scholarly journals Risk of Nursing Home Admission Among Older Americans: Does States' Spending on Home- and Community-Based Services Matter?

2007 ◽  
Vol 62 (3) ◽  
pp. S169-S178 ◽  
Author(s):  
N. Muramatsu ◽  
H. Yin ◽  
R. T. Campbell ◽  
R. L. Hoyem ◽  
M. A. Jacob ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Home Admission ◽  
Community Based ◽  
Older Americans ◽  
Community Based Services

scholarly journals Residence in HUD Housing Associated With Greater Benefit From HCBS Services for Medicaid Enrollees in Pennsylvania

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 477-478
Author(s):  
Damian Da Costa ◽  
Howard Degenholtz
Keyword(s):  
Nursing Home ◽  
Multinomial Logistic Regression ◽  
Nursing Home Admission ◽  
Community Based ◽  
Term Care ◽  
Individual Level ◽  
Risk Of Death ◽  
Care Services ◽  
Community Residence ◽  
Community Based Services

Abstract State Medicaid programs seek to shift the delivery of long-term care services away from institutional settings and toward community-based settings by expanding access to home-and-community-based services (HCBS). HCBS are hypothesized to prevent or delay the need for protracted nursing home stays. This study explores the question of which types of community residence maximize this protective effect of HCBS. We used a probabilistic matching technique to identify whether waiver-eligible Medicaid enrollees were likely to reside in project-based HUD housing in 2013. We applied multinomial logistic regression to observe the risk of long-stay nursing home admission (>100 days) relative to persistent community residence in the subsequent four years. Our model controlled for age, race, gender, urban status, and receipt of home-and-community based services. Our predictor of interest was the interaction between receipt of home and community based services (HCBS) and residence in HUD housing. The eligible baseline population included 152,632 community-residing Pennsylvania Medicaid enrollees in 2013. The analytic sample excluded individuals who died during 2013 or who were no longer waiver-eligible after 2013. Residence in HUD project-based housing while receiving HCBS is independently associated with a 27% percent reduction in risk of long-stay nursing home admission (p = .01) when controlling for individual-level demographics. No significant association was observed between the predictor of interest and risk of death during the follow-up period, suggesting that this finding is not likely confounded by individual health status. Further research should test whether this association is causal and specify possible mechanisms.

Screening and Priority-Setting to Determine Home- and Community-Based Aging Services for Older Floridians

2021 ◽  
pp. 073346482110125
Author(s):  
Lawrence Schonfeld ◽  
Jesse Bell ◽  
Mary Goldsworthy ◽  
Kevin Kip ◽  
Amber M. Gum ◽  
...  
Keyword(s):  
Service Delivery ◽  
National Standards ◽  
Third Party ◽  
Community Based ◽  
Older Americans ◽  
Caregiver Support ◽  
Aging Services ◽  
Optimal Health ◽  
Aging Network ◽  
Community Based Services

The National Aging Network serves millions of older Americans seeking home- and community-based services, but places others on waitlists due to limited resources. Little is known about how states determine service delivery and waitlists. We therefore conducted a process evaluation and analyzed data from one five-county Area Agency on Aging in Florida, where an algorithm calculates clients’ priority scores for service delivery. From 23,225 screenings over 5.5 years, clients with higher priority scores were older, married, living with caregivers, and had more health problems and needs for assistance. Approximately 51% received services (e.g., meals/nutrition, case management, caregiver support), 11% were eligible/being enrolled, and 38% remained on waitlists. Service status was complex due to multiple service enrollments and terminations, funding priorities, and transfers to third-party providers. More research is needed regarding how other states determine eligibility and deliver services, potentially informing national standards that promote optimal health in older Americans.

scholarly journals Advancing States Through the OAA Reauthorization

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 725-726
Author(s):  
Damon Terzaghi
Keyword(s):  
Significant Role ◽  
Services Research ◽  
Community Based ◽  
Older Americans ◽  
Community Based Services

Abstract States are major policymakers and funders of community-based services for older Americans and ADvancing States played a significant role in supporting the OAA authorization this year. This presentation will provide the states' perspective regarding funding, services, research and demonstrations, and more.

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.

Unmet Needs for Home and Community-Based Services Among Frail Older Americans and Their Caregivers

2010 ◽  
Vol 23 (3) ◽  
pp. 529-553 ◽  
Author(s):  
Banghwa Lee Casado ◽  
Kimberly S. van Vulpen ◽  
Stacey L. Davis
Keyword(s):  
Unmet Needs ◽  
Community Based ◽  
Older Americans ◽  
Community Based Services

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.

scholarly journals Self-Reported Dental Visits Among Older Adults Receiving Home- and Community-Based Services

2020 ◽  
pp. 073346482092532
Author(s):  
Steffany Chamut ◽  
Shahdokht Boroumand ◽  
Timothy J. Iafolla ◽  
Margo Adesanya ◽  
Elena M. Fazio ◽  
...  
Keyword(s):  
High School ◽  
Older Adults ◽  
Health Knowledge ◽  
Health Indicators ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Older Americans ◽  
Older Americans Act ◽  
Community Based Services

Objective: To investigate factors associated with infrequent dental use among older adults receiving home- and community-based services. Method: This cross-sectional study analyzed responses from the 2014 National Survey of Older Americans Act participants who received home- and community-based services. Descriptive and multivariable analyses were conducted to examine the association between infrequent dental use and key sociodemographic and health indicators. Results: Infrequent dental use was highest among adults participating in case management and home-delivered meals (63%); the lowest among those participating in congregate meals (41%). Participants who did not complete high school were 2 to 5 times more likely to be infrequent dental users compared to those with educational attainment beyond high school. Discussion: Among older adults receiving home- and community-based services, improving oral health knowledge and health literacy may reduce infrequent dental use.

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