scholarly journals Eliciting the educational needs and priorities of home care workers on end-of-life care for patients with heart failure using nominal group technique

2021 ◽  
pp. 026921632199996
Author(s):  
Dawon Baik ◽  
Peggy B Leung ◽  
Madeline R Sterling ◽  
David Russell ◽  
Lizeyka Jordan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Home Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Life Care ◽  
Care Workers ◽  
Patients With Heart Failure ◽  
Home Care Workers

Background: Home care workers, as paid caregivers, assist with many aspects of home-based heart failure care. However, most home care workers do not receive systematic training on end-of-life care for heart failure patients. Aim: To elicit the educational needs and priorities of home care workers caring for community- dwelling adults with heart failure at the end-of-life. Design: Nominal group technique involving a semi-quantitative structured group process and point rating system was used to designate the importance of priorities elicited from home care workers. Individual responses to the question, “ If you have ever cared for a heart failure patient who was dying (or receiving end-of-life care on hospice), what are some of the challenges you faced?”, were aggregated into categories using directed content analysis methods. Setting/Participants: Forty-one home care workers were recruited from a non-profit training and education organization in New York City. Results: Individual responses to the question were aggregated into five categories: (1) how to cope and grieve; (2) assisting patients with behavior changes, (3) supporting patients to improve their quality of life, (4) assisting patients with physical symptom management, and (5) symptom recognition and assessment. Conclusions: Our findings confirm the need for the formal development and evaluation of an educational program for home care workers to improve the care of heart failure patients at the end-of-life. There is also a need for research on integrating home care workers into the interprofessional healthcare team to support optimal health outcomes for patients with heart failure.

scholarly journals HEART-FAILURE TRAINING FOR HOME CARE WORKERS IN NEW YORK CITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S216-S216
Author(s):  
Madeline Sterling ◽  
Peggy Leung
Keyword(s):  
Heart Failure ◽  
New York ◽  
New York City ◽  
Home Care ◽  
York City ◽  
Nominal Group Technique ◽  
Community Dwelling ◽  
Nominal Group ◽  
Care Workers ◽  
Home Care Workers

Abstract Home care workers (HCWs), which include home health aides and personal care aides, are increasingly being used by community dwelling adults with heart failure (HF) for long-term assistance and post-acute care. Findings from our prior research suggest that HCWs are deeply involved in many aspects of HF patients’ self-care, including HF maintenance and management, but the majority have not received any HF training or HF-specific resources. Due to this, many HCWs do not feel confident caring for their clients with HF. In this symposium, we will present the findings of a qualitative study that used a nominal group technique to elicit the educational needs of 40 English and Spanish speaking agency-employed HCWs caring for HF patients in New York City. We will also present an overview of the HF training course that was developed from this data and its effect on HCWs’ HF knowledge and caregiving self-efficacy.

scholarly journals The need for flexibility when negotiating professional boundaries in the context of home care, dementia and end of life

2018 ◽  
Vol 39 (9) ◽  
pp. 1976-1995 ◽  
Author(s):  
RUTH ABRAMS ◽  
TUSHNA VANDREVALA ◽  
KRITIKA SAMSI ◽  
JILL MANTHORPE
Keyword(s):  
Home Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Working Environment ◽  
Care Staff ◽  
Life Care ◽  
Professional Boundaries ◽  
Emotional Labour ◽  
Care Workers ◽  
Home Care Workers

ABSTRACTProfessional boundaries may help care staff to clarify their role, manage risk and safeguard vulnerable clients. Yet there is a scarcity of evidence on how professional boundaries are negotiated in a non-clinical environment (e.g. the home) by the home-care workforce in the context of complex care needs (e.g. dementia, end-of-life care). Through analysis of semi-structured interviews, we investigated the experiences of home-care workers (N = 30) and their managers (N = 13) working for a range of home-care services in the South-East and London regions of England in 2016–17. Findings from this study indicate that home-care workers and their managers have clear perceptions of job role boundaries, yet these are modified in dementia care, particularly at end of life which routinely requires adaptability and flexibility. As a lone worker in a client's home, there may be challenges relating to safeguarding and risk to both clients and workers. The working environment exacerbates this, particularly during end-of-life care where emotional attachments to both clients and their family may affect the maintenance of professional boundaries. There is a need to adopt context-specific, flexible and inclusive attitudes to professional boundaries, which reconceptualise these to include relational care and atypical workplace conventions. Pre-set boundaries which safeguard clients and workers through psychological contracts may help to alleviate to some extent the pressure of the emotional labour undertaken by home-care workers.

scholarly journals Development and effectiveness of advance care planning protocol for heart failure outpatients

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
AH Higashitsuji ◽  
SO Okada ◽  
YF Fujisawa ◽  
MS Sano ◽  
NT Taguchi ◽  
...  
Keyword(s):  
Heart Failure ◽  
End Of Life ◽  
End Of Life Care ◽  
Home Visit ◽  
Decision Makers ◽  
Care Planning ◽  
Life Care ◽  
Patients With Heart Failure ◽  
Surrogate Decision Makers ◽  
Surrogate Decision

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Heart failure has a poor prognosis, and the number of patients continues to increase. Moreover, since it is a disease that causes various sufferings, substantial end-of-life care is needed. Advanced care planning (ACP) is a part of end-of-life care for patients with heart failure. ACP provides patient decision-making opportunities, documenting end-of-life preferences, and increasing end-of-life conversation. However, the ACP intervention for patients with heart failure is not integrated, and studies are insufficient. In addition, Japan follows a non-Western culture, in which participation in the medical decision-making is reluctant and considered to be less prepared for ACP. Clarifying the effects of systematic ACP on patients with heart failure in Japan can be used to determine effective interventions in Japan and may provide effective ACP intervention for patients who have no preparedness worldwide. Purpose This study aimed to identify the effect of protocol-based intervention on the outcomes of ACP in Japanese outpatients with heart failure. Methods This is a single-center retrospective observational study. Data on patient attributes, conversation records, and document information from medical records of patients who have undergone intervention using the predeveloped ACP protocol were collected. Numerical data were statistically analyzed. ACP results were evaluated by performing deductive content analysis on the basis of existing frameworks. A subgroup analysis was performed on differences in ACP outcomes based on patient attributes. Results Data were collected from 13 patients who underwent ACP intervention. The median age was 69 years. Moreover, 76% were male, 84% were married, 76% were living with family, and 46% were receiving home-visit nursing care. New York Heart Association functional classification II was the most common in the severity classification of heart failure, and ischemic cardiomyopathy was the most common etiology. Documenting patient’s wishes, recording patient’s wishes in medical record, and identifying what brings value to patient"s life were achieved in 76% of the participants. Deciding surrogate decision makers, discussing values and care preferences with the surrogate, and discussing values and care preferences with health care professionals were achieved in 69% of the participants. Differences in patient attributes, such as age and presence or absence of home-visit nursing, did not affect ACP outcomes. Conclusion Protocol-based ACP allows patients with heart failure to determine surrogate decision makers and discuss care preferences with healthcare professionals, identify what they value, and record their wishes. The protocol-based ACP had a positive impact on ACP outcomes, without being restricted by patient attributes.

scholarly journals End-of-Life Care in Patients with Heart Failure

2018 ◽  
Vol 56 (6) ◽  
pp. e114
Author(s):  
Patrick Theodore Souccar ◽  
Daniel Neves Forte ◽  
Ludhmila Abrahão Hajjar ◽  
Roberta Saretta ◽  
Roberto Kalil Filho
Keyword(s):  
Heart Failure ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Patients With Heart Failure

scholarly journals Management of Heart Failure in Patients Nearing the End of Life–There is So Much More To Do

2015 ◽  
Vol 1 (1) ◽  
pp. 31
Author(s):  
Lisa LeMond ◽  
Sarah J Goodlin ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Decision Making ◽  
End Of Life ◽  
Medical Therapy ◽  
Symptom Management ◽  
End Of Life Care ◽  
Life Care ◽  
Additive Process ◽  
Number Of Patients ◽  
Patients With Heart Failure

As the population of patients living with heart failure increases, the number of patients who will die with and from heart failure increases as well. End-of-life care in patients with heart failure is an additive process, whereby therapies to treat symptoms not alleviated by guideline-based medical therapy are integrated into the care of these individuals. This review focuses on providing clinicians with a basic framework for administration of end-of-life care in patients with heart failure, specifically focusing on decision-making, symptom management and functional management.

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