Instrumental activities of daily living and eligibility for long term home health care

Author(s):  
Dorothy Calvani ◽  
Brian Lawlor
2019 ◽  
Vol 32 (2) ◽  
pp. 67-75 ◽  
Author(s):  
Julia Burgdorf ◽  
Alicia Arbaje ◽  
Jennifer L. Wolff

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lena Nilsson ◽  
Christer Andersson ◽  
Rune Sjödahl

Abstract Background During the first pandemic wave, Sweden experienced a high mortality rate. Home healthcare reflects a group of people especially vulnerable to coronavirus disease 2019 (COVID-19). We aimed to evaluate the pattern of comorbidity and frailty in a group of individuals having fatal outcomes in home healthcare during the COVID-19 pandemic March to September 2020, and to assess the contribution of COVID-19 in the fatal outcomes. Methods A cohort of adults with confirmed COVID-19 diagnosis that deceased in home healthcare between March and September 2020 were analysed in a retrospective study comprising home healthcare in 136 facilities in one Swedish county. Main outcome measures were comorbidity and frailty. Results One hundred fifty-five individuals (88 women, 67 men) aged 57–106 (median 88) years were included in the analysis. Nine had considerable frailty (ability to perform various activities of daily living but confined to bed or chair on occasion) and the remaining 146 had severe frailty (unable to perform activities of daily living and/or confined to bed or chair; dementia necessitating care). Three or more diagnoses besides COVID-19 were present in 142 individuals and another eight had two diagnoses in addition to COVID-19. In 20 (13%) individuals, COVID-19 was assessed as the principal cause of death, in 100 (64.5%) a contributing cause, and for the remaining 35 (22.5%) death was probably caused by another comorbidity. This seemed to change over the course of the COVID − 19 pandemic, with its contributing role decreasing from the middle of the summer. Conclusions Death in home healthcare during the first wave of the pandemic mostly affected individuals with severe frailty and comorbidity at very advanced ages. One fifth of the individuals who died in home health care had another cause than Covid-19. Trial registration Clinical Trials.gov NCT04642196 date 24/11/2020.


2011 ◽  
Vol 23 (6) ◽  
pp. 412-420 ◽  
Author(s):  
Jennifer S. Riggs ◽  
Elizabeth A. Madigan ◽  
Richard H. Fortinsky

This study is a secondary analysis of data for 107 home health care heart failure patients. The authors investigate the impact of patient characteristics and nursing visit intensity on change in activities of daily living (ADL) status and instrumental activities of daily living (IADL) status and improvement/stabilization of dyspnea. Prior hospital stay (ß = .38, p = .001) and nursing visit intensity (ß = –.39, p = .001) predict improvement in ADL status. The model for change in IADL status is not significant. Patients with more than two comorbidities (OR = 6.5, p = .04) and patients who received higher nursing visit intensity (OR = 7.0, p = .04) are more likely to have improved/stabilized dyspnea at home care discharge.


2016 ◽  
Vol 28 (3) ◽  
pp. 142-149 ◽  
Author(s):  
Edith Roth Gjevjon ◽  
Tor Inge Romøren ◽  
Line Kildal Bragstad ◽  
Ragnhild Hellesø

2016 ◽  
Vol Volume 11 ◽  
pp. 1579-1587 ◽  
Author(s):  
Sigrid Mueller-Schotte ◽  
Nienke Bleijenberg ◽  
Yvonne T. van der Schouw ◽  
Marieke J. Schuurmans

Medical Care ◽  
1986 ◽  
Vol 24 (7) ◽  
pp. 641-653 ◽  
Author(s):  
Gary L. Gaumer ◽  
Howard Birnbaum ◽  
Frederick Pratter ◽  
Robert Burke ◽  
Saul Franklin ◽  
...  

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