Physical and Cognitive Impairment: Do They Require Different Kinds of Help?

Physical impairments are commonly believed to require relatively more active hands-on assistance with the activities of daily living (ADLs) while cognitive impairments use relatively more supervisory or standby assistance. Using data from the 1984 National Long-Term Care Survey, this paper examines whether the type of assistance (active, standby, assistive device, and combinations thereof) varies by cognitive status. It differs from prior studies by focusing on how assistance patterns might vary for specific ADLs. Generally, the cognitively impaired use standby help twice as frequently as the cognitively intact regardless of ADL. They also use active help and assistive devices more frequently but the disparity with the cognitively intact is not so great. Additionally, there are exceptions for particular ADL (e.g., the rate of use of assistive devices in bathing is high among the cognitively intact). There appears to be a relationship between cognitive status and type of ADL help received, but it is subtle and varies by ADL. [21 PDF pages]