HOME HEALTH CARE SERVICES QUARTERLY最新文献

Home health care is a growing treatment option for older adults who wish to remain in their homes and communities. However, the growing number of older adults with severe obesity presents a challenge for home health professionals. This study utilizes survey data from 128 home health care agencies in Arkansas and Pennsylvania to explore home health care agencies' decision-making in admitting patients with severe obesity. The responding agencies indicated that concerns about adequate staffing levels were the primary barriers to entry for severe obesity patients. Existing research on the intersection of obesity and home health care is sparse, and this study adds an organizational perspective to the scant literature on the topic. Additional research on this topic is advised to accommodate the expected growth in home health care utilization and rising obesity rates among older adults.

Peer to peer (P2P) support has been suggested as one community program that may promote aging in place. We sought to understand challenges older adults have maintaining their independence and to identify how P2P support facilitates independence. We completed 17 semi-structured interviews with older adults receiving P2P support in 3 cities in the United States. Study team members coded data using deductive and inductive conventional content analysis. Participants identified declining abilities, difficulties with mobility, and increasing cost of living as challenges to independence. P2P support facilitated independence and provided them with a new friend. The qualitative findings indicate that maintaining independence as an older adult in the United States has many challenges. P2P programs have an important role in helping older adults stay in their home by supporting mobility and promoting social engagement.

The present study investigated factors that influenced home care physiotherapy (HCP) services and profile of the practitioners in Nigeria. It also investigated if the service was registered with the Regulatory Agency. Three hundred and thirty conveniently sampled physiotherapists in Nigeria participated in the cross-sectional survey. A newly developed, nine-part, content-validated questionnaire was used to obtain information about the demographics, sources of referral, case types, frequency of treatment, costing, benefits, and challenges of the HCP, job satisfaction, and registration status. Data were analyzed using descriptive statistics. All the respondents (100%) were involved in HCP irrespective of their professional profile. The mean duration of practice experience was 9.09 ± 7.34 years. Stroke (41.8%) was the most prevalent case treated. Poor working environment (M = 4.16, R = 1-5), transportation cost (M = 4.16, R = 1-5) and intrusion by impostors (M = 3.66, R = 1-5), were some of the factors that had impact on the HCP services. A preponderance of HCP services was not registered with the Regulatory Agency in Nigeria.

Measuring the impact of care delivered at home for frail older people is a complex task given many confounding variables that may impact on the ability of service providers to identify the direct impact of their programs on their clients' well-being and quality of life. The recent publication of the 2018 Wellness and Reablement Report Outcomes indicated that organizations lack formal processes to measure the impact of their programs on service users. There are therefore limited data exits on measuring outcomes and the performance of the ACCOM tool in the real world. Knowledge of a strong causal relationship between services provided and outcomes enables confidence in assuming the care provided was largely responsible for the outcome achieved. This paper will reflect on the experiences of one service provider in Brisbane, in implementing the Australian Community Care Outcomes Measurement (ACCOM) tool to measure and demonstrate the impact of their programs.

The present study aimed to determine the effect of education based on the BASNEF model on the physical activity and improvement of motor activity in patients with stroke. This randomized control trial study was conducted on 40 patients with acute ischemic stroke admitted to a teaching hospital in Isfahan, Iran from August 2017 to September 2018. The patients were randomly divided into intervention and control groups. The intervention included personal education and a manual CD of physical activity for the intervention group. After education, the mean scores of the BASNEF model's constructs in the intervention group were significantly higher than those of the control group (P < .001). Furthermore, the motor ability of the intervention group in upper and lower extremities was significantly higher than that of the control group (p < .001). Interventions based on educational models can increase the motivation of patients with stroke in performing recommended physical activity.

Home care workers' (HCWs) approaches to home care users' acute symptoms are critical for users' safety and quality of life. However, the processes of these approaches are unclear. This study investigates how HCWs assess users' conditions. Focus group discussions and semi-structured interviews with HCWs were conducted in a rural Japanese city. HCWs' decisions were affected by interactions and previous relationships with care managers, home care nurses, physicians, and users' families. Rural HCWs act flexibly, changing the professionals and families they consult with. Understanding HCWs' behaviors and improving relationships among medical/care professionals and families can improve management of users' acute conditions.

Eldercare is often regarded as "dirty work" due to its association with dysfunctional, decaying, and diseased bodies. This paper focuses on eldercare work, and studies how current practices and organization of eldercare have been justified and legitimized in different and sometimes conflicting ways. Drawing on ethnographic fieldwork with workers in nursing homes for the elderly and homecare service, this paper examines eldercare work through the theoretical lens of "orders of worth." The concept of orders of worth affords a moral political analysis of eldercare work that helps to explain those dilemmas and situations which eldercare workers encounter and negotiate. Through the analysis, the moral entanglements between individual practices, institutional logics, and the political economy of care labor are systematically revealed.

Social workers are well positioned to address mental health complications impacting home care populations, yet social work has one of the lowest utilization rates of offered home care supports in Ontario. This study analyzed care plan data of frontline in-home social work services. Results identified adjustment to illness as the most common category and that seniors required significantly fewer visits and days on service than non-seniors. Most patients were able to accomplish their social work-based goals. Results highlight a need for further research and for capitalizing on the untapped potential value of social work home care services for patients.

We used 2010-16 Medicare Cost Reports for 10,737 freestanding home health agencies (HHAs) to examine the impact of home health (HH) and nursing home (NH) certificate-of-need (CON) laws on HHA caseload, total and per-patient variable costs. After adjusting for other HHA characteristics, total costs were higher in states with only HH CON laws ($2,975,698), only NH CON laws ($1,768,097), and both types of laws ($3,511,277), compared with no CON laws ($1,538,536). Higher costs were driven by caseloads, as CON reduced per-patient costs. Additional research is needed to distinguish whether this is due to skimping on quality vs. economies of scale.

Home care is essential for the continuity of care, but rural communities struggle to procure these services regularly. As rural populations age, these difficulties may be exacerbated. This study examines the challenges and solutions for offering home care in rural areas. Healthcare professionals held focus groups and one-on-one interviews in rural communities, and these interviews were recorded and analyzed using thematic analysis. Changing rural contexts, stakeholder relationships, and sustainable communities were the primary themes. Increasing knowledge, sharing information, and dialogue among stakeholders were also crucial. Collaboration between professions may also create more sustainable home care in rural communities.