Holding on: Older Californians with disabilities rely on public services to remain independent

Low-income older adults with disabilities in California depend on a variety of public programs to help them remain in their own homes. Last year's state budget reduced the amount of support provided by these programs, and the proposed 2011–12 budget reduces them further. This paper reports on preliminary findings from a qualitative study that is following a group of California seniors who depend on fragile arrangements of paid and unpaid help to maintain their independence. Data were collected concerning 33 older adults (age 65 and over) who are consumers of public programs that provide long-term in-home care services and supports in four large California counties. These in-depth, face-to-face interviews were usually with the older adult and his or her paid caregiver (who could be related, or not), as well as with an unpaid family member when possible. Data were independently coded by at least two researchers. The results of thematic analyses indicate that the disability needs of these older adults are often unstable, with both their physical and mental health status sometimes changing day to day. Most of these older adults with disabilities have nowhere else to turn for assistance if their public services are cut. Many are in poor physical and/or psychological condition and are just barely managing to live safely in their homes. At the same time, all of them share the common goal of remaining in their homes and maintaining their independence. Public services serve as a crucial link in the support networks of these individuals.