the availability of this 

service is limited volunteer capacity. Many counties reported that the requirement to 

work at least 15 hours a week for the stipend volunteer programs is a disincentive for 

potential volunteers. In addition, many counties reported that the reimbursement rate 

is too low to attract providers to begin offering this service. A few counties also noted 

barriers including the lack of service coverage for rural areas and for evening and 

weekend care along with the concurrent need for hands-on care which is not allowed 

under the companion service definition. 

3. Transportation, non-medical- Counties report that reimbursement rates, and in 

particular the elimination of reimbursement of non-load miles, has had an impact on the 

availability of transportation in their area. Transportation programs that utilize 

volunteers have been particularly impacted because fewer volunteers are willing to 

provide this service given the changes in mileage reimbursement. When volunteer 

programs do exist they prioritize providing medical transportation over transportation 

for non-medical needs. Access in rural areas, for out of county travel and evening and 

weekend travel continue to be barriers across the state. In addition, many counties rely 

on the capacity of the local public transportation system and often reported limitations 

with the availability and accessibility of these systems. Older adults who are not eligible 

for public assistance face additional barriers to access affordable transportation. (See 

also Transportation, medical) 

4. Respite care, in-home- Counties that reported gaps in this area often discussed 

that providers were not available or available on a limited basis. In-home respite care is 

most often available for short-term assistance (under 8 hours), but not for extended 

periods or for overnight and weekend care. Some counties noted that the 

reimbursement rate for this service prevents some providers from being willing to 

develop this service. Counties also report that it is hard to recruit providers to meet a 

need that often is irregular, one-time and on an as-needed basis. A few counties noted 

that there has not been enough demand from consumers in order to sustain the 

service. It is also difficult to find trained providers to work with consumers with high 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 169
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needs or behavioral issues. Counties report using home health agencies to provide this 

service while others are using volunteer programs. 

5. Transportation, medical- Counties face similar barriers to the availability of 

medical transportation as reported for non-medical transportation (see above). In 

general, counties report more resources are available for medical transportation. Many 

counties reported prioritizing the use of volunteer drivers for medical transportation. 

6. Adult day care- Counties most often reported that they do not have adult day care 

providers in their county or in only one part of their county. Many counties also noted a 

lack of interest by consumers in this service. Some counties have had providers attempt 

to develop this service only to have the program later close due to lack of interest. 

Some counties noted that it is not financially viable to develop or sustain an adult day 

care service in their county. Reasons include low numbers or dispersed consumers, lack 

of transportation and reimbursement rates. 

7. Respite care, out-of-home- Counties use a variety of settings for out-of-home 

respite care, including assisted living, adult foster care, nursing homes and in some 

cases hospitals. Some counties reported limited providers in general, while others 

indicated that there are providers available for this service but bed availability is often 

limited. Housing providers are not able to keep beds vacant for potential respite care if 

they have consumers who can use them full-time. Some counties also noted that the 

reimbursement rate for this service is not high enough and some providers are not 

willing to become enrolled to provide this service. Some counties noted that their 

providers may have conditions set on length of time, either that the service is limited to 

a certain number of hours or they want an extended stay. In some cases the consumer 

demand is too low to sustain the development of this service. It can also be hard to find 

appropriate settings for consumers with high needs or behavioral issues. 

8. Prevention / early intervention (behavioral / cognitive health)- Counties 

most often reported a lack of providers in their county and a lack of mental health 

professionals, especially those trained in geriatrics. Counties also reported that, as a 

result of limited funding, the priority goes to treatment services versus prevention or 

early intervention services. Some counties reported a lack of demand or interest by 

consumers to access these services even when available. 

9. Non-county case management- Many counties seemed to be basing their rating 

solely on the use of non-county case management for public pay clients. Some reported 

limited availability of case management for the private market, but face limitations such 

as the cost of the service and provider willingness to travel to remote areas. Some 

counties indicated there is no consumer demand for this service. Some counties 

reported they were not sure whether providers offering this service existed in their area 

and others reported that providers for this service do not exist. 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 170
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10. Caregiver training and support- Many counties report having no or limited 

providers in this area. The most common barriers reported for the availability of 

caregiver training and support is the low number of caregivers who participate. It was 

noted that caregivers face barriers including lack of awareness of the service, distance 

needed to travel to attend trainings or support groups, and not having a relief person to 

step in for them so that they can attending the training. 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 171
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Appendix C: Changes in Aging Services Capacity 2003-2012 

Results of the 2012 AASD Gaps Analysis Survey were compared to the results of the 

three previous Gaps Analysis survey years. As summarized in Table C1 on the next 

page, transportation (both non-medical and medical), chore service, companion 

service, respite services (both in-home and out-of-home), adult day care and 

caregiver training & support continue to be top aging service gap areas across the 

years. 

Although the categories of service have remained fairly consistent across the years, the

proportion of counties reporting gaps in these areas has grown over the years. For 

example, the percentage of counties reporting a gap in the area of chore service has 

increased from 28% in 2003 to 65% in 2012.

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 172
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Table C1: Top gaps in service capacity, 2003-2012 

Type of service Rank % of counties

2003 (72 counties)

Transportation 1 42%

Chore service 2 28%

In-home respite/ caregiver supports* 3 22%

Adult day service 4 (tie) 21%

Home delivered meals 4 (tie) 21%

2005 (76 counties)

Transportation 1 55%

Evening and weekend care** 2 50%

Chore service 3 (tie) 47%

Adult day service 3 (tie) 47%

In-home respite/ caregiver supports* 5 42%

2007 (79 counties)

Transportation 1 (tie) 63%

Companion service 1 (tie) 63%

Chore service 3 62%

Respite care, in-home 4 51%

Respite care, out-of-home 5 47%

Caregiver/ family support training 6 46%

Adult day care 7 44%

2009 (87 counties)

Non-medical transportation*** 1 66%

Chore service 2 (tie) 60%

Companion service 2 (tie) 60%

Respite care, out-of-home 4 58%

Medical transportation *** 5 56%

Respite care, in-home 6 55%

Adult day care 7 51%

Caregiver training & support 8 44%

2012 (82 counties/county agencies)

Chore Service 1 65%

Companion Service 2 63%

Transportation, non-medical* 3 61%

Transportation (medical) 4 58%

Adult Day Care 5 57%

Respite Care, In Home 6 56%

Respite Care, Out of Home 7 50%

Prevention/Early Interv (Beh/Cog Health)* 8 45%

*Surveys conducted 2001-2005 included “In-home respite/caregiver supports” as a service category. This 

service area was expanded into 3 categories in 2007: caregiver/family support training and in-home 

respite services with out-of-home respite services added as a new service category. 

** Evening and weekend care was not included as a service item on the 2007 and 2009 surveys. 

*** In 2009 transportation was separated into medical and non-medical transportation 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 173
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Acknowledgements

The Aging and Adult Services Division (AASD) of the Minnesota Department of Human 

Services would like to thank the county staff who contributed to the completion of their 

county’s 2012 Gaps Analysis survey submission. We would also like to thank the 

Eldercare Development Partnership (EDP) coordinators for their assistance in providing 

consultation and input into the 2012 LTSS Gaps Analysis survey instrument and 

process. The EDP coordinators also assisted in communicating with counties about the 

survey which increased county engagement and resulted in a 100% response rate on 

the 2012 survey. 

Minnesota 2012 County Long-Term Services and Supports Gaps Analysis Survey 174
Ohio: Compilation of AAA Service Needs and Gaps 

AAA

Transport.

Personal

Care

Homemaker

H D Meals

I & R

Caregiver

Supports

Housing

Adult Day 

CDSMP

Other

1 x x x x x

2 x x x x x

3 x x x x x

4 x x x x x

5 x x x x x

6 x x x x

7 x x x x x

8 x x x x x

9 x x x x x

10A x x x x

10B x x x

11 x x x

total 8 6 4 6 6 6 5 2 3 8

Ohio Compilation of AAA Service Needs and Gaps 175