Outcomes Associated with Home and Community-based Service Use Among Older Adults following a Nursing Home Transition

2020 ◽  
Vol 63 (8) ◽  
pp. 807-821
Author(s):  
Chanee Fabius ◽  
Noreen Shugrue ◽  
Julie T. Robison
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Service Use ◽  
Community Based ◽  
Nursing Home Transition

scholarly journals No Other Safe Care Option: Nursing Home Admission as a Last Resort Strategy

2020 ◽  
Vol 60 (8) ◽  
pp. 1504-1514
Author(s):  
Heather J Campbell-Enns ◽  
Megan Campbell ◽  
Kendra L Rieger ◽  
Genevieve N Thompson ◽  
Malcolm B Doupe
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Community Setting ◽  
Nursing Home Admission ◽  
Care Needs ◽  
Community Based ◽  
Field Notes ◽  
Care Nursing

Abstract Background and Objectives Nursing homes are intended for older adults with the highest care needs. However, approximately 12% of all nursing home residents have similar care needs as older adults who live in the community and the reasons they are admitted to nursing homes is largely unstudied. The purpose of this study was to explore the reasons why lower-care nursing home residents are living in nursing homes. Research Design and Methods A qualitative interpretive description methodology was used to gather and analyze data describing lower-care nursing home resident and family member perspectives regarding factors influencing nursing home admission, including the facilitators and barriers to living in a community setting. Data were collected via semistructured interviews and field notes. Data were coded and sorted, and patterns were identified. This resulted in themes describing this experience. Results The main problem experienced by lower-care residents was living alone in the community. Residents and family members used many strategies to avoid safety crises in the community but experienced multiple care breakdowns in both community and health care settings. Nursing home admission was a strategy used to avoid a crisis when residents did not receive the needed support to remain in the community. Discussion and Implications To successfully remain in the community, older adults require specialized supports targeting mental health and substance use needs, as well as enhanced hospital discharge plans and improved information about community-based care options. Implications involve reforming policies and practices in both hospital and community-based care settings.

Transition from Home Care to Nursing Home: Unmet Needs in a Home- and Community-Based Program for Older Adults

2012 ◽  
Vol 24 (3) ◽  
pp. 251-270 ◽  
Author(s):  
Julie Robison ◽  
Noreen Shugrue ◽  
Martha Porter ◽  
Richard H. Fortinsky ◽  
Leslie A. Curry
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Home Care ◽  
Unmet Needs ◽  
Community Based

scholarly journals Older Emergency Department Patients: Does Baseline Care Status Matter?

2020 ◽  
Vol 23 (4) ◽  
pp. 289-296
Author(s):  
Fabrice Immanuel Mowbray ◽  
Komal Aryal ◽  
Eric Mercier ◽  
George Heckman ◽  
Andrew P. Costa
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Nursing Home ◽  
Home Care ◽  
Support Services ◽  
Service Use ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Post Discharge ◽  
Formal Support

Background Little is known about the prognostic differences between older emergency department (ED) patients who present with different formal support requirements in the community. We set out to describe and compare the patient profiles and patterns of health service use among three older ED cohorts: home care clients, nursing home residents and those receiving no formal support. Methods We conducted a secondary analysis of the Canadian cohort from the interRAI multinational ED study. Data were collected using interRAI ED contact assessment on patients 75 years of age and older (n = 2,274), in eight ED sites across Canada. A series of descriptive statistics were reported. Adjusted as­sociations were determined using logistic regression. Results Older adults receiving no formal support services were most stable. However, they were most likely to be hospitalized. Older home care clients were most likely to report depressive symptoms and distressed caregivers. They also had the great­est odds of frequent ED visitation post-discharge (OR=1.9; 95% CI=1.39–2.59). Older adults transferred from a nursing home were the frailest but had the lowest odds of hospital admission (OR=0.14; 95% CI=0.09–0.23). Conclusion We demonstrated the importance of inquiring about commu­nity-based formal support services and provide data to support decision-making in the ED.  

scholarly journals Home and Community-Based Service Use by Vulnerable Older Adults

2015 ◽  
pp. gnv149 ◽  
Author(s):  
Raven H. Weaver ◽  
Karen A. Roberto
Keyword(s):  
Older Adults ◽  
Service Use ◽  
Community Based

scholarly journals Utilization and Expenditures of High-Need, High-Cost Older Adults With Disabilities

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 158-158
Author(s):  
Cleanthe Kordomenos ◽  
Molly Knowles ◽  
Micah Segelman ◽  
Sarita Karon
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Inpatient Care ◽  
Nursing Home Care ◽  
Community Based ◽  
Adults With Disabilities ◽  
Care Models ◽  
Patterns Of Utilization ◽  
Services And Supports

Abstract The factors that lead people to have high needs for care can vary greatly, with implications for the best approaches to serving their needs. One high need group of interest is older adults with disabilities and multiple comorbidities. There is variation in need within this group. Of particular interest is the subset that is both high need and high cost (HNHC). We present work describing Medicare and Medicaid utilization and expenditures for this high need group and the HNHC subset. Over 7.6 million people were identified as high need; 13.6% of them also were defined as HNHC. Patterns of utilization differed between these groups, with the HNHC group more likely to use inpatient care and nursing home care, but less likely to use community-based long-term services and supports. These findings have implications for the development of care models that might best meet the needs of this population.

scholarly journals Home and Community Based Services for People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 668-669
Author(s):  
Howard Degenholtz ◽  
Raymond Van Cleve
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Home Care ◽  
Physical Disability ◽  
Personal Care ◽  
Community Based ◽  
The Past ◽  
People With Dementia ◽  
Similar Information ◽  
Community Based Services

Abstract Home and Community Based Services has grown as an alternative to nursing homes over the past 30 years. While there are extensive data on nursing home staffing, there is a dearth of similar information about Medicaid financed home care. We use data from 2014-2016 Pennsylvania Medicaid to examine personal care for elderly with and without dementia across the range of physical disability. One challenge is that even though physical function can be measured in terms of discrete tasks (i.e., limitation in bathing, dressing, toileting), analysis of the amount of care people receive has to take into account the combination of dementia and combinations of ADL limitations. We found that older adults with dementia receive one hour more of personal care per day at the lowest level of disability and 1.5 hours at the highest level. The increased need for caregiving hours should be incorporated into policies that guide HCBS programs.

Deficits in Selective Attention Alter Gait in Frail Older Adults

GeroPsych ◽  
2016 ◽  
Vol 29 (1) ◽  
pp. 29-36 ◽  
Author(s):  
Véronique Cornu ◽  
Jean-Paul Steinmetz ◽  
Carine Federspiel
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Selective Attention ◽  
Dual Task ◽  
Nursing Home Residents ◽  
Gait Rehabilitation ◽  
Rehabilitation Programs ◽  
Gait Parameters ◽  
Growing Body ◽  
Task Conditions

Abstract. A growing body of research demonstrates an association between gait disorders, falls, and attentional capacities in older adults. The present work empirically analyzes differences in gait parameters in frail institutionalized older adults as a function of selective attention. Gait analysis under single- and dual-task conditions as well as selective attention measures were collected from a total of 33 nursing-home residents. We found that differences in selective attention performances were related to the investigated gait parameters. Poorer selective attention performances were associated with higher stride-to-stride variabilities and a slowing of gait speed under dual-task conditions. The present findings suggest a contribution of selective attention to a safe gait. Implications for gait rehabilitation programs are discussed.

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