scholarly journals The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study

2020 ◽  
pp. 107755872096090
Author(s):  
Nancy Dudley ◽  
Jacqueline Miller ◽  
Mary Lou Breslin ◽  
Susan A. Chapman ◽  
Joanne Spetz

The objective of this study was to explore how home care workers and the agencies that employ them interact with their state’s nurse practice act in the provision of care. Using a qualitative case study approach, we selected four states with varying levels of restrictiveness in their nurse delegation regulations. We conducted interviews ( N = 45) with state leaders, agency leaders, and home care workers to learn how these policies affect the home care workforce’s ability to perform care tasks for their clients in order to allow clients to remain in their own homes. We found that increased training and input from registered nurses is needed to identify appropriate health maintenance tasks to delegate to home care workers and support development of training strategies. The federal government could support the development of evidence-based guidelines for training and competency testing as well as for appropriate delegation of health maintenance tasks.

Author(s):  
Teemu Rantanen ◽  
Teppo Leppälahti ◽  
Jaakko Porokuokka ◽  
Sari Heikkinen

Technological advances in elderly care have been rapid, and the introduction of robots in care will be a topical issue in the near future. There has been little research into the possibility of influencing care workers’ attitudes towards robots by project activities, and how to make the change easier for work communities. This study focuses on a robotics project that took place in elderly and home care services in one municipality in Finland (total of 45 care workers). During the project, four robotics workshops and one extended pilot session were implemented. The study follows quasi-experimental settings, and it included two measurements (before and after project activities) and a control group, but no randomization. The data were collected by questionnaires and were analyzed statistically. The project under study brought about minor positive changes in home care workers’ attitudes towards the usefulness of care robots. In the final measurement, the difference between the test group and the control group was significant in the two dimensions of positive attitudes. The research supports the hypothesis that project activities can be used to influence home care workers’ attitudes towards robots. This can also facilitate the introduction of care robots in home care services. However, the construction of a technology-positive care culture is a long-term process, which requires training and development, technological development and strong strategic management at various levels.


2009 ◽  
Vol 21 (4) ◽  
pp. 779-786 ◽  
Author(s):  
Liat Ayalon

ABSTRACTBackground: Foreign home care services provided to frail older adults by individuals from the developing world are a global phenomenon. This study evaluated the challenges associated with live-in foreign home care from the perspective of older care recipients and their family members.Methods: Qualitative interviews were conducted with 23 family members and seven older care recipients. Interviews were analyzed thematically.Results: Three main themes were identified: (i) the intense fears associated with witnessing the decline of the older care recipient and the subsequent employment of a foreign home care worker; (ii) actual negative experiences within this caregiving setting; and (iii) the ways in which family members and older care recipients coped with these challenging experiences.Conclusions: The key to this caregiving arrangement is the establishment of trust. Yet, many care recipients experienced violations of trust that resulted in abuse and neglect, which served to further intensify fears and concerns about this caregiving arrangement. The same coping methods used to maintain this arrangement, despite fears and concerns, are the ones responsible for maintaining the older care recipient in an abusive situation.


2017 ◽  
Vol 26 (2) ◽  
pp. 418-424
Author(s):  
Paul C Treacy ◽  
Douglas MacKay

In June 2016, a US Department of Labor rule extending minimum wage and overtime pay protections to home care workers such as certified nursing assistants and home health aides survived its final legal challenge and became effective. However, Medicaid officials in certain states reported that during the intervening decades when these protections were not in place, their states had developed a range of innovative services and programs providing home care to people with disabilities—services and programs that would be at risk if workers were newly owed minimum wage and overtime pay. In this article, we examine whether the Department of Labor was right to extend these wage protections to home care workers even at the risk of a reduction in these home care services to people with disabilities. We argue that it was right to do so. Home care workers are entitled to these protections, and, although it is permissible under certain conditions for government to infringe workers’ occupational rights and entitlements, these conditions are not satisfied in this case.


2019 ◽  
Vol 3 (4) ◽  
pp. 567-583
Author(s):  
Jill Manthorpe ◽  
Tushna Vandrevala ◽  
Ruth Abrams ◽  
Kritika Samsi

Caring for people with dementia often necessitates inter-professional and inter-agency working but there is limited evidence of how home care staff work as a team and with professionals from different agencies. Through analysis of semi-structured interviews, we explored the experiences of home care workers (n = 30) and managers of home care services (n = 13) in England (2016‐17). Both groups sought to collaboratively establish formal and informal practices of teamwork. Beyond the home care agency, experiences of interacting with the wider health and care workforce differed. More explicit encouragement of support for home care workers is needed by other professionals and their employers.


2021 ◽  
Vol 13 (13) ◽  
pp. 7277
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Paolo Fabbietti ◽  
Giovanni Lamura

The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were reported. Seven clusters were identified, reflecting different combinations of changes in the formal/informal care provision. In most countries, informal care is more resilient than home care services that formal providers deliver. Since they are an essential source for sustainable care, their challenges related to care should be addressed. The impact of the pandemic does not follow the traditional characterization of welfare regimes. A clustering effort may yield more understanding of the priorities that future care policies should exhibit at the national level and may identify potential systems for policymakers to enhance sustainability of care for community-dwelling older adults.


1987 ◽  
Vol 77 (2) ◽  
pp. 209-210 ◽  
Author(s):  
D A Snow ◽  
L S Kleinman

2018 ◽  
Vol 31 (1) ◽  
pp. 30-34
Author(s):  
Mahcube Cubukcu

This study aims to evaluate the impact of urinary incontinence on the quality of life in those receiving home care services and the factors that influence this. This cross-descriptive study was performed in 180 patients who were served from Home Care Services between 01 and 28 February 2018. An International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) was implemented in person to those who gave their informed consent with orientation and cooperation. The mean age of a 180 patients was 74.40 ± 7.80 years (min = 18, max = 104), of which 55.2% were women. The mean ICIQ-SF score was found to be 12.42 ± 4.83 (min = 0, max = 21). The lowest points were given as responses to the question, “In your opinion, what amount of leakage do you experience?” The highest points, however, were given to the question of “How much does urinary leakage interfere with your everyday life?” It was seen that when quality of life is assessed with a visual analog scale within the ICIQ-SF, the quality of life for 66.6% of elderly individuals was affected moderately or significantly. The mean ICIQ-SF scores were higher in those with chronic diseases ( p < .005). Urinary Incontinence negatively affects quality of life to a moderate and significant degree in those receiving home care. The quality of life for those who have chronic diseases was worse. In this respect, there is a need to support patients in those receiving home care services.


CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S75
Author(s):  
A. Dukelow ◽  
M. Lewell ◽  
J. Loosley ◽  
S. Pancino ◽  
K. Van Aarsen

Introduction: The Community Referral by Emergency Medical Services (CREMS) program was implemented in January 2015 in Southwestern Ontario. The program allows Paramedics interacting with a patient to directly refer those in need of home care support to their local Community Care Access Centre (CCAC) for needs assessment. If indicated, subsequent referrals are made to specific services (e.g. nursing, physiotherapy and geriatrics) by CCAC. Ideally, CREMS connects patients with appropriate, timely care, supporting individual needs. Previous literature has indicated CREMS results in an increase of home care services provided to patients. Methods: The primary objective of this project is to evaluate the impact of the CREMS program on Emergency Department utilization. Data for all CCAC referrals from London-Middlesex EMS was collected for a thirteen month period (February 2015-February 2016). For all patients receiving a new or increased service from CCAC the number of Emergency Department visits 2 years before referral and 2 years after referral were calculated. A related samples Wilcoxon Signed Rank Test was performed to examine the difference in ED visits pre and post referral to CCAC. Results: There were 213 individuals who received a new or increased service during the study timeframe. Median [IQR] patient age was 77 [70-85.5]. 113/213 (53%) of patients were female. The majority of patients 135/213 (63.4%) were a new referral to CCAC. The median [IQR] number of hospital visits before referral was 3 [1-5] and after referral was 2 [0-4]. There was no significant difference in the overall number of ED visits before versus after referral (955 vs 756 visits, p = 0.051). Conclusion: Community based care can improve patient experience and health outcomes. Paramedics are in a unique position to assess patients in their home to determine who might benefit from home care services. CREMS referrals for this patient group showed a trend towards decreased ED visits after referral but the trend was not statistically significant.


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