Abstract:

To ensure care for future cohorts of disabled elderly, policy planners have proposed that volunteers provide unpaid home care, including establishing a system of service credit banking (SCB), under which persons who volunteer services would accrue care credits that they could use to obtain similar service when they become disabled. Four questions are addressed: (1) Is there a substantial group of elderly who lack primary group affiliations, placing them at risk? (2) Is there significant need for services among the disabled? (3) Is the level of elderly volunteering sufficient to meet such a need? (4) Do volunteers originate from groups likely to subsequently have unmet needs? Analysis of data from the 1984 National Health Interview Survey, Supplement on Aging (N = 13,807 with a follow-up subset of 5,151 Rs aged 70+ at baseline) reveals that most elderly are embedded in a network of primary groups: only 2% of Rs aged 65+ reported engaging in none of 7 types of social interaction in the preceding 2 weeks; 94% reported that somebody would be available to care for them for a few days if necessary. Volunteering is shown to be strongly associated with higher socioeconomic status, whereas greater disability & lack of help are associated with lower socioeconomic status. Those most needing assistance (the socially isolated) are least likely to have earned caregiver credits. Thus, an organized volunteer system would achieve success only among a fraction of the isolated elderly.