Are Home Care Aides Interested in Helping Clients Do Physical Activity?

Abstract The current home care paradigm dictates home care aides (HCAs) provide prescribed help with activities of daily living, rather than stimulating older adults’ reserves to maintain independence. Little is known about whether HCAs are interested in expanding their role to promote their clients’ health. This study examined HCAs’ interest in helping clients do physical activity among workers who care for their family members or clients assigned by home care agencies in a Medicaid-funded home care program. Data came from brief surveys completed by HCAs at state-mandated in-service training sessions (N=602; 42% caring for non-family clients only, 38% family clients only, 20% both family and non-family clients). Ordered logit analysis was conducted to examine whether HCAs caring for family clients differ from those caring for non-family clients in levels of interest in helping clients do safe physical activity as part of home care work, controlling for HCAs’ age, gender, language (English/Spanish), and years of home care experience. HCAs’ interest levels were high (62% very, 21% somewhat, 8% slightly, 9% not at all interested). Ordered logit analysis indicated that HCAs caring for family members had significantly higher interest levels than those caring for non-family clients only (83% higher among HCAs caring for both family and non-family clients, 30% higher among HCAs caring for family clients only). To reflect HCAs’ interests and to maintain clients’ independence, home care workforce training should direct its attention to empower HCAs to assume health-promoting roles.

Download Full-text

Perceived Stress and Health among Home Care Aides: Caring for Older Clients in a Medicaid-Funded Home Care Program

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.2019.0052 ◽

2019 ◽

Vol 30 (2) ◽

pp. 721-738

Author(s):

Naoko Muramatsu ◽

Rosemary K. Sokas ◽

Valentina V. Lukyanova ◽

Joseph Zanoni

Keyword(s):

Home Care ◽

Perceived Stress ◽

Care Program ◽

Care Aides ◽

Home Care Aides ◽

Stress And Health

Download Full-text

Physical Activity, Outcome Expectations, and Social Support in Dyads of Frail Older Adults and Their Home Care Aides

Innovation in Aging ◽

10.1093/geroni/igaa057.1299 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 404-404

Author(s):

Lijuan Yin ◽

Naoko Muramatsu

Keyword(s):

Physical Activity ◽

Social Support ◽

Older Adults ◽

Home Care ◽

Qualitative Data ◽

Outcome Expectations ◽

Community Dwelling ◽

Care Recipients ◽

Care Aides ◽

Home Care Aides

Abstract Frail community-dwelling older adults increasingly receive home care and continue to face barriers to participating in physical activity (PA) that could help maintain their function. Home care aides (HCAs) are well-positioned to promoting PA among older home care recipients because of their established relationship and regular interpersonal exchanges; yet, the role of HCAs in promoting and supporting PA in home care settings is seldomly studied. Using the quantitative and qualitative data from a 4-month home-based gentle PA intervention delivered by HCAs to their clients in a Medicaid-funded home care setting, the current study examined whether outcome expectations for exercise (OEE) held by HCAs led to client PA outcomes (i.e. functional limitations and physical performance) through social support for exercise (SSE) provided by HCAs. Longitudinal mediation analysis of 46 HCA-client dyads showed that higher baseline OEE held by HCAs were related to greater SSE reported by clients after the intervention (p<.05; bootstrapped standard errors), controlling for client-level covariates, including baseline OEE, age, gender, comorbidity, and whether HCA was client’s family member. Unexpectedly, SSE did not have significant association with client PA outcomes nor mediated the relationship between OEE held by HCAs and client PA outcomes. Qualitative data suggested alternative factors may explain the results, such as clients’ family beliefs in the intervention and clients’ participation experiences (such as expectation fulfillment). Future research should consider older home care clients’ family contexts to enhance our understanding of HCAs’ roles in preserving the function of growing numbers of older home care recipients.

Download Full-text

PHYSICAL ACTIVITY INTERVENTION IN HOME CARE: COMPARING FAMILY AND NON-FAMILY CAREGIVING DYADS

Innovation in Aging ◽

10.1093/geroni/igz038.733 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S202-S203

Author(s):

Naoko Muramatsu ◽

Lijuan Yin

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Home Care ◽

Family Caregiving ◽

Intervention Program ◽

Physical Activity Intervention ◽

Family Members ◽

Care Program ◽

Care Providers ◽

Client Outcomes

Abstract An increasing number of states pay family members who care for older adults in Medicaid-funded home care. Previous research documented pros and cons of hiring family members as home care providers. However, little is known about whether family and non-family caregiving dyads function differently when they participate in health promotion interventions in home care. Using data collected in a pilot study of a gentle physical activity program delivered by home care workers in a Medicare home care program, this study compared 18 family and 32 non-family caregiving dyads in client outcomes (self-reported and performance-based function) and process outcomes (exercise-related social support provided by home care aides) before and after the intervention. Linear mixed models indicated that client outcomes improved after the 4-month intervention (p<0.05), controlling for clients’ age, gender, and number of chronic conditions. Compared to family caregiving dyads, greater improvement in exercise-related support was observed in non-family caregiving dyads (p<0.05), where care providers offered less exercise-related support at baseline. The intervention program was received well by both family and non-family dyads, as expressed by one of the caregivers: “It makes my client feel good about herself. I also feel good for my client.” Results suggest that empowering caregivers with health promotion skills is a promising strategy, especially in non-family caregiving dyads. Further research is warranted to produce evidence-based health promotion programs for family and non-family caregiving dyads in home care.

Download Full-text

Attitudes of In-Home Care Aides toward Elderly Persons: Refinement of the Oberleder Attitude Scale

Perceptual and Motor Skills ◽

10.1177/00315125890693-207 ◽

1989 ◽

Vol 69 (3-2) ◽

pp. 1103-1106

Author(s):

Betty G. Dillard ◽

Betty L. Feather

Keyword(s):

Elderly Patients ◽

Home Care ◽

Attitude Scale ◽

Elderly Persons ◽

Positive Attitudes ◽

Care Aides ◽

Home Care Aides

The Oberleder Attitude Scale was reduced from 25 to 16 items and was factored into three major concepts, potential, limitations, and stereotypes. Responses of 345 in-home care aides indicated that the 345 aides held positive attitudes toward their elderly patients.

Download Full-text