Current practices of family caregiver training during home health care: A qualitative study

2021 ◽  
Author(s):  
Julia G. Burgdorf ◽  
Alicia I. Arbaje ◽  
Jo‐Ana Chase ◽  
Jennifer L. Wolff
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Home Health Care ◽  
Family Caregiver ◽  
Home Health ◽  
Caregiver Training ◽  
Current Practices

scholarly journals Impact of Family Caregiver Training on Hospitalization During Medicare Home Health Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 252-253
Author(s):  
Julia Burgdorf ◽  
Jennifer Wolff
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Acute Care ◽  
Home Health Care ◽  
Family Caregiver ◽  
Unmet Need ◽  
Home Health ◽  
Care Utilization ◽  
Caregiver Training ◽  
Acute Care Utilization

Abstract Medicare home health providers are required to offer family caregiver training; however, there is little information regarding the impact of family caregiver training on patient outcomes in home health or other care delivery settings. A better understanding of this relationship is necessary to guide development of caregiver training interventions and inform policy discussions surrounding family caregiver training access. This research assesses whether and how unmet need for family caregiver training is associated with acute care utilization during Medicare home health. We examine 1,217 (weighted n=5,870,905) fee-for-service Medicare beneficiaries who participated in the National Health and Aging Trends Study (NHATS) and received Medicare-funded home health care between 2011-2016. We link NHATS data with home health patient assessments and Medicare claims, drawing measures of family caregivers’ need for training from home health clinician reports and determining provision of training from Medicare claims. Using weighted, multivariable logistic regressions, we model the marginal change in probability of acute care utilization during home health as a function of family caregivers’ unmet need for training. We found that older adults whose family caregivers had an unmet need for training had a probability of acute care utilization during home health that was 18 percentage points (p=0.001) greater than those whose family caregivers both needed and received training, holding all covariates at their means. Findings support the importance of connecting family caregivers to training resources and suggest one avenue by which investing in caregiver training may be cost-effective for integrated payers and providers.

scholarly journals Family Caregiver Training During Medicare Home Health Care: Clinician Perspectives

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 535-535
Author(s):  
Julia Burgdorf ◽  
Alicia Arbaje
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Home Health Care ◽  
Family Caregiver ◽  
Home Health ◽  
Assessment Tools ◽  
Caregiver Training ◽  
Cyclic Process ◽  
Care Providers

Abstract During Medicare home health care, providers often rely on family caregivers to help meet patients’ care needs. Beginning in 2018, CMS requires home health agencies to provide training to family caregivers. This qualitative study is the first research to examine current patterns of family caregiver training, and related facilitators and barriers, during Medicare-funded home health care. We conducted semi-structured key informant interviews with home health nurses and physical therapists (n=19) from 4 diverse agencies, then performed thematic analysis of interview transcripts using a hybrid inductive and deductive coding approach. Clinicians described family caregiver education as a dynamic and cyclical process: simultaneously providing patient care, training family caregivers, and gathering additional information about patient needs and caregiver capabilities, then adjusting the care plan accordingly. We present a model of this cyclic process and describe its four major stages: Initial Assessment, Education, Reassessment, and Adjustment. Additionally, clinicians identified a range of structural, individual, and interpersonal factors which impact their ability to successfully train family caregivers. We define each factor and, using illustrative quotes from our interviews, elucidate its role as a facilitator and/or barrier to clinicians’ educational efforts. Findings provide the first model of caregiver training during home health care and highlight policy and practice changes to better support clinicians in these efforts; including greater visit flexibility, access to more experienced clinical mentors, and standardized caregiver assessment tools designed for this unique care setting.

scholarly journals Effect of Family Caregiver Need for Training on Medicare Home Health Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 149-150
Author(s):  
Julia Burgdorf ◽  
Elizabeth Stuart ◽  
Jennifer Wolff
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Home Health Care ◽  
Family Caregiver ◽  
Medication Management ◽  
Self Care ◽  
Home Health ◽  
Caregiver Training ◽  
Health Providers ◽  
Training Interventions

Abstract Medicare home health providers are required to offer family caregiver training; however, there is little information regarding the impact of family caregiver training on home health care intensity. A better understanding of this relationship is necessary to inform development and prioritization of caregiver training interventions in this setting. This research assesses whether and how family caregiver need for training affects care intensity during Medicare home health. We examine 1,217 (weighted n=5,870,905) fee-for-service Medicare beneficiaries who participated in the National Health and Aging Trends Study (NHATS) between 2011-2015 and received Medicare-funded home health care within one year of survey. Using propensity score adjusted, multivariable logistic and negative binomial regression, we model the relationship between family caregiver need for activity-specific training and the number/type of visits received during Medicare home health. We found that older adults whose family caregiver required training on self-care tasks had greater odds of receiving any therapy visits (aOR: 1.70; 95% CI: 1.01, 2.86), aide visits (aOR: 2.12; 95% CI: 1.11, 4.05), or training visits (aOR: 1.49; 95% CI:1.01, 2.21). Older adults whose family caregiver required training on medication management had greater odds of receiving any nursing visits (aOR: 3.03; 95% CI: 1.06, 8.68) and incurred 1.06 (95% CI: 0.11, 2.01) additional nursing visits. Findings support the importance of connecting family caregivers to training resources. Additionally, findings suggest that home health providers should consider prioritizing training interventions which focus on caregiving activities most closely tied to resource utilization: self-care and medication management.

scholarly journals Practices used by a home care team: implications for caregivers

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Yara Cardoso Silva ◽  
Kênia Lara Silva ◽  
Isabela Silva Câncio Velloso
Keyword(s):  
Health Care ◽  
Discourse Analysis ◽  
Qualitative Study ◽  
Home Care ◽  
Home Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Home Health ◽  
Care Team ◽  
Power Relationship

ABSTRACT Objectives: to analyze the practices of a home care team and their implications for caregivers’ performance. Methods: qualitative study with data obtained from observation of 21 users, 30 caregivers and 6 professionals from the home health care service in a municipality in Minas Gerais, from February to June 2018. The material was analyzed from the perspective of discourse analysis according to Michel Foucault. Results: team interference upon caregivers is exercised by disciplinary practices and prescriptive, authoritative and surveilling behaviors. The team’s knowledge-power relationship determines caregivers’ acceptance through convincing or through difficulty of understanding assigned orientations. Educational practices would enable caregivers to be constituted as active, participative, empowered and reflective subjects. Final Considerations: team practices interfere with caregivers’ ways of acting and being and they have implications in objectification and subjectification processes.

There???s No Place Like Home: A Qualitative Study of the Working Conditions of Home Health Care Providers

2007 ◽  
Vol 49 (3) ◽  
pp. 327-337 ◽  
Author(s):  
Pia Markkanen ◽  
Margaret Quinn ◽  
Catherine Galligan ◽  
Stephanie Chalupka ◽  
Letitia Davis ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Working Conditions ◽  
Home Health Care ◽  
Home Health ◽  
Care Providers

Older Adult Factors Associated With Identified Need for Family Caregiver Assistance During Home Health Care

2019 ◽  
Vol 32 (2) ◽  
pp. 67-75 ◽  
Author(s):  
Julia Burgdorf ◽  
Alicia Arbaje ◽  
Jennifer L. Wolff
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Activities Of Daily Living ◽  
Family Caregivers ◽  
Older Adult ◽  
Home Health Care ◽  
Family Caregiver ◽  
Daily Living ◽  
Home Health ◽  
Clinical Severity

Family caregivers make important contributions to home health care for older adults, but knowledge of the specific roles they assume is lacking. We analyzed data from 1,758 community-dwelling Medicare beneficiaries aged 65+ receiving Medicare-funded home health care between 2011 and 2016, using linked National Health and Aging Trends Study and Outcomes and Assessment Information Set data. Most (86.7%) beneficiaries receiving home health care had an identified need for family caregiver assistance, and nearly 6 in 10 (57.9%) had identified need for caregiver assistance with five or more tasks. After examining significant associations between older adult characteristics and identified needs for caregiver assistance with specific tasks, we identified three profiles of older adults who demonstrate similar patterns of identified need for family caregiver assistance during home health. These profiles include: (1) older adults with greater functional impairment who more often had identified need for assistance with Instrumental Activities of Daily Living, advocacy, or Activities of Daily Living; (2) older adults with cognitive impairment who more often had identified need for assistance with medication administration or supervision; and (3) older adults with greater clinical severity who more often had identified need for assistance with medical procedures and equipment. Findings support calls to develop training interventions and strengthen the partnership between home health providers and family caregivers. These three profiles present a potential framework for the development of family caregiver training programs.

Exploring Barriers to the Development of Home Health Care in Iran: A Qualitative Study

2021 ◽  
pp. 108482232110385
Author(s):  
Toktam Kianian ◽  
Mojgan Lotfi ◽  
Vahid Zamanzadeh ◽  
Ahad Rezayan ◽  
Maryam Hazrati ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Home Health Care ◽  
Group Discussion ◽  
Home Health ◽  
Political Issues ◽  
Key Stakeholders ◽  
Main Components ◽  
Study Participants

Changes in society’s needs have increased individuals’ desire to be independent and receive health care at home. Home health care (HHC) is one of the main components of realizing these ambitions. However, there is a serious concern about the state of development of the HHC industry in Iran and the quality of its services. This study aims to explore the barriers to the development of HHC in Iran. This qualitative study with a conventional content analysis approach was conducted in Tabriz, Iran, from October 2019 to March 2020. Twenty-one key stakeholders including nurses, home health directors, physicians, policy-makers, patients, and their families participated in the study. Participants were selected using purposive sampling. Data were collected using a focus group discussion (FGD) and 18 semi-structured in-depth interviews and analyzed using Graneheim and Lundman’s techniques. Data collection continued until saturation was reached. Three main themes emerged from the analysis: quality management challenges, insufficient infrastructure and policy, and political issues. The findings show that applying standard strategies to monitor the quality of services, paying attention to infrastructure, and having a clear framework for policy-making are beneficial for the development of the HHC industry. Health managers can monitor and upgrade the quality of HHC services by defining standards and assessment indicators, as well as providing comprehensive data. It is suggested that legislators consider the principles of community-based accountability, justice, and accessibility their top priority. Moreover, policymakers need to develop a roadmap to reform policies to create the conditions for the development of this industry.

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