Impact of informal care levels on discontinuation of living at home in community-dwelling dependent elderly using various community-based services

2011 ◽  
Vol 52 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Masafumi Kuzuya ◽  
Jun Hasegawa ◽  
Yoshihisa Hirakawa ◽  
Hiromi Enoki ◽  
Sachiko Izawa ◽  
...  
Keyword(s):  
Informal Care ◽  
Community Dwelling ◽  
Community Based ◽  
Dependent Elderly ◽  
Community Based Services ◽  
At Home

Models of home care services for persons with dementia: a narrative review

2015 ◽  
Vol 27 (10) ◽  
pp. 1593-1600 ◽  
Author(s):  
Lee-Fay Low ◽  
Jennifer Fletcher
Keyword(s):  
Case Management ◽  
Home Care ◽  
Integrated Care ◽  
Community Dwelling ◽  
Narrative Review ◽  
Nursing Home Admission ◽  
Community Based ◽  
People With Dementia ◽  
The Impact ◽  
Community Based Services

ABSTRACTBackground:Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care.Methods:We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs.Results:Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study.Conclusions:There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.

scholarly journals Informal and formal care infrastructure and perceived need for caregiver training for frail US veterans referred to home and community-based services

2010 ◽  
Vol 6 (1) ◽  
pp. 57-66 ◽  
Author(s):  
Courtney Harold Van Houtven ◽  
Eugene Z. Oddone ◽  
Morris Weinberger
Keyword(s):  
Primary Care ◽  
Informal Care ◽  
Medical Center ◽  
Caregiver Training ◽  
Community Based ◽  
Home Health Services ◽  
Home Based ◽  
Chi Squared ◽  
Us Veterans ◽  
Community Based Services

Objectives: To describe the informal care network of US veterans referred to home and community-based services (Homemaker Home Health services, H/HHA, or Home-Based Primary Care, HBPC) at the Durham Veterans Affairs Medical Center (VAMC), including: quantity and types of tasks provided and desired content for caregiver training programs. Methods: All primary care patients referred to H/HHA or HBPC during the preceding 3 months were sent questionnaires in May 2007. Additionally, caregivers were sent questionnaires if a patient gave permission. Descriptive statistics and chi-squared tests were performed. Results: On average, patients received 5.6 hours of VA care and 47 hours of informal care per week. 26% of patients (38% of patients with caregiver proxy respondents) and 59% of caregivers indicated the caregiver would be interested in participating in a training program by phone or on-site. Significant barriers to participation existed. The most common barriers were: transportation; no time due to caregiving or work demands; caregiver’s own health limitations; and no need. Conclusions: Caregiver training needs to be tailored to overcome barriers to participate. Overcoming these barriers may be possible through in-home phone or internet training outside traditional business hours, and by tailoring training to accommodate limiting health problems among caregivers.

scholarly journals Integrated Home‐ and Community‐Based Services Improve Community Survival Among Independence at Home Medicare Beneficiaries Without Increasing Medicaid Costs

2019 ◽  
Vol 67 (7) ◽  
pp. 1495-1501 ◽  
Author(s):  
Girish Valluru ◽  
Jean Yudin ◽  
Christine L. Patterson ◽  
Joanna Kubisiak ◽  
Peter Boling ◽  
...  
Keyword(s):  
Medicare Beneficiaries ◽  
Community Based ◽  
Community Based Services ◽  
At Home

scholarly journals The direct cost of disability of community-dwelling older persons in Belgium

2020 ◽  
pp. 1-28
Author(s):  
Sophie Cès ◽  
Anne-Sophie Lambert ◽  
Johanna de Almeida Mello ◽  
Anja Declercq ◽  
Niko Speybroeck ◽  
...  
Keyword(s):  
Informal Care ◽  
Older Persons ◽  
Community Dwelling ◽  
Service Utilisation ◽  
Elderly Persons ◽  
Total Cost ◽  
Formal Support ◽  
Disabled Elderly ◽  
The Cost ◽  
At Home

Abstract Current policies aim to promote and develop community-based support of disabled elderly persons, yet knowledge of the cost implications is insufficient. Thus, we aimed to estimate, for three disability profiles and three presence levels of the main informal carer (none, non-cohabitant, cohabitant), the cost of formal and informal support currently provided at home in Belgium. In this cross-sectional study, a sample of 5,642 disabled elderly persons living at home was established between 2010 and 2016. The administrative database of the Belgian public healthcare insurance was merged with other prospective data on social care service utilisation, informal care and disability. The total cost of formal support ranged from €725 to €1,344 (on average, per person, per month), depending on the three disability profiles identified. Twenty-five per cent of persons with the highest level of disability (important functional limitations and cognitive impairment) and helped by a cohabitant carer, had a low total cost of formal support: below €382 per month. Informal care represented the main cost component of total support costs in the three disability profiles (between 64 and 76%). To prevent the worsening of situations of disabled older persons and their informal carers, better detection of seriously disabled persons with low levels of formal support is crucial.

Satisfaction and Sense of Well Being Among Medicaid ICF/MR and HCBS Recipients in Six States

2009 ◽  
Vol 47 (2) ◽  
pp. 63-83 ◽  
Author(s):  
Roger J. Stancliffe ◽  
K. Charlie Lakin ◽  
Sarah Taub ◽  
Giuseppina Chiri ◽  
Soo-yong Byun
Keyword(s):  
Developmental Disabilities ◽  
Care Facility ◽  
Well Being ◽  
Intermediate Care ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Community Based Services ◽  
Day Program ◽  
At Home

Abstract Self-reported satisfaction and sense of well-being were assessed in a sample of 1,885 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services in 6 states. Questions dealt with such topics as loneliness, feeling afraid at home and in one's neighborhood, feeling happy, feeling that staff are nice and polite, and liking one's home and work/day program. Loneliness was the most widespread problem, and there were also small percentages of people who reported negative views in other areas. Few differences were evident by HCBS and ICF/MR status. The findings document consistent benefits of residential support provided in very small settings—with choices of where and with whom to live—and to individuals living with family.

Gender and Transportation Access among Community-Dwelling Seniors

2007 ◽  
Vol 26 (2) ◽  
pp. 149-158 ◽  
Author(s):  
Josette Dupuis ◽  
Deborah R. Weiss ◽  
Christina Wolfson
Keyword(s):  
Unmet Needs ◽  
Community Dwelling ◽  
Social Effects ◽  
Urban Setting ◽  
Lower Income ◽  
Community Based ◽  
Multivariable Analyses ◽  
Design And Methods ◽  
Community Based Services ◽  
Income Satisfaction

ABSTRACTPurpose: This study estimates the prevalence of problems with transportation in a sample of community-dwelling seniors residing in an urban setting and investigates the role that gender plays in the ability of seniors to remain mobile in their communities.Design and Methods: Data collected as part of a study assessing the prevalence and consequences of unmet needs for community-based services in a random sample of 839 elderly aged 75 years and older were employed in bivariate and multivariable analyses.Results: The prevalence of problems with transportation was 23 per cent, with 33 per cent of females and 10 per cent of males categorized as having problems with transportation. Of those subjects categorized as having problems with transportation, 88 per cent were women. In addition to being predominantly women, those who reported problems with transportation were older, in poorer health, and had lower income and income satisfaction.Implications: Problems with transportation are an important issue facing seniors; women, in particular. These results highlight the differences in aging as experienced by women and men with respect to social effects, needs, and the significance attached to the experience.

scholarly journals Interrogating the Relevance of Home and Community-Based Services in Addressing Old Age Challenges in Lagos State, Nigeria

2014 ◽  
Vol 12 (1) ◽  
Author(s):  
Bola Amaike
Keyword(s):  
Older People ◽  
Old Age ◽  
Informal Care ◽  
Institutional Care ◽  
Well Being ◽  
Subjective Assessment ◽  
Community Based ◽  
Care Recipients ◽  
Lagos State ◽  
Community Based Services

The article examines the relevance of informal care in addressing old age challenges in Lagos State. Although informal care is an integral aspect of caregiving in Nigeria, it has received little or no attention because of dearth of policy thrust and framework. Older people in Nigeria receive informal care which helps to promote optimal ageing and socio-economic well-being. A total of 1,321 retired older men and women in Lagos State, who were care recipients, were asked to assess the nature and sources of old age care as well as their preferences for old age care. The findings indicate that older people preferred informal care to institutional care because the former promotes autonomy, independence and respect from caregivers. This article is based on older people’s subjective assessment of home and community-based services which serves as a useful guide to researchers and social gerontologists in addressing old age challenges in Lagos State, Nigeria.

scholarly journals Risk of Hospitalization Associated With Different Constellations of Home & Community Based Services

2021 ◽  
Author(s):  
Ray Van Cleve ◽  
Evan Cole ◽  
Howard Degenholtz
Keyword(s):  
Initial Level ◽  
Secondary Data ◽  
Community Dwelling ◽  
Adult Day Care ◽  
Community Based ◽  
Inpatient Hospitalization ◽  
Medicaid Population ◽  
Low Levels ◽  
To Receive ◽  
Community Based Services

Abstract Background:Identify the association between specific combinations of home and community-based services (HCBS) and risk of acute hospitalization. Methods:Data for this study came from Pennsylvania Medicaid claims, enrollment files, enrollee evaluations, and Medicare and Medicaid hospitalization records. This analysis compared risk of inpatient hospitalization across an entire state Medicaid population of community dwelling elderly individuals receiving HCBS. Twelve constellations of HCBS were identified, each composed of different services. Using logistic regression, we derived predicted probabilities of experiencing hospitalization for people in each constellation. This was secondary data analysis conducted outside of a hospital. This study used observational data. There was no randomization.Results:The highest risk of hospitalization, 15.1%, was associated with use of home delivered meals and low levels of PAS. The lowest risk of hospitalization, 7.5% was associated with use of adult day care and low levels of PAS. An 11.6% risk of hospitalization was associated with people who had applied to receive HCBS but were deemed ineligible. This risk was higher than all other constellations of HCBS except for the risk associated with using only low levels of PAS (13.9%) and using low levels of PAS and home delivered meals (15.1%). Conclusions: Using medium and high levels of PAS was associated with lower hospitalization risk compared to only low levels of PAS. Offering a higher initial level of PAS upon enrollment in Medicaid could potentially reduce hospitalization risk. People receiving home delivered meals had an elevated hospitalization risk.

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