Personal contributions to the cost of nursing home care
Subtitle: policy differences and their impact on community-dwelling spouses.
Published: 2005
Language: eng
Number of pages: 409
Description: The purpose of this research is to explore the impact of Canadian policy regarding personal contributions to nursing home care costs on the financial situations and quality of life of community-dwelling spouses of nursing home residents. In this study, I use three provincial case studies to represent the three policy types: Alberta (per diem-based policy), Manitoba (income-based policy) and Nova Scotia (income- and asset-based policy). Each case study includes (a) semistructured, qualitative interviews with 16 to 19 spousal caregivers; (b) interviews with four to six key informants who are knowledgeable in the area of nursing home placement and related financial matters; and (c) a documents review. I base the research on two propositions, framed in life course theory: (a) that the type of policy in place in a particular region can socially and economically impact on community-dwelling spouses; and (b) that the financial situation and quality of life reported by community-dwelling spouses are also shaped by their experiences of caregiving and marriage transitions. Results show that provinces in which policies are more demanding of personal financial resources have three financially-related quality of life outcomes for community-dwelling spouses: more reductions in discretionary spending, more future-related financial concerns, and more concerns about fairness. These effects are strongest in Nova Scotia. Community-dwelling spouses in all three provinces also identify other quality of life issues, related to household management and activity choices. These issues are closely linked to the transition experiences of the participants, and are only affected in a minor way by financial situations arising from the cost of nursing home care. In a cross-case analysis, I show that several moderating characteristics affect the way that policies and transitions are experienced by participants. The moderating characteristics are grounded in the life course of the participants, arising either from their personal history, or from their historical/spatial context. I conclude the study with recommendations relating to payment policies and the transition experiences of community-dwelling spouses.
Notes: Source: Dissertation Abstracts International, Volume: 66-10, Section: A, page: 3764.

Thesis (Ph.D.)--University of Toronto, 2005.

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