Commentary on the Future of the Home Care Workforce: Training and Supporting Aides as Members of Home‐Based Care Teams

BACKGROUND: Family support during stroke treatment at home is crucial. However, post-stroke patients’ long-term care will be a problem for families, reducing the level of life satisfaction and physical burden for caregivers. Furthermore, families may experience depression. AIM: Analyzing family conditions related to physical, psychological, and spiritual conditions that receive home-based health worker interventions. METHODS: Study implemented systematic review design with Prisma guidelines, initially with the identification of article sources, following by article screening, checking the eligibility of studies then appraised the selected articles. Three databases were used, Ebsco, PubMed, and PROQUEST. Only studies using quasi-experimental, pre-experimental, and RCT designs were included in this study. Furthermore, those articles were published between 2014 until 2019, full type article and conducted anykind of home intervention for stroke patients and/or family member. Keywords that were employed “Stroke, Apoplexy, Cerebrovascular Accident, Vascular Accident, Home Care Services, home care, Home Health Care, Domiciliary Care, Physical, Physics, Psychological Factors, Psychological Side Effects, Psychosocial Factors, Spirituality.” Totally, 19,528 articles were obtained. Finally, only six eligible articles met review requirements. RESULTS: Implementation of home-based care lowered the physical fatigue of the family. In psychological responses showed that home-based care could reduce the incidence of depression and anxiety levels. Another impact was that the family felt helped because patients could more independently do their activities. Furthermore, the family always supported to motivate the patients to do their daily tasks. CONCLUSION: Home-based interventions for stroke patients can reduce depression, anxiety, and fatigue for the family caregiver.

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Job Design for Home Care Work: Perspectives From Employers and Home Care Aides

Innovation in Aging ◽

10.1093/geroni/igab046.834 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 218-218

Author(s):

Robyn Stone ◽

Alex Hennessa ◽

Natasha Bryant

Keyword(s):

Home Care ◽

Work Environment ◽

Business Models ◽

Job Design ◽

Non Profit ◽

For Profit ◽

Home Based ◽

Care Aides ◽

Home Care Aides ◽

Home Based Care

Abstract Home-based care is a rapidly growing sector becoming more important to individuals, families, providers, and payers. The ways in which agencies create the work environment for home care aides who are essentially in their clients’ homes is not adequately documented and may be changing rapidly with labor market innovations. This qualitative study describes how different home care business models (e.g., non-profit VNAs, for-profit franchises, uber-style matching, worker-owned coops) address job design and the overall work environment for home care aides. Interviews with employers and focus groups with home care aides examine workplace practices, how work is organized and supported when the workforce is virtual and the workplace is a client’s home, and the perceived attributes of a positive workplace environment across business models. This study fills significant knowledge gaps about home care workplace design and the role of agencies in creating a supportive environment.

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New model for the home-based care of the future

Elderly Care ◽

10.7748/eldc.2.1.18.s19 ◽

1990 ◽

Vol 2 (1) ◽

pp. 18-18

Keyword(s):

New Model ◽

Home Based ◽

The Future ◽

Home Based Care

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Therapeutic Kinship Care: A Carer's Perspective

Children Australia ◽

10.1017/cha.2014.29 ◽

2014 ◽

Vol 39 (4) ◽

pp. 221-225 ◽

Cited By ~ 4

Author(s):

Lynne McPherson ◽

Noel MacNamara

Keyword(s):

Foster Care ◽

Home Care ◽

Conceptual Model ◽

Residential Care ◽

Kinship Care ◽

Therapeutic Foster Care ◽

The Past ◽

Out Of Home Care ◽

Home Based ◽

Home Based Care

Kinship-care placements in Australia are now more prevalent than foster care and are the fastest growing form of out-of-home care in this country (AIHW, 2014). On 30 June 2013, 93% of Australian children in out-of-home care were in home-based care, with 43% of these in foster care and 48% in relative/kinship care (AIHW, 2014). The past decade has seen a greater understanding of children's needs in out-of-home care, with models of therapeutic care showing promise in Australia and internationally. These models, however, are designed almost exclusively for children placed in foster care or residential care, and as such do not consider the unique features of kinship care. This paper will identify the needs of children in out-of-home care, before briefly examining the concepts of therapeutic foster care as a response to children who have experienced trauma. Key distinctions between foster care and kinship care will be highlighted and implications for a conceptual model of therapeutic kinship care discussed.

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Home-Based Care and Standard Hospital Care for Patients with Severe Mental Illness: A Randomised Controlled Trial

The British Journal of Psychiatry ◽

10.1192/bjp.162.2.239 ◽

1993 ◽

Vol 162 (2) ◽

pp. 239-243 ◽

Cited By ~ 17

Author(s):

C. J. Simpson ◽

C. P. Seager ◽

J. A. Robertson

Keyword(s):

Mental Illness ◽

Randomised Controlled Trial ◽

Home Care ◽

Daily Living ◽

Hospital Care ◽

Controlled Trial ◽

Home Based ◽

Randomised Controlled ◽

Home Based Care ◽

Hospital Group

ObjectiveTo compare the efficacy of home based care with standard hospital care in treating serious mental illness.DesignRandomised controlled trial.SettingSouth Southwark, London.Patients189 patients aged 18–64 living in catchment area. 92 were randomised to home based care (daily living programme) and 97 to standard hospital care. At three months' follow up 68 home care and 60 hospital patients were evaluated.Main outcome measuresUse of hospital beds, psychiatric diagnosis, social functioning, patients' and relatives' satisfaction, and activity of daily living programme staff.ResultsHome care reduced hospital stay by 80% (median stay 6 days in home care group, 53 days in hospital group) and did not increase the number of admissions compared with hospital care. On clinical and social outcome there was a non–significant trend in favour of home care, but both groups showed big improvements. On the global adjustment scale home care patients improved by 26.8 points and the hospital group by 21.6 points (difference 5.2; 95% confidence interval -1.5 to 12). Other rating scales showed similar trends. Home care patients required a wide range of support in areas such as housing, finance, and work. Only three patients dropped out from the programme.ConclusionsHome based care may offer some slight advantages over hospital based care for patients with serious mental illness and their relatives. The care is intensive, but the low drop out rate suggests appreciation. Changes to traditional training for mental health workers are required.

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The future nursing voice

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692003000400002 ◽

2003 ◽

Vol 11 (4) ◽

pp. 413-419 ◽

Cited By ~ 4

Author(s):

Verena Tschudin

Keyword(s):

International Research ◽

Code Of Ethics ◽

Nursing Ethics ◽

Political Work ◽

Home Based ◽

The Future ◽

Political Voice ◽

Care Of Elderly ◽

Home Based Care

Based on some articles in the journal Nursing Ethics, the author outlines some of the areas of major importance for nursing in the future. These areas - the care of elderly people, long-term home-based care, genetics, international research and conflict and war - demand a new voice of nursing, which is a political voice. The rationale for a political voice is the ICN Code of ethics for nurses and the fourfold responsibilities laid on nurses: to promote health, to prevent illness, to restore health, and to alleviate suffering. Some indications are given on how nurses can engage in political work.

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CHALLENGES AND OPPORTUNITIES FOR TRAINING AND SUPPORTING AIDES AS MEMBERS OF HOME-BASED CARE TEAMS

Innovation in Aging ◽

10.1093/geroni/igz038.793 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S216-S216

Author(s):

Robyn Stone ◽

Natasha Bryant

Keyword(s):

Home Care ◽

Scope Of Practice ◽

Ability To Work ◽

Training And Education ◽

Team Members ◽

Home Based ◽

Challenges And Opportunities ◽

Competency Based ◽

Care Aides ◽

Home Based Care

Abstract Despite home heath/home care aides being the informal “eyes and ears” of the health system, team-based home care initiatives have not incorporated this workforce into their programs. This presentation summarizes barriers to their inclusion: a basic lack of understanding on the part of clinical team members of the complex tasks these caregivers perform, inadequate investments in competency-based aide training and education, and variation in state nurse delegation laws that limit aides’ scope of practice and their ability to work effectively in teams. This is followed by a review of several programs that have successfully included aides as key members of home care teams. The presentation concludes with recommendations on how federal and state policymakers, educators and health systems and providers can support inclusion of aides in team-based care through standardization of competency-based training programs, expansion of nurse delegation nationwide, and support for piloting, evaluation, dissemination and replication of promising models.

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Where Policy Meets Practice: Employer Perspectives on Scheduling and Hours for Home Care Aides

Journal of Applied Gerontology ◽

10.1177/0733464817739153 ◽

2017 ◽

Vol 38 (11) ◽

pp. 1615-1634 ◽

Cited By ~ 2

Author(s):

Elizabeth Nisbet ◽

Jennifer Craft Morgan

Keyword(s):

Home Care ◽

State Level ◽

Direct Care ◽

Employment Policy ◽

Policy And Practice ◽

Care Services ◽

Home Based ◽

Fair Labor Standards Act ◽

Care Aides ◽

Home Based Care

In a context of growing demand for home-based direct care services, the need to retain direct care workers (DCWs) is clear. The Patient Protection and Affordable Care Act, changes to the Fair Labor Standards Act, and state-level changes in Medicaid support for home-based care together have affected agencies that hire DCWs, with implications for an issue that affects worker satisfaction: scheduling. Many home-based aides employed by agencies cannot count on consistent or sufficient hours. Hours shortfall and instability have been recognized as important issues for retail and restaurant workers, but focused on less for care aides. This study uses semistructured interviews with agency representatives to examine these issues from an employer perspective, with a focus on how the competing influences of health care, labor, and employment policy shape scheduling and a review of how recommendations for changes in policy and practice in other sectors might apply to home care.

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