There is a large and growing population of individuals with serious illness living in the community who are poor, homebound, and heavily reliant on caregiver support. Individuals of middle-income who do not qualify for Medicaid and lack the financial cushion of those with greater wealth may be especially vulnerable to becoming homebound. Using data from the National Health and Aging Trends Study, a nationally representative sample of Medicare beneficiaries, we prospectively examine the association between homebound status, caregiving and income. Among community-dwelling non-homebound individuals, those in the highest income brackets are least likely to become homebound or to be in nursing homes over 2 years of follow-up. This work demonstrates the role of economic factors on residence and quality of life and suggests that we need to expand policy initiatives to better serve those income groups most vulnerable to the costs related to living in the community with serious illness.
展开▼
