“Doing the Right Thing”: Family Caregivers Managing Medical and Nursing Tasks in the Postacute Home Health Care Setting

2020 ◽  
pp. 073346482096125
Author(s):  
Jo-Ana D. Chase ◽  
David Russell ◽  
Daniel B. Kaplan ◽  
Michael V. Bueno ◽  
Rungnapha Khiewchaum ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Family Caregivers ◽  
Health Care System ◽  
Home Health Care ◽  
Home Health ◽  
Future Research ◽  
Emotional Impact ◽  
Care Needs ◽  
Care System

Family caregivers often manage complex medical and nursing tasks (MNTs) for older adults transitioning from hospital to home. To explore caregivers’ experiences managing MNTs in the postacute home health care (HHC) setting, we interviewed by phone 20 caregivers of older adults who received HHC following a hospitalization. Interviews were recorded, transcribed, and analyzed using directed content analysis. Caregivers highlighted the technical complexity and emotional impact of performing MNTs, as well as social (e.g., family, friends) and environmental (e.g., neighborhood, housing) resources they leveraged to meet the older adults’ care needs. Caregivers also identified challenges coordinating care and services within HHC and the larger health care system. Caregiver engagement in the postacute HHC setting should incorporate tailored training and support, assessments of socioenvironmental context and resources, and facilitated navigation of the health care system. Future research should elucidate factors associated with successful collaborative relationships among HHC providers, older adults, and their caregivers in the postacute HHC setting.

scholarly journals Caregivers’ Experiences Regarding Training and Support in the Post-Acute Home Health-Care Setting

2019 ◽  
Vol 7 (4) ◽  
pp. 561-569
Author(s):  
Jo-Ana D Chase ◽  
David Russell ◽  
Meridith Rice ◽  
Carmen Abbott ◽  
Kathryn H Bowles ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Family Caregivers ◽  
Learning Strategies ◽  
Home Health Care ◽  
Home Health ◽  
Barriers To Learning ◽  
Telephone Interviews ◽  
Qualitative Descriptive ◽  
Training And Support

Background: Post-acute home health-care (HHC) services provide a unique opportunity to train and support family caregivers of older adults returning home after a hospitalization. To enhance family-focused training and support strategies, we must first understand caregivers’ experiences. Objective: To explore caregivers’ experiences regarding training and support for managing older adults’ physical functioning (PF) needs in the post-acute HHC setting. Method: We conducted a qualitative descriptive study using semi-structured telephone interviews of 20 family caregivers. Interviews were recorded, transcribed, and analyzed using conventional content analysis. Results: We identified the following primary categories: facilitators to learning (eg, past experience, learning methods), barriers to learning (eg, learning on their own, communication, timing/logistics, preferred information and timing of information delivery), and interactions with HHC providers (eg, positive/negative interactions, provider training and knowledge). Conclusion: Caregivers were responsive to learning strategies to manage older adults’ PF needs and, importantly, voiced ideas to improve family-focused training and support. HHC providers can use these findings to tailor training and support of family caregivers in the post-acute HHC setting.

Dialogue Experiment for Elderly People in Home Health Care System

2003 ◽  
pp. 418-423 ◽  
Author(s):  
Shin-ya Takahashi ◽  
Tsuyoshi Morimoto ◽  
Sakashi Maeda ◽  
Naoyuki Tsuruta
Keyword(s):  
Health Care ◽  
Elderly People ◽  
Health Care System ◽  
Home Health Care ◽  
Home Health ◽  
Care System

scholarly journals A PROFILE OF CAREGIVING AMONG SEPSIS SURVIVORS RECEIVING POST-ACUTE HOME HEALTH CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S218-S218
Author(s):  
Jo-Ana D Chase ◽  
Christina R Whitehouse ◽  
Lizeyka Jordan ◽  
Kathryn H Bowles
Keyword(s):  
Health Care ◽  
Hospital Discharge ◽  
Home Health Care ◽  
Medication Administration ◽  
Home Health ◽  
Future Research ◽  
Medical Procedures ◽  
Care Needs ◽  
Sepsis Survivors ◽  
Training And Support

Abstract Sepsis survivors transitioning from hospital-to-home are clinically complex. Family caregivers can face challenges managing patients’ care needs; however, skilled home health care (HHC) can serve as an important resource during this care transition. This study’s purpose was to describe caregiving needs among older sepsis survivors receiving post-acute HHC, and identify sources of unmet caregiving needs. We conducted a retrospective analysis of a national dataset of Medicare beneficiaries starting a new HHC episode who were after hospital discharge for sepsis between 2013 and 2014 (n=165,228). All patients received at least one HHC visit the first week after hospital discharge. Caregiving activities included seven items from the start of care Outcome and Assessment Information Set. Descriptive statistics were used to examine types of caregiving activities and needs, demographics, and clinical information. Proportions of patients with unmet caregiving needs ranged from 9%-29%, with the largest proportion of unmet needs in activities of daily living (ADL) assistance (29%), medication administration (28%), and medical procedures/treatments (25%). Unmet caregiving needs across activities were largely due to a caregiver needing training/supportive services (75%-88%), suggesting that many sepsis survivors receiving HHC have caregivers who are available to help, but who lack the knowledge and skills to manage patients’ complex care needs. Thus, HHC providers should address caregiving training and support needs, especially related to assistance with ADLs, medication administration, and medical procedures/treatments. Future research is needed to determine specific educational strategies for caregiver training and support, especially related to skills and knowledge assessment, and training delivery and monitoring.

Older Adult Factors Associated With Identified Need for Family Caregiver Assistance During Home Health Care

2019 ◽  
Vol 32 (2) ◽  
pp. 67-75 ◽  
Author(s):  
Julia Burgdorf ◽  
Alicia Arbaje ◽  
Jennifer L. Wolff
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Activities Of Daily Living ◽  
Family Caregivers ◽  
Older Adult ◽  
Home Health Care ◽  
Family Caregiver ◽  
Daily Living ◽  
Home Health ◽  
Clinical Severity

Family caregivers make important contributions to home health care for older adults, but knowledge of the specific roles they assume is lacking. We analyzed data from 1,758 community-dwelling Medicare beneficiaries aged 65+ receiving Medicare-funded home health care between 2011 and 2016, using linked National Health and Aging Trends Study and Outcomes and Assessment Information Set data. Most (86.7%) beneficiaries receiving home health care had an identified need for family caregiver assistance, and nearly 6 in 10 (57.9%) had identified need for caregiver assistance with five or more tasks. After examining significant associations between older adult characteristics and identified needs for caregiver assistance with specific tasks, we identified three profiles of older adults who demonstrate similar patterns of identified need for family caregiver assistance during home health. These profiles include: (1) older adults with greater functional impairment who more often had identified need for assistance with Instrumental Activities of Daily Living, advocacy, or Activities of Daily Living; (2) older adults with cognitive impairment who more often had identified need for assistance with medication administration or supervision; and (3) older adults with greater clinical severity who more often had identified need for assistance with medical procedures and equipment. Findings support calls to develop training interventions and strengthen the partnership between home health providers and family caregivers. These three profiles present a potential framework for the development of family caregiver training programs.

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