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In Singapore, policy makers expect families to remain actively involved in the care of their frail older relatives, as manifestly expressed in its Many Helping Hands approach to long-term care. To enable families to fulfill this expectation, the government has enacted policies that encourage the hiring of foreign domestic workers (FDWs) to complement or supplement informal caregiving efforts. Using the Andersen Behavioral Model, we were interested in identifying caregiver and care receiver characteristics that might predict the hiring of FDWs. With data from a convenience sample of 488 informal caregivers, we ran logistic regression regressing the hiring of an FDW on various predisposing, enabling, and need factors. Of interest, enabling factors such as household income, housing type, and educational level were predictive of hiring an FDW in the home. Only one need factor, time spent in caregiving, was predictive of the increased likelihood to hire an FDW. Policies that encourage the marketization of care are likely to favor those with financial means and inadvertently ignore the caregiving burdens of lower income families. In addition, we suggest research and policies to ensure the well-being and protection of FDWs who have become a key component of the long-term care policy and practice in Singapore. [ABSTRACT FROM AUTHOR]

This study describes what types of service use barriers older adults' informal care-givers perceive and examines how these barriers differentiate care-giver service use patterns. Analysing the 2004 National Long-Term Care Survey and Informal Care-giver Data Set (N=1908) in the United States of America, this study reports the prevalence of service barriers for each type of service as well as for overall service use. Service barriers are measured in terms of availability, awareness, affordability, staff quality, privacy violation, complex bureaucracy, language barriers, qualification of each programme and no thought of service. Andersen's health behaviour model guides determinants related to care-giver service use patterns. As a main outcome, care-giver service use patterns (light service users, selective in-home users, and multiple service users) are examined in relation to service use barriers when other predisposing, enabling and need variables are controlled. Of the ten service use barriers defined in this study, awareness and no thought of service are the most prevalent barriers. Care-givers reporting service barriers of availability, awareness and affordability are more likely to be light service users compared to multiple service users and selective in-home service users. These findings highlight the significance of enhancing awareness of care-giver supportive services as well as increasing availability and financial support for service use. [ABSTRACT FROM PUBLISHER]

Purpose: The article seeks to identify patterns of service utilization among informal caregivers of frail older adults. In particular, the study examined determinants that explain heterogeneous variations in caregivers’ service use patterns. Methods: Using a latent class analysis (LCA) on the 2004 National Long-Term Care Survey and Informal Caregiver data (n = 1,908), this study classifies overall patterns of caregiver service utilization: financial information, support group, respite service, day care or senior center, personal or nursing care, housework, meal delivery, transportation, house modification, and assistive devices. With an emphasis on caregivers’ service use patterns and social network derived from the Network Episode Model, the modified Andersen model guides determinants of these patterns. Results: The LCA classified a hierarchical structure of service use patterns: multiple service users, selective in-home service users, and light service users. Caregivers’ network compositions signified heterogeneity in service use patterns. Care recipient- and caregiver-related needs contributed to distinguishing service use patterns. Implications: Differentiation of services may be important for meeting caregivers’ needs and distributing program resources by identifying target populations for intervention. This typology process may tailor specific interventions to better support caregivers. [ABSTRACT FROM PUBLISHER]