Pub Date : 2023-04-27DOI: 10.1177/10848223231170599
Gro Næss, T. Wyller, E. Gjevjon
Early identification and follow-up of sub-acute and acute functional decline in older persons living with multimorbidity at home require integrated and proactive care by interdisciplinary health personnel. Yet, in the context of the task-oriented and fragmented home healthcare services, early identification is challenging. Therefore, the aim of this study was to identify preconditions for the success of a proactive and interdisciplinary follow-up of older recipients of home healthcare. We conducted a qualitative secondary analysis of data from 6 focus group interviews with registered nurses and nurse leaders. In addition, we performed and analyzed data from 2 new focus group interviews with general practitioners and RNs who had a role as super users in a developmental project which introduced a clinical instrument for early identification of sub-acute and acute functional decline (sub-acute functional decline in the elderly—SAFE). Their experiences with using SAFE constituted the backdrop for the study. In total, 41 representatives of the interprofessional primary care staff of 3 city districts participated. Having a common goal, sharing tasks and having reciprocal understanding of each health profession’s contribution, systems and tools and clinical leadership were all seen as important factors for succeeding in the proactive and interdisciplinary follow-up of older recipients of home healthcare. Clinical leadership was deemed the strongest precondition, and clear leadership which promotes integrative and proactive care by facilitating interdisciplinary collaboration appears to be the main key for success.
{"title":"Clinical Leadership – An Important Precondition for the Success of Proactive and Interdisciplinary Follow-up of Frail Older Recipients of Home Healthcare","authors":"Gro Næss, T. Wyller, E. Gjevjon","doi":"10.1177/10848223231170599","DOIUrl":"https://doi.org/10.1177/10848223231170599","url":null,"abstract":"Early identification and follow-up of sub-acute and acute functional decline in older persons living with multimorbidity at home require integrated and proactive care by interdisciplinary health personnel. Yet, in the context of the task-oriented and fragmented home healthcare services, early identification is challenging. Therefore, the aim of this study was to identify preconditions for the success of a proactive and interdisciplinary follow-up of older recipients of home healthcare. We conducted a qualitative secondary analysis of data from 6 focus group interviews with registered nurses and nurse leaders. In addition, we performed and analyzed data from 2 new focus group interviews with general practitioners and RNs who had a role as super users in a developmental project which introduced a clinical instrument for early identification of sub-acute and acute functional decline (sub-acute functional decline in the elderly—SAFE). Their experiences with using SAFE constituted the backdrop for the study. In total, 41 representatives of the interprofessional primary care staff of 3 city districts participated. Having a common goal, sharing tasks and having reciprocal understanding of each health profession’s contribution, systems and tools and clinical leadership were all seen as important factors for succeeding in the proactive and interdisciplinary follow-up of older recipients of home healthcare. Clinical leadership was deemed the strongest precondition, and clear leadership which promotes integrative and proactive care by facilitating interdisciplinary collaboration appears to be the main key for success.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"18 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80538343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-25DOI: 10.1177/10848223231169038
W. Cabin
There is significant literature about the Medicare Outcome and Information Assessment (OASIS). A new OASIS Version E, effective January 2023, makes significant changes in assessing patient mental health. However, a literature review indicates no studies of the anticipated effectiveness of the OASIS-E on improving psychosocial care of Medicare home health beneficiaries. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 36 home care social workers from 5 different home health agencies in the New York City metropolitan area between August 1, 2022, and November 30, 2022. Four themes emerged from the study, namely that social workers believe the OASIS-E revisions: are an improvement over prior OASIS versions; are cumbersome and do not require administration by a social worker; do not impose specific guidance requirements on using new measures scoring results in making care decisions; and do not address coverage of specific interventions that address patients with significant mental health issues. Policymakers are urged to modify the OASIS-E guidance manual to require use of new mental health assessment scores in care planning and to expand coverage of evidence-based treatment interventions for patients with significant assessed mental health conditions.
{"title":"“They Are Measures Without Impact”: Home Care Social Workers Criticize OASIS-E","authors":"W. Cabin","doi":"10.1177/10848223231169038","DOIUrl":"https://doi.org/10.1177/10848223231169038","url":null,"abstract":"There is significant literature about the Medicare Outcome and Information Assessment (OASIS). A new OASIS Version E, effective January 2023, makes significant changes in assessing patient mental health. However, a literature review indicates no studies of the anticipated effectiveness of the OASIS-E on improving psychosocial care of Medicare home health beneficiaries. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 36 home care social workers from 5 different home health agencies in the New York City metropolitan area between August 1, 2022, and November 30, 2022. Four themes emerged from the study, namely that social workers believe the OASIS-E revisions: are an improvement over prior OASIS versions; are cumbersome and do not require administration by a social worker; do not impose specific guidance requirements on using new measures scoring results in making care decisions; and do not address coverage of specific interventions that address patients with significant mental health issues. Policymakers are urged to modify the OASIS-E guidance manual to require use of new mental health assessment scores in care planning and to expand coverage of evidence-based treatment interventions for patients with significant assessed mental health conditions.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"s3-43 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90833144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-21DOI: 10.1177/10848223231169504
H. Marani, Allie Peckham
As utilization of home care increases across Canada, questions are emerging concerning the extent to which home care expenses, many of which are not publicly covered, are borne by unpaid caregivers of home care recipients. In this systematic review, we review English-language literature published between 2001 and 2022 exploring the magnitude and sources of home care costs incurred by unpaid caregivers in Canada. Of particular interest were empirical, cost-of-illness studies that describe the implications of these costs across domains of financial risk, including caregivers’ income level, employment status, and personal health. Following the screening of 492 studies derived across 6 databases (OVID Medline, CINAHL, PsycINFO, AMED, EconLit, and EMBASE), 24 studies were included in this review. Overall, few studies describe how home care expenses incurred by unpaid caregivers contribute to their financial risk. While some studies characterize the direct costs of caregiving incurred by caregivers, including out-of-pocket expenditure on transportation to medical appointments, respite care, home renovations, supplemental housekeeping, and prescription medications, limited studies attempt to estimate the magnitude of these expenses. Concerning financial risk, the literature is chiefly concerned with indirect costs of caregiving, including consequences on caregivers’ employment (foregone wages). Findings from this literature review suggest further work is needed in Canadian context to document costs associated with unpaid home care provision.
{"title":"Unpaid Caregiver Costs in Canada: A Systematic Review","authors":"H. Marani, Allie Peckham","doi":"10.1177/10848223231169504","DOIUrl":"https://doi.org/10.1177/10848223231169504","url":null,"abstract":"As utilization of home care increases across Canada, questions are emerging concerning the extent to which home care expenses, many of which are not publicly covered, are borne by unpaid caregivers of home care recipients. In this systematic review, we review English-language literature published between 2001 and 2022 exploring the magnitude and sources of home care costs incurred by unpaid caregivers in Canada. Of particular interest were empirical, cost-of-illness studies that describe the implications of these costs across domains of financial risk, including caregivers’ income level, employment status, and personal health. Following the screening of 492 studies derived across 6 databases (OVID Medline, CINAHL, PsycINFO, AMED, EconLit, and EMBASE), 24 studies were included in this review. Overall, few studies describe how home care expenses incurred by unpaid caregivers contribute to their financial risk. While some studies characterize the direct costs of caregiving incurred by caregivers, including out-of-pocket expenditure on transportation to medical appointments, respite care, home renovations, supplemental housekeeping, and prescription medications, limited studies attempt to estimate the magnitude of these expenses. Concerning financial risk, the literature is chiefly concerned with indirect costs of caregiving, including consequences on caregivers’ employment (foregone wages). Findings from this literature review suggest further work is needed in Canadian context to document costs associated with unpaid home care provision.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78508184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-17DOI: 10.1177/10848223231167878
C. Foster, L. Morales, Andrea J. Fawcett, Cara Coleman
Despite the rising prevalence of children with medical complexity who need extensive medical care at home, the literature evaluating pediatric home healthcare has not been well summarized. Our objective was to systematically review the evidence-base of pediatric home healthcare to understand what is currently know about access and quality of home healthcare for children. Pubmed, Ovid Medline, Embase, CINAHL, Cochrane Library, Proquest Dissertations and Theses Global were searched for studies in the United States, United Kingdom, Canada, and Australia English publications (1980-2020) regarding children (≤18 years) using shift-based home healthcare services. Blinded independent review was conducted followed by extraction of study characteristics including how each study examined access and/or quality, which was categorized using the National Academy of Medicine quality dimensions. Of 9533 abstracts, 101 were included. Most were US (82%) and regional (72%) studies. Half (54%) focused on home nursing followed by home services generally (43%). The majority (77%) evaluated access and patient-family centeredness (62%); their results identified consistent limitations in access and quality resulting in negative impacts on patients and families. Less than 20% of publications addressed safety, effectiveness or equity. Bias scoring found that quantitative studies were universally weak, but qualitative studies were mostly moderate or strong. Results are limited by design heterogeneity and exclusion of training research. While research in pediatric home healthcare has increased, studies remain observational and rarely evaluate quality in reproducible ways. More rigorous measures and interventional research are needed to improve this healthcare sector for children.
{"title":"Access and Quality of Pediatric Home Healthcare: A Systematic Review","authors":"C. Foster, L. Morales, Andrea J. Fawcett, Cara Coleman","doi":"10.1177/10848223231167878","DOIUrl":"https://doi.org/10.1177/10848223231167878","url":null,"abstract":"Despite the rising prevalence of children with medical complexity who need extensive medical care at home, the literature evaluating pediatric home healthcare has not been well summarized. Our objective was to systematically review the evidence-base of pediatric home healthcare to understand what is currently know about access and quality of home healthcare for children. Pubmed, Ovid Medline, Embase, CINAHL, Cochrane Library, Proquest Dissertations and Theses Global were searched for studies in the United States, United Kingdom, Canada, and Australia English publications (1980-2020) regarding children (≤18 years) using shift-based home healthcare services. Blinded independent review was conducted followed by extraction of study characteristics including how each study examined access and/or quality, which was categorized using the National Academy of Medicine quality dimensions. Of 9533 abstracts, 101 were included. Most were US (82%) and regional (72%) studies. Half (54%) focused on home nursing followed by home services generally (43%). The majority (77%) evaluated access and patient-family centeredness (62%); their results identified consistent limitations in access and quality resulting in negative impacts on patients and families. Less than 20% of publications addressed safety, effectiveness or equity. Bias scoring found that quantitative studies were universally weak, but qualitative studies were mostly moderate or strong. Results are limited by design heterogeneity and exclusion of training research. While research in pediatric home healthcare has increased, studies remain observational and rarely evaluate quality in reproducible ways. More rigorous measures and interventional research are needed to improve this healthcare sector for children.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"8 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88718908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-07DOI: 10.1177/10848223231166372
Brigitte Belanger, Olivia Weeks, Ashli Suiters, Paul Arthur
An emerging crisis of care exists in the United States in the treatment of aging adults with neurocognitive disorders (NCD). Families face great obstacles locating resources and finding appropriate caregiving options for their needs. Occupational therapy practitioners are well suited to assist both persons with NCD and their care partners through training and support services to promote safety and independence and maximize participation in activities of daily living. Occupational therapy practitioners increasingly employ Animal Assisted Therapy (AAT) programs with tailored activities to foster problem-solving skills to enhance performance and behavior, improving quality of life. This feasibility study employed mixed-methodology to establish a proof of concept by offering a series of six 90-minute AAT group intervention sessions with persons with NCD and care partners at an Alzheimer’s Resource Center in Florida. While quantitative results were not significant, many promising qualitative themes emerged to direct future inquiry in AAT interventions with this population.
{"title":"The Role of Animal-Assisted Therapy (AAT) in Neurocognitive Disorder Group Interventions: Benefits for Participants and Care Partners","authors":"Brigitte Belanger, Olivia Weeks, Ashli Suiters, Paul Arthur","doi":"10.1177/10848223231166372","DOIUrl":"https://doi.org/10.1177/10848223231166372","url":null,"abstract":"An emerging crisis of care exists in the United States in the treatment of aging adults with neurocognitive disorders (NCD). Families face great obstacles locating resources and finding appropriate caregiving options for their needs. Occupational therapy practitioners are well suited to assist both persons with NCD and their care partners through training and support services to promote safety and independence and maximize participation in activities of daily living. Occupational therapy practitioners increasingly employ Animal Assisted Therapy (AAT) programs with tailored activities to foster problem-solving skills to enhance performance and behavior, improving quality of life. This feasibility study employed mixed-methodology to establish a proof of concept by offering a series of six 90-minute AAT group intervention sessions with persons with NCD and care partners at an Alzheimer’s Resource Center in Florida. While quantitative results were not significant, many promising qualitative themes emerged to direct future inquiry in AAT interventions with this population.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"35 1","pages":"222 - 230"},"PeriodicalIF":1.1,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42242815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-07DOI: 10.1177/10848223231165754
R. Saglam Aksut, Busra Yavuz, Mehmet Aksut, Deniz Gunay, M. Kırali
Heart transplantation is the most important treatment option in end-stage heart failure, and heart transplant recipients should be monitored at home by healthcare professionals in terms of symptoms and self-care requisites. The aim of this study is to examine symptoms and self-care requisites of patients with heart transplantation after discharge. Symptoms and self-care requisites of 81 patients who had heart transplantation between 2015 and 2020 were evaluated retrospectively in this study. Survey data were collected using the telephone interview method. It was determined that 77.8% of the patients were male and their mean age was 41.87 ± 2.51 years. Fatigue (91.4%), pain in the back, neck, and joints (86.4%), restlessness/agitation (81.5%), weight gain (71.6%), and edema in the lower extremities (71.6%) were the first 5 common symptoms experienced at home after heart transplantation. It was also found that the vast majority of patients (80.2%) answered negatively to the question of eliminating the lack of knowledge about the disease, and some of the patients were found not to pay attention to some important issues (e.g., regular blood pressure check, quitting smoking, etc.). Findings revealed that patients with heart transplantation experience a series of symptoms, and their self-care requisites were mostly focused on education and information specific to the disease after discharge. As a part of public health nursing practices, home care concentrating on symptoms and learning needs of patients should be planned and organized with a multidisciplinary approach to decrease rehospitalization and contribute to cost-effectiveness after heart transplantation.
{"title":"Symptoms Experienced at Home and Self-Care Requisites of Patients After Heart Transplantation: A Retrospective Study","authors":"R. Saglam Aksut, Busra Yavuz, Mehmet Aksut, Deniz Gunay, M. Kırali","doi":"10.1177/10848223231165754","DOIUrl":"https://doi.org/10.1177/10848223231165754","url":null,"abstract":"Heart transplantation is the most important treatment option in end-stage heart failure, and heart transplant recipients should be monitored at home by healthcare professionals in terms of symptoms and self-care requisites. The aim of this study is to examine symptoms and self-care requisites of patients with heart transplantation after discharge. Symptoms and self-care requisites of 81 patients who had heart transplantation between 2015 and 2020 were evaluated retrospectively in this study. Survey data were collected using the telephone interview method. It was determined that 77.8% of the patients were male and their mean age was 41.87 ± 2.51 years. Fatigue (91.4%), pain in the back, neck, and joints (86.4%), restlessness/agitation (81.5%), weight gain (71.6%), and edema in the lower extremities (71.6%) were the first 5 common symptoms experienced at home after heart transplantation. It was also found that the vast majority of patients (80.2%) answered negatively to the question of eliminating the lack of knowledge about the disease, and some of the patients were found not to pay attention to some important issues (e.g., regular blood pressure check, quitting smoking, etc.). Findings revealed that patients with heart transplantation experience a series of symptoms, and their self-care requisites were mostly focused on education and information specific to the disease after discharge. As a part of public health nursing practices, home care concentrating on symptoms and learning needs of patients should be planned and organized with a multidisciplinary approach to decrease rehospitalization and contribute to cost-effectiveness after heart transplantation.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"2 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83790388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-07DOI: 10.1177/10848223231166114
Zihan Zhang, Chieko Kato, Otsuka Yoshiomi
As global aging increases, the issue of long-term care is becoming increasingly important. This study examined the factors influencing the preferences of older Japanese people for long-term care. Three hundred Japanese people over 65 years old were recruited to participate in this online survey on preferences for long-term care. Structural Equation Modeling (SEM) was conducted to demonstrate the effects of various variables. The results showed that support from the community, family savings, awareness of family caregiving, psychological indebtedness, and self-efficacy directly affected the preferences for long-term care. Gender, age, social participation, cohabitation, and health status self-assessment indirectly affected the preferences. This study demonstrated the influence of relevant factors, especially psychological factors, on the long-term care preferences of older Japanese people.
{"title":"Factors Influencing the Preferences of Older Japanese People for Long-term Care","authors":"Zihan Zhang, Chieko Kato, Otsuka Yoshiomi","doi":"10.1177/10848223231166114","DOIUrl":"https://doi.org/10.1177/10848223231166114","url":null,"abstract":"As global aging increases, the issue of long-term care is becoming increasingly important. This study examined the factors influencing the preferences of older Japanese people for long-term care. Three hundred Japanese people over 65 years old were recruited to participate in this online survey on preferences for long-term care. Structural Equation Modeling (SEM) was conducted to demonstrate the effects of various variables. The results showed that support from the community, family savings, awareness of family caregiving, psychological indebtedness, and self-efficacy directly affected the preferences for long-term care. Gender, age, social participation, cohabitation, and health status self-assessment indirectly affected the preferences. This study demonstrated the influence of relevant factors, especially psychological factors, on the long-term care preferences of older Japanese people.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"7 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81266253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-07DOI: 10.1177/10848223231165274
W. Cabin
There is significant literature on the existence and adverse effects of social isolation and depression among the elderly, exacerbated by the recent COVID-19 pandemic. A literature review indicates no studies of how the Medicare home health benefit addresses social isolation and depression, including no studies of home care social workers’ perceptions of the nature and consequences of Medicare coverage. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 44 home care social workers from 5 different home health agencies in the New York City metropolitan area between November 1, 2021 and May 31, 2022. Six themes emerged from the study. Social workers believe: (1) extensive social isolation and depression exist among Medicare home health beneficiaries; (2) Medicare home health policy provides no systematic measure to detect or monitor social isolation and a limited measure for depression among the homebound elderly; (3) Medicare home health policy provides no coverage to treat either depression or social isolation; (4) effective interventions are available to prevent and treat depression and social isolation. Social workers also believe that: (5) the lack of social isolation and depression coverage results in additional mental and physical health conditions; (6) lack of social isolation and depression coverage exacerbates existing mental and physical health conditions. Policymakers are urged to modify the Medicare home health benefit to improve detection and monitoring of social isolation and depression as well as coverage of appropriate evidence-based preventative and treatment interventions.
{"title":"They Live in an Isolation Chamber: Medicare Fails the Depressed Homebound Elderly","authors":"W. Cabin","doi":"10.1177/10848223231165274","DOIUrl":"https://doi.org/10.1177/10848223231165274","url":null,"abstract":"There is significant literature on the existence and adverse effects of social isolation and depression among the elderly, exacerbated by the recent COVID-19 pandemic. A literature review indicates no studies of how the Medicare home health benefit addresses social isolation and depression, including no studies of home care social workers’ perceptions of the nature and consequences of Medicare coverage. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 44 home care social workers from 5 different home health agencies in the New York City metropolitan area between November 1, 2021 and May 31, 2022. Six themes emerged from the study. Social workers believe: (1) extensive social isolation and depression exist among Medicare home health beneficiaries; (2) Medicare home health policy provides no systematic measure to detect or monitor social isolation and a limited measure for depression among the homebound elderly; (3) Medicare home health policy provides no coverage to treat either depression or social isolation; (4) effective interventions are available to prevent and treat depression and social isolation. Social workers also believe that: (5) the lack of social isolation and depression coverage results in additional mental and physical health conditions; (6) lack of social isolation and depression coverage exacerbates existing mental and physical health conditions. Policymakers are urged to modify the Medicare home health benefit to improve detection and monitoring of social isolation and depression as well as coverage of appropriate evidence-based preventative and treatment interventions.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"52 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77754542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-28DOI: 10.1177/10848223231162861
Junrong Shi, C. Scott
Problem behaviors among persons with Alzheimer’s Disease (AD) have a significant impact on caregivers. However, caregivers’ subjective reaction to the problem behaviors better predicts the caregiving outcomes than the objective frequency of problem behaviors. With a sample recruited from community agencies serving Alzheimer’s Disease (AD) caregivers (n = 108), this study examined the effect of various factors on the caregivers ’reaction to different types of problem behaviors, including demographics, caregivers’ knowledge about the AD, and resilience level, controlling for the frequency of problem behaviors and other caregiving context factors. Caregivers’ reaction to problem behaviors was measured by the Revised Memory and Behavior Problem Checklist. Findings indicated that African American caregivers had a lower level of reactions to disruptive ( B = −3.956; p < .01) and depressive behaviors ( B = −2.443; p < .05) than white caregivers, but not for memory-loss problems. Age, being spousal caregivers, and knowledge of AD only affected reactions to memory-loss problems but not for other types of behaviors. No effects were observed for personal resilience. Intervention should be tailored to the varied needs of family caregivers to deal with problem behaviors among people with AD to delay institutionalization. More training/resources at the skill level over the information-only caregiver intervention should be promoted.
{"title":"Examination of Factors Associated With Informal Caregivers’ Reactions to Different Problem Behaviors Among Persons With Alzheimer’s Disease","authors":"Junrong Shi, C. Scott","doi":"10.1177/10848223231162861","DOIUrl":"https://doi.org/10.1177/10848223231162861","url":null,"abstract":"Problem behaviors among persons with Alzheimer’s Disease (AD) have a significant impact on caregivers. However, caregivers’ subjective reaction to the problem behaviors better predicts the caregiving outcomes than the objective frequency of problem behaviors. With a sample recruited from community agencies serving Alzheimer’s Disease (AD) caregivers (n = 108), this study examined the effect of various factors on the caregivers ’reaction to different types of problem behaviors, including demographics, caregivers’ knowledge about the AD, and resilience level, controlling for the frequency of problem behaviors and other caregiving context factors. Caregivers’ reaction to problem behaviors was measured by the Revised Memory and Behavior Problem Checklist. Findings indicated that African American caregivers had a lower level of reactions to disruptive ( B = −3.956; p < .01) and depressive behaviors ( B = −2.443; p < .05) than white caregivers, but not for memory-loss problems. Age, being spousal caregivers, and knowledge of AD only affected reactions to memory-loss problems but not for other types of behaviors. No effects were observed for personal resilience. Intervention should be tailored to the varied needs of family caregivers to deal with problem behaviors among people with AD to delay institutionalization. More training/resources at the skill level over the information-only caregiver intervention should be promoted.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"7 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74646459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-22DOI: 10.1177/10848223231160273
A. Shehadeh, S. Hunter, S. Jeong
To develop and validate a scale, the Self-management of Dementia by Carers (SMDC). Mixed-methods were used. First, the domains of the SMDC Scale were identified through a systematic literature review and interviews with expert professionals and carers. Then the following psychometrics were performed: content and face validity, internal consistency, test-retest reliability, and construct validity. The final scale had 58-item grouped into 6 factors. The internal consistency and test-retest reliability coefficients were excellent. This scale can be used to determine carers’ ability to assist the person living with dementia to self-manage this condition in clinical practice and research.
{"title":"Development and Validation of the Self-management of Dementia by Family Carers (SMDFC) Scale","authors":"A. Shehadeh, S. Hunter, S. Jeong","doi":"10.1177/10848223231160273","DOIUrl":"https://doi.org/10.1177/10848223231160273","url":null,"abstract":"To develop and validate a scale, the Self-management of Dementia by Carers (SMDC). Mixed-methods were used. First, the domains of the SMDC Scale were identified through a systematic literature review and interviews with expert professionals and carers. Then the following psychometrics were performed: content and face validity, internal consistency, test-retest reliability, and construct validity. The final scale had 58-item grouped into 6 factors. The internal consistency and test-retest reliability coefficients were excellent. This scale can be used to determine carers’ ability to assist the person living with dementia to self-manage this condition in clinical practice and research.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82381540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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