Monitoring the performance of local health authorities in start of long term care program in Toscana

ABSTRACTAs the demand for home care services increases, health care agencies should be able to predict the intake capacity of community-based long-term care (CBLTC) programs. Two hundred and thirty-seven clients entering a CBLTC program were assessed for activities of daily living (ADL) and cognitive and affective functioning and were then followed to monitor attrition and reasons why clients left the program. Compromised ADL functioning at baseline increased likelihood of death and institutionalization by 2 per cent each year. Over a 10-year period, reduced cognitive functioning at baseline increased the risk of death by 9 per cent and decreased the likelihood of leaving the program due to improvement by 18 per cent. Reduced affective functioning at baseline increased the risk of institutionalization during the course of the study by 3 per cent. Routine functional assessments with the elderly may help in the management of similar home care programs.

Download Full-text

Long-Term Care Spending Relevant to U.S. Medicaid Expansion

Sustainable Health and Long-Term Care Solutions for an Aging Population - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-5225-2633-9.ch003 ◽

2018 ◽

pp. 46-70

Author(s):

Mary Schmeida ◽

Ramona Sue McNeal

Keyword(s):

Financial Incentives ◽

Long Term Care ◽

Financial Incentive ◽

State Level ◽

Care Program ◽

Nursing Facility ◽

Term Care ◽

Care Services ◽

The U.S

The U.S. population is living longer, placing a demand on long-term care services. In the U.S., Medicaid is the primary player in funding costly long-term care for the aged poor. As a major health reform law, the 2010 Patient Protection and Affordable Care Act, Public Law 111-148, gives financial incentive for states to expand Medicaid, transitioning long-term care services from facilities toward community care. Facing other funding obligations and recent recessions, not all states expanded their Medicaid long-term care program using the financial incentives. Some states continue to spend more dollars on traditional nursing facility care despite legislation. This chapter explores why some states spend more revenue on nursing facility long-term care despite enhanced federal funding to reform, while others are spending more on home and community-based services. Regression analysis and 50 state-level data is used.

Download Full-text

Medicaid Expansion

International Journal of Public and Private Perspectives on Healthcare Culture and the Environment ◽

10.4018/ijppphce.2018070103 ◽

2018 ◽

Vol 2 (2) ◽

pp. 42-53

Author(s):

Mary Schmeida ◽

Ramona McNeal

Keyword(s):

Long Term Care ◽

Financial Incentive ◽

State Level ◽

Care Program ◽

Nursing Facility ◽

Term Care ◽

Care Services ◽

Patient Protection ◽

Level Data

U.S. longevity is placing a demand on long-term care services for the impaired and elderly. Medicaid is the primary insurance program in funding costly long-term care for the aged poor. As a major health reform law, the 2010 Patient Protection and Affordable Care Act, Public Law 111-148, gives financial incentive for states to expand Medicaid, transitioning long-term care services from costly facilities toward home and community-based care. Not all states choose to expand their Medicaid long-term care program despite the financial incentive, but instead they continue spending on nursing facility care despite the less costly option of community care. This article explores why some states have been reluctant to expand long-term care into the community. Regression analysis and 50 state-level data is used.

Download Full-text

Shelved Long-Term Care Program Gets Congressional Scrutiny

Caring for the Ages ◽

10.1016/j.carage.2012.01.010 ◽

2012 ◽

Vol 13 (1) ◽

pp. 4

Author(s):

Frances Correa

Keyword(s):

Long Term Care ◽

Care Program ◽

Term Care

Download Full-text

Comparing Changes and Transitions of Home Care Clients in Retirement Homes and Private Homes

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980819000473 ◽

2019 ◽

Vol 39 (3) ◽

pp. 421-431

Author(s):

Jeffrey Poss ◽

Chi-Ling Sinn ◽

Galina Grinchenko ◽

Lialoma Salam-White ◽

John Hirdes

Keyword(s):

Risk Factors ◽

Home Care ◽

Long Term Care ◽

Local Health ◽

Caregiver Distress ◽

Retirement Home ◽

Term Care ◽

Home Residency ◽

Private Homes

ABSTRACTLong-stay home care clients mostly reside in private homes or retirement homes, and the type of residence may influence risk factors for long-term care placement. This multi-state analytic study uses RAI-Home Care and administrative data from the Hamilton Niagara Haldimand Brant Local Health Integration Network to model conceptualized states of risk at baseline through a 13-month follow-up period. Modifiable risk factors in these states were client loneliness or depressive symptoms, and caregiver distress. A higher adjusted likelihood of being discharged deceased was found for the lowest-risk clients in retirement homes. Adjusting for client, service, and caregiver characteristics, retirement home residency was associated with higher likelihood of placement in a long-term care home; reduced caregiver distress; and increased client loneliness/depression. As an alternative to private home settings as the location for aging in place among these long-stay home care clients, retirement home residency represents some trade-offs between client and informal caregiver.

Download Full-text

“We just get paid for 12 hours a day, but we work 24”: home health aide restrictions and work related stress

BMC Health Services Research ◽

10.1186/s12913-019-4664-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Jillian L. Shotwell ◽

Eve Wool ◽

Andrzej Kozikowski ◽

Renee Pekmezaris ◽

Jill Slaboda ◽

...

Keyword(s):

New York ◽

Long Term Care ◽

Care Program ◽

Home Health ◽

Term Care ◽

Home Based ◽

Primary Care Program ◽

Related Stress ◽

The Impact

Abstract Background Home-bound patients in New York State requiring long-term care services have seen significant changes to their benefits due to turmoil in the Managed Long Term Care (MLTC) market. While there has been research conducted regarding the effect of MLTC challenges on beneficiaries, the impact of MLTC regulatory changes on home health aides has not been explored. Methods Qualitative interviews were conducted with formal caregivers, defined as paid home health aides (HHAs) (n = 13) caring for patients in a home-based primary care program in the New York City metropolitan area. HHAs were asked about their satisfaction with the home based primary care program, their own job satisfaction, and whether HHA restrictions affect their work in any way. Interviews were audio-recorded, transcribed, and analyzed. Results Two main themes emerged: (1) Pay, benefits and hours worked and (2) Concerns about patient well-being afterhours. HHAs are working more hours than they are compensated for, experience wage stagnation and loss of benefits, and experience stress related to leaving frail clients alone after their shifts end. Conclusions HHAs experience significant job-related stress when caring for frail elderly patients at home, which may have implications for both patient care and HHA turnover. As government bodies contemplate new policy directions for long-term care programs which rely on HHAs the impact of these changes on this vulnerable workforce must be considered.

Download Full-text