| The oldest-old (85+) are the fastest growing age group in Canada and the largest group of formal long term care service users, yet little is known about the patterns of formal long term care use among this group, or the changes that lead to the utilization of these services over time. Using data from the Aging in Manitoba Longitudinal Study (AIM), the current work describes patterns of formal long term care use among those AIM participants who were born in 1911 or earlier and who had complete interview data from the 1983, 1990 and 1996 study waves (N = 616). The work describes changes in health and functioning and the physical environment that are associated with these patterns and their endpoints. The Evans and Stoddard (1994) population health framework guided the secondary analysis, and the fifteen in-depth, qualitative interviews that were completed with randomly selected members of the larger sample.;Findings indicated eleven patterns of formal long term care service use. Thirty-eight percent of the sample did not use any formal long term care at any of the three cross-sectional periods under consideration. Patterns and endpoints varied by sex, by region of residence, and by the direction and extent to which changes in health and functioning occurred over the thirteen year period. Changes in the physical environment were not associated with particular patterns of formal long term care service use. The qualitative data enhanced the quantitative findings, and identified gaps in the available secondary data.;The primary messages emanating from this work are that: (1) the majority of the oldest-old are able to continue to live in their own homes without the assistance of formal long term care, (2) different factors lead to the use of home care than lead to the use of nursing home care, (3) the Evans and Stoddard (1994) population health framework provides a useful organizational tool for this type of research, and (4) qualitative and quantitative data together provide a richer understanding of the factors that lead to the use of formal long term care among people who survive past the age of 85. |
