Autonomy and acceptance of nontraditional long-term care services among the older people in Taiwan

Purpose: Customer-driven service is the latest trend in providing long-term care. This study is to explore the relationship of four kinds of autonomy and the acceptance of nontraditional institutional long-term care (day care, respite care, assisted living, unit care, and group home) for the older people in Taiwan. Methods: Data was collected from 167 people aged 50 years or older in the community elder college by self-written questionnaire with the assistance of the interviewees. The independent variables were health autonomy, informational autonomy, living autonomy (flexible schedule and privacy) and financial autonomy (disposable income, subjective sufficiency, willingness to buy long-term care/medical insurance, saving for the future). Other controlling variables included demographics and family support. Logistic regression was applied for analysis. Results: The acceptance of five kinds of long-term care ranged from 75.9% to 84.9%. Financial autonomy (subjective financial sufficiency and willingness to buy long-term care insurance or medical insurance) and information autonomy were significantly related to acceptance of all the five kinds of long-term care. Other financial autonomy variables and younger age were also related to long-term care acceptance, and higher requirement of privacy and flexible schedule were related to nontraditional institutional services. Conclusion: Financial autonomy and informational autonomy were the most important factors when considering the use of nontraditional long-term care. In addition, living autonomy was emphasized in the acceptance of institutional service. Implications for long-term care policy and management will be discussed.