Caregiver Reward and Burden: Differing Constructs in Family Members Providing Care for Medically Ill Homebound Older Adults

2019 ◽  
Vol 32 (5-6) ◽  
pp. 361-370
Author(s):  
Victoria M. Wilkins ◽  
Jo Anne Sirey ◽  
Martha L. Bruce
Keyword(s):  
Older Adults ◽  
Caregiver Burden ◽  
Home Health Care ◽  
Health Care Services ◽  
Caregiver Support ◽  
Medically Ill ◽  
Care Services ◽  
Homebound Older Adults ◽  
Caregiver Interventions ◽  
The Individual

Objective: This study examined the relationship between caregiver burden and reward and how each relates to factors, such as depression, within the caregiving dyad. Method: A total of 101 older adults and their primary family caregivers were recruited upon enrolling in home health care services. Patients were assessed for sociodemographic information, depression, disability, pain, and caregiver support at baseline and at 8 weeks. Caregivers were assessed at baseline for sociodemographic information, depression, caregiver burden, caregiver reward, and caregiving tasks they provide. Results: Burden and reward were significantly inversely correlated, but differentially associated with distinct patient and caregiver variables. Patients whose caregivers reported higher baseline levels of caregiver reward were more likely to have lower depression scores at follow-up. Discussion: Given that different aspects of patients and caregivers influence reward and burden, assessing caregivers for both burden and reward may better target caregiver interventions at the individual and family levels, particularly for older adult depression.

scholarly journals A qualitative study of home health care experiences among Chinese homebound adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rui Zhou ◽  
Joyce Cheng ◽  
Shuangshuang Wang ◽  
Nengliang Yao
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Qualitative Study ◽  
Home Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Technical Skills ◽  
Home Health ◽  
Care Services ◽  
Homebound Older Adults

Abstract Background Home health care services (HHC) are emerging in China to meet increased healthcare needs among the homebound population, but there is a lack of research examining the efficiency and effectiveness of this new care model. This study aimed to investigate care recipients’ experiences with HHC and areas for improvement in China. Methods This research was a qualitative study based on semi-structured interviews. Qualitative data were collected from homebound adults living in Jinan, Zhangqiu, and Shanghai, China. A sample of 17 homebound participants aged 45 or older (mean age = 76) who have received home-based health care were recruited. Conceptual content analysis and Colaizzi’s method was used to generate qualitative codes and identify themes. Results The evaluations of participants’ experiences with HHC yielded both positive and negative aspects. Positive experiences included: 1) the healthcare delivery method was convenient for homebound older adults; 2) health problems could be detected in a timely manner because clinicians visited regularly; 3) home care providers had better bedside manners and technical skills than did hospital-based providers; 4) medical insurance typically covered the cost of home care services. Areas that could potentially be improved included: 1) the scope of HHC services was too limited to meet all the needs of homebound older adults; 2) the visit time was too short; 3) healthcare providers’ technical skills varied greatly. Conclusions Findings from this study suggested that the HHC model benefited Chinese older adults—primarily homebound adults—in terms of convenience and affordability. There are opportunities to expand the scope of home health care services and improve the quality of care. Policymakers should consider providing more resources and incentives to enhance HHC in China. Educational programs may be created to train more HHC providers and improve their technical skills.

scholarly journals A Qualitative Study of Healthcare Experiences Among Chinese Homebound Adults Receiving Home Health Care Services

2020 ◽  
Author(s):  
Rui Zhou ◽  
Joyce Cheng ◽  
Shuangshuang Wang ◽  
Nengliang (Aaron) Yao
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Qualitative Study ◽  
Home Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Technical Skills ◽  
Home Health ◽  
Care Services ◽  
Homebound Older Adults

Abstract Background: Home health care services (HHC) are emerging in China to meet increased healthcare needs among the homebound population, but research examining the efficiency and effectiveness of this new care model is rare. This study aimed to investigate care recipients’ experiences with HHC and areas for improvement in China.Methods: This research was a qualitative study based on semi-structured interviews. Qualitative data were collected from homebound adults living in Jinan, Zhangqiu, and Shanghai, China. A sample of 17 homebound participants aged 45 or older (mean age = 76) who have received home-based clinical care were recruited. Colaizzi’s descriptive phenomenological method was used to generate qualitative codes and identify themes.Results: The evaluations of participants’ experiences with HHC yielded both positive and negative aspects. Positive experiences included: 1) the healthcare delivery method was convenient for homebound older adults; 2) health problems could be detected in a timely manner because doctors visited regularly; 3) home care providers had better bedside manners and technical skills than did hospital-based providers; 4) medical insurance typically covered the cost of home care services. Areas that could potentially be improved included: 1) the scope of HHC services was too limited to meet all the needs of homebound older adults; 2) the visit time was too short; 3) healthcare providers’ technical skills varied greatly.Conclusions: Findings from this study suggested that the HHC model benefited Chinese older adults, primarily homebound adults, in terms of convenience and affordability. There are opportunities to expand the scope of home health care services and improve the quality of care. Policymakers may consider providing more resources and incentives to enhance HHC in China. Educational programs may be created to train more HHC providers and improve their technical skills.Trial registration: Not applicable

scholarly journals Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services

2017 ◽  
Vol 15 (1) ◽  
pp. 20-26
Author(s):  
Guillermina R. Solis ◽  
Jane Dimmitt Champion
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Home Health Care ◽  
Fall Risk ◽  
Health Care Services ◽  
Home Care Services ◽  
Recurrence Risk ◽  
The United States ◽  
Care Services ◽  
Risk Of Fall

Introduction: Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person’s quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. Method: A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. Results: A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Conclusion: Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

The association among knowledge of and confidence in home health care services, acculturation, and family caregivers' relationships to older adults of Mexican descent

2018 ◽  
Vol 39 (6) ◽  
pp. 689-695
Author(s):  
Janice D. Crist ◽  
Mary Lee Montgomery ◽  
Alice Pasvogel ◽  
Linda R. Phillips ◽  
Evangeline M. Ortiz-Dowling
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Family Caregivers ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Health ◽  
Mexican Descent ◽  
Care Services

scholarly journals Timing of Home Health Care Initiation and 30-Day Rehospitalizations among Medicare Beneficiaries with Diabetes by Race and Ethnicity

2021 ◽  
Author(s):  
Jamie M. Smith ◽  
Olga F. Jarrín ◽  
Haiqun Lin ◽  
Charlotte Thomas-Hawkins ◽  
Jennifer Tsui
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Health ◽  
Urban Setting ◽  
Medicare Beneficiaries ◽  
Timely Initiation ◽  
Care Services ◽  
Racial Ethnic

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. Building on prior findings of racial/ethnic disparities in post-acute referral and utilization of home health, this study examined timing of home health care initiation and 30-day rehospitalization outcomes. Using linked Medicare administrative, assessment, and claims datasets (2014-2016), we identified 209,150 Medicare beneficiaries, age 50 and older, who were referred to post-acute home health following a diabetes-related index hospitalization. Multivariate logistic regression models included patient demographics, neighborhood area deprivation, and rural/urban setting. Home health care initiated within one week was associated with lower risk of 30-day rehospitalization (days 0-2, OR=0.88, 95% CI 0.86-0.91; days 3-7, OR=0.87, CI 0.84-0.90). In contrast, a late start of services (days 8-14) was associated with a higher risk of 30-day rehospitalization (OR=2.2, CI 2.0-2.3). This pattern of results was observed across all racial/ethnic patient groups. However, racial/ethnic minority patients were less likely to receive timely home health care services compared to white patients. Timely initiation and coordination of home health care is one strategy to improve outcomes following diabetes-related hospitalizations that benefits older adults of all racial/ethnic groups.

scholarly journals HOME HEALTH CARE AS A PREDICTOR OF SURVIVAL AMONG PEOPLE LIVING WITH ALZHEIMER’S DISEASE AND RELATED DEMENTIAS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S823-S823
Author(s):  
Olga F Jarrín ◽  
Abner Nyandege ◽  
Irina B Grafova
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Assisted Living ◽  
Health Care Services ◽  
Home Health ◽  
Living Environment ◽  
Administrative Claims ◽  
Risk Of Death ◽  
Care Services ◽  
The Individual

Abstract Over the past 10 years, dementia care has been shifting to the community; however, there are significant regional and sociodemographic differences in the use of formal home health care services. Does the use of home health care improve survival and other outcomes among people diagnosed with dementia? The aim of the study was to determine the individual, societal, and health systems predictors of survival after a diagnosis of dementia. Using linked Medicare administrative, claims, and assessment data (N = 4,349,565); we found that home health care significantly reduced risk of death for males, but not females. This effect was strongest among older adults between the ages of 65 and 80. While men who were living alone or in a congregate/assisted living environment benefited the most (O.R. = 0.87) the effect was also strong for men living with a spouse or other caregiver (O.R. = 0.90). These findings suggest home health care may provide a survival advantage for men through the provision of rehabilitative and supportive services, as well as patient and family caregiver education. Further research is needed to understand if sex based survival differences are associated with the intensity of home health care services provided or social determinants of health.

scholarly journals Access to Five Nonprimary Health Care Services by Homebound Older Adults: An Integrative Review

2018 ◽  
Vol 31 (1) ◽  
pp. 55-69
Author(s):  
Cynthia Sterling-Fox
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Integrative Review ◽  
Future Research ◽  
Care Providers ◽  
Care Services ◽  
Homebound Older Adults ◽  
The Impact

Globally, the number of homebound older adults is rising exponentially as the aging population increases. Homebound older adults have complex medical and psychological issues for which many receive home-based primary care services. The purpose of this integrative review was to identify, analyze, and synthesize the existing literature regarding homebound older adults’ need for, use of, and access to five nonprimary health care services. They are dental, nutritional, optical, pharmacy, and psychological services. The integrative review was conducted using a database search of CINAHL, Health Source: Nursing Education, PubMed, Medline, PsycINFO, and Cochrane, that was supplemented by a hand search. Little research was found addressing the five nonprimary health care services. Five themes emerged from the 10 studies. They were (1) complex and interrelated health problems require more health care services; (2) perceived unimportance of nonprimary health care services; (3) barriers to use of and access to nonprimary health care services; (4) the impact of socioeconomic and demographical factors on access to services; and (5) the impact of psychological factors (depression and social isolation) on the use and access to health care services. These findings suggest further inequity and barriers to health care services by homebound older adults. Future research is needed with nonprimary health care providers to examine the clinical outcomes and costs of providing the services to homebound older adults.

Differences in Transitional Care Provided to Mexican American and Non-Hispanic White Older Adults

2016 ◽  
Vol 28 (2) ◽  
pp. 159-167 ◽  
Author(s):  
Janice D. Crist ◽  
Kari M. Koerner ◽  
Joseph T. Hepworth ◽  
Alice Pasvogel ◽  
Catherine A. Marshall ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Transitional Care ◽  
Insurance Coverage ◽  
Home Health ◽  
Hospital Length Of Stay ◽  
Care Services ◽  
Hispanic White

Background:Transitional care, assisting patients to move safely through multiple health care settings, may be insufficient for older Hispanic patients. Purpose: Describe home health care services referral rates for Hispanic and non-Hispanic White (NHW) patients and factors that influence case managers’ (CMs’) discharge planning processes. Design: Organized by the Ethno-Cultural Gerontological Nursing Model, health records were reviewed ( n = 33,597 cases) and supplemented with qualitative description ( n = 8 CMs). Findings: Controlling for gender, insurance type, age, and hospital length of stay, NHW older adults received more home health care services referrals (odds ratio = 1.23). Insurance coverage was the most frequent determinant of CMs’ post–hospital care choices, rather than patients’ being Hispanic. NHW older adults were more likely to have insurance than Hispanic older adults. Implications: Insurance coverage being CMs’ primary consideration in determining patients’ dispositions is a form of systems-level discrimination for Hispanic vulnerable groups, which combined with other hospital-level constraints, should be addressed with policy-level interventions.

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