Expanding the Home Care Concept: Blurring Distinctions among Home Care, Institutional Care, and Other Long-Term-Care Services

1995 ◽  
Vol 73 (2) ◽  
pp. 161 ◽  
Author(s):  
Rosalie A. Kane
Keyword(s):  
Home Care ◽  
Long Term Care ◽  
Institutional Care ◽  
Term Care ◽  
Care Services

scholarly journals Hospital to Home: Supporting the Transition From Hospital to Home for Older Adults

2021 ◽  
pp. 084456212110443
Author(s):  
Brittany Barber ◽  
Lori Weeks ◽  
Lexie Steeves-Dorey ◽  
Wendy McVeigh ◽  
Susan Stevens ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Family Caregivers ◽  
Older Adult ◽  
Long Term Care ◽  
Home Care Services ◽  
Term Care ◽  
Care Services ◽  
Hospital To Home

Background An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Older adults often lack adequate support to transition from hospital to home, without access to appropriate health services when they are needed in the community and resources to live safely at home. Purpose This study collaborated with an existing enhanced home care program called Home Again in Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods Using a case study design, this study examined in-depth experiences of multiple stakeholders, from December 2019 to February 2020, through analysis of nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results Findings indicate home care services for older adults are being sought too late, after hospital readmission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services led to barriers preventing family caregivers from continuing to care for older adults at home. Conclusions This study contributes knowledge about gaps within home care and transitional care services, highlighting the importance of investing in additional home care services for rehabilitation and prevention of rapidly deteriorating health.

A Comparative Analysis of Costs to Government for Home Care and Long-term Residential Care Services, Standardized for Client Care Needs

2007 ◽  
Vol 26 (S1) ◽  
pp. 149-161 ◽  
Author(s):  
Marcus J. Hollander ◽  
Neena L. Chappell
Keyword(s):  
Home Care ◽  
Residential Care ◽  
Long Term Care ◽  
Lower Cost ◽  
Level Of Care ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Residential Long Term Care

ABSTRACTThis paper reports on the results of analyses using administrative data from British Columbia for 10 years from fiscal 1987/1988 to 1996/1997, inclusive, to examine the comparative costs to government of long-term home care and residential care services. The analyses used administrative data for hospital care, physician care, drugs, and home care and residential long-term care. Direct comparisons for cost and utilization data were possible, as the same care-level classification system is used in BC for home care and residential care clients. Given significant changes in the type and/or level of care of clients over time, a full-time equivalent client strategy was used to maximize the accuracy of comparisons. The findings suggest that, in general, home care can be a lower-cost alternative to residential care for clients with similar care needs. The difference in costs between home care and residential care services narrows considerably for those who change their type and/or level of care, and home care was found to be more costly than long-term institutional care for home care clients who died. The findings from this study indicate that with the appropriate substitution for residential care services, in a planned and targeted manner, home care services can be a lower-cost alternative to residential long-term care in integrated systems of care delivery that include both sets of services.

scholarly journals Predictors of Effort-Reward Imbalance Among Employees Providing Three Types of Long-Term Care Services in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 183-184
Author(s):  
Ayumi Honda ◽  
Elizabeth Fauth ◽  
Yin Liu ◽  
Sumihisa Honda
Keyword(s):  
Long Term Care ◽  
Institutional Care ◽  
Working Hours ◽  
Term Care ◽  
Factors Associated ◽  
Work Related ◽  
Care Services ◽  
Home Based ◽  
Reward Imbalance

Abstract Increasingly, employees are leaving their jobs as long-term care workers in Japan. The purpose of this study was to identify predictive factors of effort-reward imbalance (ERI) among employees in long-term care, to better understand factors associated with excessive effort and reduced reward. This cross-sectional study included 944 participants providing three types of long-term care: home-based (n=201), community-based (n=128), and institutional (n=615). Multiple logistic regression analysis was used to identify factors associated with self-reported ERI, where higher ERI scores indicated greater work-related efforts and lower rewards. Key independent variables included type of occupation, employment status, position, daily working hours, job satisfaction, and annual income. Our results showed that low job satisfaction was the sole common factor associated with ERI in employees across all three types of long-term care. Other predictive factors for ERI differed by type of long-term care services. Working longer hours predicted ERI in community-based and institutional care employees, but not home-based care employees. For institutional care employees, being a care manager, holding a position of department head, having family-related stress were risk factors for ERI, suggesting that in this setting, the rewards of higher income and more prestige in leadership positions are offset by greater work-related demands. In conclusion, factors associated with ERI were both common and distinct among employees providing different types of long-term care services. Adjusting work demands and working hours, and identifying unique contributors to ERI within specific long-term care settings may help with job retention in these occupations.

scholarly journals Hospital to Home: Supporting the Transition from Hospital to Home for Older Adults

2021 ◽  
Author(s):  
Brittany Barber ◽  
Lori Weeks ◽  
Lexie Steeves-Dorey ◽  
Wendy McVeigh ◽  
Susan Stevens ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Older Adult ◽  
Long Term Care ◽  
Home Care Services ◽  
Adult Patients ◽  
Term Care ◽  
Care Services ◽  
Hospital To Home

Abstract Background: An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Within Canada, approximately 10 percent of newly admitted long-term care residents could have potentially been cared for at home. Without adequate support from health care services to transition older adults from hospital to home, they often lack access to appropriate services when they are needed in the community thus making them more vulnerable to avoidable hospital visits, rapid deterioration of health, and earlier and unnecessary placement into residential long-term care. The purpose of this study was to collaborate with an existing enhanced home care program called Home Again in Halifax, Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods: Through a retrospective case study design, we analyzed nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results: Findings indicate home care services for older adults are being sought too late, after hospital re-admission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services ultimately led to barriers preventing family caregivers from continuing to care for older adults at home, such as absence of overnight services, a lack of information about home care services, and a lack of knowledge to navigate resources available. Conclusion: This study contributes knowledge about gaps within home care and transitional care services, highlighting the significance of investing in additional home care services for rehabilitation and the prevention of rapidly deteriorating health when older adults are discharged home after their first hospital visit. By understanding experiences and challenges of patients, family or friend caregivers, and healthcare professionals, we identified ways to reduce healthcare costs and improve the delivery and quality of home care services to better support older adult patients and their family or friend caregivers and to ensure hospitalized older adults are not unnecessarily admitted to nursing homes.

scholarly journals Does context matter? Voluntary work in long-term care

2021 ◽  
Vol 12 (1) ◽  
pp. 155-180
Author(s):  
Laila Tingvold ◽  
Oddvar Førland
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Long Term Care ◽  
Home Care Services ◽  
Voluntary Work ◽  
Term Care ◽  
Home Setting ◽  
Care Services

Introduction: Increased voluntary work in long-term care (LTC) is encouraged in white papers in Norway as well as in many other western states. This is due to the growth in the number of service recipients and a subsequent economic burden for the state. Voluntary work in nursing homes and home care services take place in different spatial contexts, but little attention has been paid to how the different contexts may potentially influence the possibilities for voluntary work. The aim of this study is to obtain new knowledge of the significance of context in recruitment of volunteers in LTC. Method: A cross-sectional study was conducted among leaders in nursing homes and home services in 50 municipalities across all regions of Norway. Descriptive analysis was used. Results: According to the leaders, home care services had less voluntary work than nursing homes. Respondents from home care scored “poor flow of information” and “low interest in the municipality” as major hinderances, more so than respondents from nursing homes did. Discussion: Nursing homes typically have many residents under one roof following a similar schedule. Thus, volunteer-run activities are held more easily at set times and incorporated into the daily life of the institutions. On the other hand, home dwellers in home care stay in a more individualised setting with more autonomy and can opt out of activities that nursing home residents would normally join. Skill acquisition, networking and socializing are common motivations for volunteering, and a nursing home setting may be an easier context to obtain this. The governmental endeavour for increased voluntary work in LTC can be seen as an effort to meet expected rises in public expenditure. However, the realism can be debated due to substantial challenges on the future potential of volunteerism in LTC, especially in the home care context.

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