The Impact of Consolidating AAA on the Delivery of HCBS: Evidence From Iowa

2019 ◽  
Vol 39 (7) ◽  
pp. 751-759
Author(s):  
Kanika Arora ◽  
Sato Ashida ◽  
Erin M. Mobley ◽  
G. Joseph Sample
Keyword(s):  
Older Adults ◽  
Detectable Effect ◽  
American Population ◽  
Community Based ◽  
Mixed Methods Approach ◽  
Average Proportion ◽  
Quasi Experimental ◽  
The Impact ◽  
Community Based Services ◽  
Qualitative Analyses

In this study, the authors evaluate the 2013 consolidation of Iowa’s Area Agencies on Aging (AAA) on the delivery of home and community-based services (HCBS) to older adults in the state. A mixed-methods approach combined a quasi-experimental design using longitudinal service delivery data with qualitative analyses of surveys and interviews with AAA staff and clients. Overall, consolidation had no detectable effect on the proportion of older adults served by the AAAs. Subgroup analysis showed that consolidation increased the average proportion of older adults served in nonmetropolitan counties and the proportion served through congregate meals. AAA staff and clients described both positive and negative aspects of consolidation: better collaboration across agencies, improved consistency in services, significant challenges with completing consolidation processes, and serving expanded geographic areas. As the American population ages and budgetary allocations tighten, findings from this evaluation can inform other states considering similar restructuring efforts.

scholarly journals COVID-19 Lockdown Measures: Impact On Older Adults With Dementia And Their Caregivers In Singapore

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 142-142
Author(s):  
Tharshini Lokanathan ◽  
Hui-Ching Chen ◽  
W Quin Yow
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Family Caregivers ◽  
Support Networks ◽  
Behavioral Changes ◽  
Physical And Mental Health ◽  
Community Based ◽  
Caregiving Stress ◽  
Community Based Services ◽  
Qualitative Analyses

Abstract Family caregivers typically rely on community-based services and social support networks to supplement their caregiving of older adults with dementia (OAwD). In April 2020, the Singapore government implemented a partial lockdown to contain the spread of COVID-19. We assessed the policy's impact on the physical and mental health of caregivers and their OAwD. As part of a larger study, 30 caregivers were interviewed and rated the stress they experienced when caring for an OAwD during the partial lockdown. Qualitative analyses found significant behavioral changes in OAwD such as irritability, aggression and hallucinations, which led some caregivers to believe their dependents’ condition had deteriorated, as well as heightened levels of caregiving stress. Overall, our preliminary results suggested that although social distancing measures may be effective in containing the spread of COVID-19, these measures could lead to negative outcomes on vulnerable populations such as OAwD and their caregivers.

Home First: Exploring the Impact of Community-based Home Care for Older Adults and Their Family Caregivers

2019 ◽  
Vol 39 (3) ◽  
pp. 432-442 ◽  
Author(s):  
Roslyn M. Compton ◽  
Alex Olirus Owilli ◽  
Vera Caine ◽  
Charlotte Berendonk ◽  
Donna Jouan-Tapp ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Family Caregivers ◽  
Adult Population ◽  
Care Home ◽  
Community Based ◽  
Care Processes ◽  
Older Adult Population ◽  
The Impact ◽  
Community Based Services

ABSTRACTGiven the rapidly expanding older adult population, finding health care approaches that support older adults to age in their choice of place, with an accompanying philosophical re-orientation of health services, is becoming more urgent. We studied the Home Care Home First – Quick Response Project to understand how clients over age 75 and their family caregivers perceived the enhanced community-based services delivered through Home First. Using interpretive description as the methodological design, we explored the experiences of eight older adults and 11 family caregivers; all older adults were enrolled in Home First due to a significant change in their health status. We identified four themes: growing older in chosen places with support, philosophy of care, processes of Home First, and the significance of Home First for clients. Overall, clients and family caregivers responded positively to the Home First services. Clients valued their independence and growing older in places they had specifically chosen.

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.

Determining the Long-Term Effectiveness of a Group-Based Physical Activity Program

2018 ◽  
Vol 20 (3) ◽  
pp. 401-408
Author(s):  
Anamica Batra ◽  
Richard C. Palmer ◽  
Elena Bastida ◽  
H. Virginia McCoy ◽  
Hafiz M. R. Khan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Healthy Aging ◽  
Population Level ◽  
The United States ◽  
South Florida ◽  
Community Based ◽  
Evidence Based Programs ◽  
The Impact

Objective. In 2015, only half (48%) of older adults in the United States (≥60 years) reported engaging in any kind of physical activity. Few studies examine the impact of evidence-based programs when adopted in community-based settings. The purpose of this study is to assess the effectiveness of EnhanceFitness (EF) upto 12-months. Method. EF was offered to older adults in South Florida. A total of 222 EF classes were offered between October 2008 and December 2014. Program consisted of a 1-hour session held three times a week. Even though participation was required for 4 months, 1,295 participants continued the program for at least 1 year. Results. All participants showed significant improvement in outcome measures. A mean change of 1.5, 1.7, and 1.9 was seen in number of chair stands at 4, 8, and 12 months (p < .001), respectively. The number of arm curls performed improved from 16.8 at baseline to 18.8, 18.8, and 19.2 at 4-, 8-, and 12-months, respectively. Participants improved their up-and-go time by decreasing from 9.1 (baseline) to 8.7 (4 months) to 8.6 (12 months; p = .001). Discussion. Randomized controlled trials are commonly used to determine the efficacy of an intervention. These interventions when disseminated at the population level have the potential to benefit large masses. EF is currently offered at more than 700 locations. This tremendous success of EF brings attention to an important question of continuous monitoring of these programs to ensure program consistency and intended outcomes. The model used by the Healthy Aging Regional Collaborative could be replicated by other communities.

scholarly journals ELDER ABUSE AMID THE OPIOID EPIDEMIC: APS CASES IN RURAL AMERICA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S763-S763
Author(s):  
Pamela B Teaster ◽  
Karen A Roberto ◽  
Jyoti Savla
Keyword(s):  
Older Adults ◽  
Elder Abuse ◽  
Standard Errors ◽  
Opioid Misuse ◽  
Rural America ◽  
Opioid Use ◽  
Care Needs ◽  
Community Based ◽  
Community Based Services ◽  
Physical Care

Abstract Older adults are hidden victims of the opioid crises, suffering abuse at the hands of those who seek resources to support their addiction. Using APS data from 2015-2017 provided by the Kentucky Department for Community-Based Services, we used a logistic regression model with robust standard errors to examine whether substantiated cases of elder abuse were associated with opioid misuse by perpetrators. Overall, 9% of the 462 substantiated cases over the three-year period involved perpetrators were substance users. The percentage of these cases rose from 5% in 2015 to 13% in 2016 before dropping to 7% of elder abuse cases in 2017. Opioid use was most prevalent among perpetrators of financial abuse of older adults with cognitive and/or physical care needs. The current study offers a first look at empirical linkages between opioid misuse and elder abuse and revealed consistencies across cases that call for further investigation.

scholarly journals THE IMPACT OF THE OPIOID EPIDEMIC ON OLDER ADULTS: FINDINGS FROM A NATIONAL SURVEY OF COMMUNITY-BASED ORGANIZATIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S738-S738
Author(s):  
Kathleen A Cameron ◽  
Lauren E Popham ◽  
Angelica Herrera-Venson
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
National Survey ◽  
National Council ◽  
Opioid Epidemic ◽  
Opioid Misuse ◽  
Strategic Partnerships ◽  
Community Based ◽  
Community Based Organizations ◽  
The Impact

Abstract The National Council on Aging (NCOA) conducted a national survey of community-based organizations (CBOs) in early 2019 to better understand how older adults, people with disabilities, and their caregivers are affected by the opioid epidemic and identify new resources and tools needed by CBOs to better serve their community needs. Specifically, the survey asked about the extent to which CBOs’ service delivery and level of effort has changed as a result of the opioid epidemic; unique issues reported by this population, directly or indirectly resulting from opioid misuse by them or loved ones; how organizations screen and refer older adults and individual with disabilities for support associated with opioid misuse; how organizations may be connecting with local or state initiatives addressing the opioid epidemic, or forming strategic partnerships to respond to emerging client needs; and pinpoint gaps in resources that may help organizations to more effectively respond to these issues. Over 200 organizations, representing urban, suburban and rural communities, responded to the survey and included senior centers, area agencies on aging, Senior Health Insurance Assistance Programs, as well as health care organizations. Seventy percent of organizations report spending more effort to address the needs of older adults/caregivers who are adversely affected by opioid misuse/abuse since 2 years ago. Common health and financial concerns, current strategies related to screening, partnership development, and educational programming as reported by CBOs will be presented. This session will include a discussion of opportunities to assist CBOs address the opioid-related needs of their older adult clients.

scholarly journals THE INTERSECTION OF ETHICS AND VULNERABLE ELDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S238-S238
Author(s):  
Pamela B Teaster ◽  
Georgia Anetzberger
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Ethical Issues ◽  
Elder Abuse ◽  
Cognitive Status ◽  
Ethical Challenges ◽  
Community Based ◽  
Conducting Research ◽  
Definition Of ◽  
Community Based Services

Abstract Researchers, practitioners and policymakers are daily confronted with multiple and competing situations regarding vulnerable older adults and the complex issues that they face in all aspects of their lives. Challenges can arise in the provision of social services, dispensing justice, conducting research, or addressing legal issues. The purpose of this symposium is to discuss dilemmas that vulnerable older adults and concerned others face by elucidating current and future challenges facing this population, particularly in the realms of compromised health (cognitive impairment); effective status (gender); care arrangements (home and community-based services); and abuse, neglect, and exploitation. Teaster and Anetzberger discuss relevant ethical theories and principles as well as a definition of vulnerability. Santos and Nichols-Hadeed report on ethical issues embedded in vulnerable elders’ cognitive status. Bowland and Halaas highlight the intersection of ethics, gender and vulnerable elders. Niles-Yokum and Beaumaster discuss the nexus of ethics and the provision of home and community based services for vulnerable older adults. Heisler considers vulnerabilities of older adults and ethical challenges when addressing elder abuse. Throughout the papers, we weave the ethical principles of autonomy, beneficence, nonmaleficence, and justice.

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