scholarly journals Dementia Home Care Resources: How Are We Managing?

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Catherine Ward-Griffin ◽  
Jodi Hall ◽  
Ryan DeForge ◽  
Oona St-Amant ◽  
Carol McWilliam ◽  
...  
Keyword(s):  
Home Care ◽  
Aging In Place ◽  
Home Care Services ◽  
Case Managers ◽  
Dementia Care ◽  
Ethnographic Study ◽  
Formal Care ◽  
Care Needs ◽  
Equal Distribution ◽  
Care Services

With the number of people living with dementia expected to more than double within the next 25 years, the demand for dementia home care services will increase. In this critical ethnographic study, we drew upon interview and participant data with persons with dementia, family caregivers, in-home providers, and case managers in nine dementia care networks to examine the management of dementia home care resources. Three interrelated, dialectical themes were identified: (1)finite formal care-inexhaustible familial care,(2)accessible resources rhetoric-Iinaccessible resources reality,and (3)diminishing care resources-increasing care needs. The development of policies and practices that provideavailable, accessible, andappropriateresources, ensuringequitable, not necessarily equal, distribution of dementia care resources is required if we are to meet the goal of aging in place now and in the future.

scholarly journals Unmet care needs are common among community-dwelling older people with memory problems in Finland

2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Community Dwelling ◽  
Care Needs ◽  
Care Services ◽  
Memory Problems ◽  
More Care ◽  
Community Dwelling Older People ◽  
With Memory

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

Case Manager Work and Workload: Uncovering a Wicked Problem—A Secondary Analysis Using Interpretive Description

2018 ◽  
Vol 31 (2) ◽  
pp. 83-91
Author(s):  
K. D. Fraser ◽  
L. Garland Baird ◽  
S. Labonte ◽  
H. O’Rourke ◽  
N. S. Punjani
Keyword(s):  
Home Care ◽  
Secondary Analysis ◽  
Case Manager ◽  
Home Care Services ◽  
Case Managers ◽  
Wicked Problem ◽  
Interpretive Description ◽  
Care Services ◽  
Workload Measurement ◽  
Measurement Tools

Canada’s population is aging, and by 2027, it is expected that 22 million people will be older than 65 years. Home care services were used by 2.2 million individuals, or 8% of Canadians 15 years of age and older in 2012. Home care programs are continually expanding to meet the needs of the growing number of clients, and goals include keeping people in their homes for as long as possible, delaying the need for institutional care, and maintaining quality of life. Case managers are the gatekeepers to home care in Canada. They collaborate with families to plan care, coordinate home care services and community supports, as well as monitor client progress and evaluate outcomes. The aim of our study was to conduct a qualitative secondary analysis to understand the factors that influence case manager work and workload in home care. We completed a secondary analysis of four data sets from four primary studies of related concepts that occurred between 2006 and 2013. Our study design was inductively driven using the tenets of interpretive description. Case managers’ work and workloads are messy and affected by interrelated complex structures of home care programs within health care systems. The concept of a wicked problem, which describes a problem that is complex and intractable, is a useful construct we use to gain some clarity around the work and workload problems that case managers face. Case managers aim to make a positive difference in their client’s lives, but are constantly dealing with change, and can experience feelings of being their client’s last resort with the resulting pressure ultimately impacting their workload. In addition, case managers reported health system failures, including a lack of capacity and structural integration within home care programs that increase their work and workload. Case manager work and workload requires further research including the development and refinement of accurate workload measurement tools that consider the multiple aspects of professional responsibilities and case management activities. Workload and workload measurement tools are needed to account for the unplanned and unpredictable nature of case management work and assist with the distribution of more equitable caseloads among case managers and home care teams.

scholarly journals Organizational flow chart of home care for children with special health care needs

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Vanessa Rossetto ◽  
Beatriz Rosana Gonçalves de Oliveira Toso ◽  
Rosa Maria Rodrigues
Keyword(s):  
Health Care ◽  
Home Care ◽  
Home Care Services ◽  
Special Health Care Needs ◽  
Flow Chart ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Care Services ◽  
Special Health

ABSTRACT Objective: To develop a workflow protocol for Home Care (HC) services in the HC2 modality for children with special health care needs (CSHCN) in the state of Parana. Method: Quantitative, descriptive, exploratory, multiple case studies. Data was collected with professionals from the eight home care services in Parana. Data were analyzed using the Strengths, Weaknesses, Opportunities and Threats (SWOT) methodology, from which a 5W2H method of action plan was developed, resulting in a flow chart. Results: Considering the strategies found in Home Care services, such as planned hospital discharge, caregiver training, organized transportation and singular therapeutic project, a flow organization protocol for children with special health care needs in Home Care services was developed. Conclusion: The protocol developed makes it possible to organize the care provided to children with special health care needs in home care.

Evaluation of aging in place model with home care services and registered nurse care coordination in senior housing

2011 ◽  
Vol 59 (1) ◽  
pp. 37-46 ◽  
Author(s):  
Marilyn J. Rantz ◽  
Lorraine Phillips ◽  
Myra Aud ◽  
Lori Popejoy ◽  
Karen Dorman Marek ◽  
...  
Keyword(s):  
Home Care ◽  
Care Coordination ◽  
Registered Nurse ◽  
Aging In Place ◽  
Home Care Services ◽  
Senior Housing ◽  
Nurse Care ◽  
Care Services

Exit, voice and indifference – older people as consumers of Swedish home care services

2015 ◽  
Vol 36 (10) ◽  
pp. 2163-2181 ◽  
Author(s):  
JOHAN VAMSTAD
Keyword(s):  
Home Care ◽  
Older People ◽  
Choice Model ◽  
Informed Choice ◽  
Home Care Services ◽  
Publicly Funded ◽  
Care Needs ◽  
Telephone Interviews ◽  
Care Services ◽  
The Difference

ABSTRACTSweden has in the last 20 years undergone an extensive process of marketisation of its home care sector. Where the public sector once was the only provider of home care services, there is now a wide array of different, private alternatives for older people to choose from, using their publicly funded voucher. The publicly funded home care services in Sweden are, in other words, to a large extent organised according to the principles of a quasi-market. Older people with care needs are therefore now considered to be consumers of home care since they are expected to make an informed choice of home care provider according to their own preferences. This paper studies the extent to which older people with care needs assume this role and how they do it, using Hirschman's well-known theory on ‘exit, voice and loyalty’ and theory on the difference between care and market logic. The study is based on results from a research project using telephone interviews to ask a large number of older people in three Swedish cities about their experience of making this choice. The results show that they had difficulty understanding how to choose and what the purpose of the choice was. The conclusion of this study suggests some possible reasons why policy makers in Sweden continue to favour the freedom-of-choice model in spite of these poor results.

scholarly journals “I Could Not Manage This Long-Term, Absolutely Not.” Aging in Place, Informal Care, COVID-19, and the Neighborhood in Flanders (Belgium)

2021 ◽  
Vol 18 (12) ◽  
pp. 6482
Author(s):  
Jakob D’herde ◽  
Wesley Gruijthuijsen ◽  
Dominique Vanneste ◽  
Veerle Draulans ◽  
Hilde Heynen
Keyword(s):  
Informal Caregivers ◽  
Aging In Place ◽  
Family Care ◽  
Social Solidarity ◽  
Formal Care ◽  
Care Needs ◽  
Good Opportunity ◽  
Telephone Interviews ◽  
Care Services ◽  
Provision Of Care

Public health and care policies across OECD (Organisation for Economic Co-operation and Development) countries increasingly encourage aging in place, enabled by both formal care networks, and informal (family) care and social solidarity in the neighborhood. However, little is known about how a person’s neighborhood might affect their aging in place. The COVID-19 crisis unintendedly offered a good opportunity to observe the neighborhood’s role in the provision of care. Since formal care services were often limited during the lockdown, informal caregiving may have increased. However, intergenerational contacts in and outside of the household were strongly discouraged by governments worldwide, adding another layer of complexity to caregiving. The aim of this qualitative study was to assess how informal caregivers in Flanders managed to provide care to their care receivers, and what role the neighborhood played in this provision of care. Sixteen qualitative Skype and telephone interviews with informal caregivers were conducted between June and December 2020 to understand their experiences and coping strategies. Overall, most respondents increased their frequency of caregiving during the first lockdown. They took on the extra care needs during the lockdown themselves, and did not actively invoke any kind of neighborhood support. The significance of the neighborhood seemingly remained limited. This was often not because no help was offered, but rather due to a sense of pride or the fear of infection, and an increased effort by family caregivers.

scholarly journals Comparison of Care Utilization and Institutional Death Rates among Older Adults according to Different Types of Home Care Facilities: a retrospective cohort study in Fukuoka, Japan

2020 ◽  
Author(s):  
Sung-A Kim ◽  
Akira Babazono ◽  
Aziz Jamal ◽  
Yunfei Li ◽  
Ning Liu
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Home Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Home Care Services ◽  
Care Utilization ◽  
Care Needs ◽  
Care Services ◽  
Comorbidity Index

AbstractObjectiveWe compared the use of various care services and institutional deaths in older adults among these facility types.DesignThis was a retrospective cohort study.MethodsWe used administrative claim data from April 2014 to March 2017. The study participants comprised Fukuoka Prefecture residents aged 75 and older with certified care needs of level 3 or more in April 2014 and who received home care services during the study period. Participants were divided into 4 groups according to the facility type from which they received home care services: General Clinics, Home Care Support Clinics and hospitals (HCSCs), Enhanced HCSCs with beds and Enhanced HCSCs without beds. The outcomes were utilization of medical and long-term care services and the incidence of institutional deaths. We constructed generalized linear regression models. The evaluated potential risk factors were sex, age, care needs levels, and Charlson comorbidity index (CCI) scores.ResultsThe numbers of inpatient care days were 54.3 days, 70.0 days, 64.7 days, and 75.1 days for users of enhanced HCSCs with beds, enhanced HCSCs without beds, HCSCs, and general clinics, respectively. While the number of home care days were 63.8 days, 50.9 days, 57.8 days, and 29.0 days, respectively. The odds of institutional death in general clinic users were 2.32 times higher (P<0.001) than users of enhanced HCSCs with beds.ConclusionsParticipants who used enhanced HCSCs with beds had reduced inpatient care utilization, increased home care utilization, increased home-based end-of-life care utilization, and fewer institutional deaths. These findings suggest that hospitalizations and institutional deaths could be reduced by further expanding the role of enhanced HCSCs with beds. Our study provides useful information for further investigations of home care for older adults as part of community-based integrated care.Strengths and limitations of this studyThis was a retrospective cohort study including 18,347 participants.We followed up participants for 3 years.We considered the level of care needs and Charlson comorbidity index as confounders. Despite that, the inclusion of these variables did not provide detailed information about living conditions that reflect family structure and characteristics of living.We calculated the number of years that participants lived during the study period, and the annual utilization rates per person-year of observation were estimated.There were no clinical data for individual participants because this study focused on the types of healthcare facilities that provide home care.

scholarly journals WHEN A LITTLE GOES A LONG WAY: EXPANDING HOME CARE SERVICES TO ADULTS WITH DISABILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S160-S161
Author(s):  
Serena Hasworth ◽  
Jaclyn Winfree ◽  
Ozcan Tunalilar ◽  
Diana White
Keyword(s):  
Home Care ◽  
Qualitative Interviews ◽  
Pilot Project ◽  
Home Care Services ◽  
Case Managers ◽  
Term Care ◽  
Consumer Responses ◽  
Care Services ◽  
Rural Access ◽  
Levels Of Service

Abstract Policy makers are increasingly interested in reducing public spending while maintaining quality of life. Since 1975, Oregon Project Independence (OPI) has supported community-based adults aged 60 and older to avoid or delay the need for residential long-term care services by increasing access to personal and home care services. The program also aims to prevent the need for Medicaid by optimizing personal resources and natural supports. In 2014, the OPI Expansion (OPI-E) pilot project began to serve adults aged 18-59 with disabilities in seven of Oregon’s seventeen Area Agencies on Aging (AAAs). This poster describes the evaluation of the expansion using three data sources: administrative data about consumer characteristics compiled by the AAAs and State of Oregon from 2015-2017 (N=3,824 traditional consumers, N= 581 OPI-E consumers), qualitative interviews conducted with AAA directors and OPI-E case managers (N=23), and a survey of current OPI-E consumers (N=126). Compared to traditional OPI consumers, OPI-E consumers were somewhat more likely to be men and people of color. Interviews with AAA staff highlighted the need for outreach, lack of service provider capacity, unique characteristics of younger consumers, and issues related to data management and rural access. Staff reported valuing the program, noting how “even low levels of service go a long way.” Qualitative and quantitative consumer responses showed consumers found OPI-E services invaluable. The majority stressed their appreciation for the program, with several describing it as “lifesaving.” These three sources informed recommendations for expanding the OPI-E program statewide.

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