scholarly journals Impact of Social Isolation Due to COVID-19 on VA Home-Based Primary Care Veterans and Caregivers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 579-579
Author(s):  
Chelsea Manheim ◽  
Nelly Solorzano ◽  
Juli Barnard ◽  
Tamar Wyte-Lake ◽  
Leah Haverhals
Keyword(s):  
Primary Care ◽  
Social Isolation ◽  
Assisted Living ◽  
Care Delivery ◽  
Veterans Affairs ◽  
Assisted Living Facilities ◽  
Department Of Veterans Affairs ◽  
Home Based Primary Care ◽  
Home Based ◽  
Virtual Visits

Abstract In December 2020 we began conducting phone interviews with Veterans, and their caregivers, receiving care through the United Sates (US) Department of Veterans Affairs (VA) Home Based Primary Care (HBPC) program. Our goal was to describe experiences of Veterans and caregivers managing changes in care delivery related to the COVID-19 pandemic and navigating increased social isolation due to social distancing. We interviewed 38 Veterans (average age 78) and caregivers (average age 62) across seven VA HBPC programs. Findings showed those living in their own homes found increased isolation more manageable than those living in assisted living facilities, which restricted visitors. Caregivers had a harder time managing isolation than Veterans, as Veterans were used to being primarily homebound. Veterans and caregivers relied on increased phone communication with their HBPC teams, with some began participating in virtual visits. Implications include insights into better supporting older, homebound adults and their caregivers during disasters.

scholarly journals Preparedness and response activities of the US Department of Veterans Affairs (VA) home-based primary care program around the fall 2017 hurricane season

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tamar Wyte-Lake ◽  
Claudia Der-Martirosian ◽  
Karen Chu ◽  
Rachel Johnson-Koenke ◽  
Aram Dobalian
Keyword(s):  
Primary Care ◽  
Large Scale ◽  
Care Program ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
Home Based Primary Care ◽  
Home Based ◽  
Early Implementation ◽  
Hurricane Season ◽  
At Risk Populations

Abstract Background Large-scale natural disasters disproportionally affect both the medically complex and the older old, groups that are responsible for most medical surge after a disaster. To understand how to ameliorate this surge, we examined the activities of the nine US Department of Veterans Affairs (VA) Home Based Primary Care (HBPC) programs impacted during the 2017 Fall Hurricane Season. Methods Convergent mixed methods design, incorporating independently conducted qualitative and quantitative analyses. Phase One: 34 clinical staff were interviewed from the nine VA HBPC programs impacted by Hurricanes Harvey, Irma, and Maria to examine the experiences of their HBPC programs in response to the Hurricanes. Phase Two: Secondary quantitative data analysis used the VA’s Corporate Data Warehouse (CDW) to examine the electronic health records of patients for these same nine sites. Results The emergency management activities of the HBPC programs emerged as two distinct phases: preparedness, and response and recovery. The early implementation of preparedness procedures, and coordinated post-Hurricane patient tracking, limited disruption in care and prevented significant hospitalizations among this population. Conclusions Individuals aged 75 or older, who often present with multiple comorbidities and decreased functional status, typically prefer to age in their homes. Additionally, as in-home medical equipment evolves, more medically vulnerable individuals are able to receive care at home. HBPC programs, and similar programs under Medicare, connect the homebound, medically complex, older old to the greater healthcare community. Engaging with these programs both pre- and post-disasters is central to bolstering community resilience for these at-risk populations.

scholarly journals Home-Based Primary Care Led-Outbreak Mitigation in Assisted Living Facilities in the First 100 Days of Coronavirus Disease 2019

2020 ◽  
Vol 21 (7) ◽  
pp. 951-953 ◽  
Author(s):  
William R. Mills ◽  
Janet M. Buccola ◽  
Susan Sender ◽  
Joseph Lichtefeld ◽  
Nicholas Romano ◽  
...  
Keyword(s):  
Primary Care ◽  
Assisted Living ◽  
Assisted Living Facilities ◽  
Home Based Primary Care ◽  
Home Based

scholarly journals Adaptations to In-Home Health Care Due to COVID-19: The VA’s Home-Based Primary Care Program

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 467-467
Author(s):  
Leah Haverhals ◽  
Chelsea Manheim ◽  
Nelly Solorzano ◽  
Suzanne Gillespie ◽  
Tamar Wyte-Lake
Keyword(s):  
Primary Care ◽  
Home Health Care ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Care Program ◽  
Department Of Veterans Affairs ◽  
Face To Face ◽  
Home Based Primary Care ◽  
Home Based ◽  
Primary Care Program

Abstract The COVID-19 pandemic disrupted traditional Home Based Primary Care (HBPC) care processes, including changes to provision of face-to-face care in-home for older adults. Our study describes and explains care delivery changes Department of Veterans Affairs (VA) HBPC programs made in response to the pandemic. We fielded a national survey to all 140 VA HBPC programs, targeting interdisciplinary care teams and HBPC leadership. We structured survey questions using a mixed method approach with both closed and open-ended questions, applying a qualitative content analysis approach to open-ended responses complemented by analysis of descriptive quantitative data. Preliminary findings highlight the value and consideration of different telehealth modalities when caring for an older, homebound population, as well as creative adaptations HBPC teams made to deliver care during the pandemic. Implications include nascent development of decision-making paradigms beyond the pandemic particularly for appropriate use of telehealth modalities for older homebound adults.

Dedicated to the Mission: Strategies US Department of Veterans Affairs Home‐Based Primary Care Teams Apply to Keep Veterans at Home

2019 ◽  
Vol 67 (12) ◽  
pp. 2511-2518 ◽  
Author(s):  
Leah M. Haverhals ◽  
Chelsea Manheim ◽  
Carrie Gilman ◽  
Jurgis Karuza ◽  
Tobie Olsan ◽  
...  
Keyword(s):  
Primary Care ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
Home Based Primary Care ◽  
Home Based ◽  
Primary Care Teams ◽  
At Home

Addressing COVID-19 Worry and Social Isolation in Home-Based Primary Care

2020 ◽  
Author(s):  
Rachel Elizabeth Weiskittle ◽  
Michelle Mlinac ◽  
LICSW Nicole Downing
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Social Workers ◽  
Social Isolation ◽  
Mental Health Providers ◽  
Health Providers ◽  
Home Based Primary Care ◽  
Home Based ◽  
Socially Isolated

Social distancing measures following the outbreak of COVID-19 have led to a rapid shift to virtual and telephone care. Social workers and mental health providers in VA home-based primary care (HBPC) teams face challenges providing psychosocial support to their homebound, medically complex, socially isolated patient population who are high risk for poor health outcomes related to COVID-19. We developed and disseminated an 8-week telephone or virtual group intervention for front-line HBPC social workers and mental health providers to use with socially isolated, medically complex older adults. The intervention draws on skills from evidence-based psychotherapies for older adults including Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, and Problem-Solving Therapy. The manual was disseminated to VA HBPC clinicians and geriatrics providers across the United States in March 2020 for expeditious implementation. Eighteen HBPC teams and three VA Primary Care teams reported immediate delivery of a local virtual or telephone group using the manual. In this paper we describe the manual’s development and clinical recommendations for its application across geriatric care settings. Future evaluation will identify ways to meet longer-term social isolation and evolving mental health needs for this patient population as the pandemic continues.

scholarly journals Preparedness and Response Activities of the VA Home-Based Primary Care Program Around the Fall 2017 Hurricane Season

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 591-591
Author(s):  
Tamar Wyte-Lake ◽  
Claudia Der-Martirosian ◽  
Aram Dobalian
Keyword(s):  
Primary Care ◽  
Large Scale ◽  
Care Program ◽  
Department Of Veterans Affairs ◽  
Home Based Primary Care ◽  
Home Based ◽  
Early Implementation ◽  
Hurricane Season ◽  
Patient Health ◽  
At Risk Populations

Abstract Individuals aged seventy-five or older, who often present with multiple comorbidities and decreased functional status, typically prefer to age in their homes. Additionally, as in-home medical equipment evolves, more medically vulnerable individuals can receive care at home. Concomitantly, large-scale natural disasters disproportionally affect both the medically complex and the older old, two patient groups responsible for most medical surge after a disaster. To understand how to ameliorate this surge, we examined the activities of the nine US Department of Veterans Affairs Home-Based Primary Care programs during the 2017 Atlantic Hurricane Season. These and similar programs under Medicare connect the homebound to the healthcare community. Study findings support early implementation of preparedness procedures and intense post-Hurricane patient tracking as a means of limiting reductions in care and preventing significant disruptions to patient health. Engaging with home-based primary care programs during disasters is central to bolstering community resilience for these at-risk populations.

Variation in Value-Based Outcome Measures Among Assisted Living Communities Served by a Home-Based Primary Care Practice During COVID-19

2020 ◽  
Vol 33 (1) ◽  
pp. 45-48
Author(s):  
William R. Mills ◽  
Janet M. Buccola ◽  
Jamie Roosa ◽  
Lisa Lemin ◽  
Lynn Cappelli ◽  
...  
Keyword(s):  
Primary Care ◽  
Assisted Living ◽  
Primary Care Practice ◽  
Hospitalization Rate ◽  
Care Practice ◽  
Community Settings ◽  
Home Based Primary Care ◽  
Home Based ◽  
The Mean ◽  
At Home

We aimed to determine the hospitalization rate and average days spent at home in a population of assisted living (AL) residents served by a home-based primary care (HBPC) practice during the COVID-19 pandemic. We provided on-site HBPC to 1,699 AL residents and calculated hospitalization rate and days spent at home. The AL population had a mean age of 84 ± 10 years and 73% were female. The mean hospitalization rate was 449 admissions per 1,000 per year, and there was wide variation among AL communities. AL residents spent a mean of 358 days at home per year, and the average days spent at home varied during the COVID-19 pandemic. Use of these measures may help AL articulate its value proposition by enabling seniors with complex health needs to live in community settings for as many days as possible.

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