SAFE – Home Opioid Management Education (SAFE-HOME) in older adults: a naloxone awareness program for home health workers

The SAFE-Home Opioid Management Education (SAFE-HOME) Naloxone Awareness pilot program utilized home health workers (HHWs) in rural settings to educate older adults prescribed opioids on naloxone access and use. This work expands the SAFE-HOME program to urban settings to prepare HHWs to educate community-dwelling older adults on opioid risks and life-saving naloxone. This prospective, interventional cohort study evaluated 60-min synchronous, virtual HHW educational training sessions describing opioid risks in older adults, opioid overdose signs and symptoms, and naloxone access and use. Knowledge assessments were conducted pre- and post-intervention via a pre-developed assessment tool in a repeated measure model. Outcomes included change in total opioid and naloxone knowledge, and baseline total and individual opioid and naloxone knowledge. Six educational sessions were held (n = 154). The average pre- and post-education scores were 62.7% (n = 108) and 83.5% (n = 82), respectively (p < 0.001). Of the 69 participants who completed both pre- and post-education assessments, the average change in total score was +19.6% (p < 0.001), opioid knowledge score −0.4% (p = 0.901), and naloxone knowledge score +32.9% (p < 0.001). At baseline, HHWs were knowledgeable on opioid risks, but lacked familiarity with naloxone access and use. Targeting HHWs with opioid and naloxone training positions them to effectively educate at-risk community-dwelling older adults.

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

Journal of Patient Experience ◽

10.1177/2374373519869156 ◽

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.

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Music Is Healing: Developing a Music Module for a Pain Management Intervention for African American Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.2967 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 815-815

Author(s):

Mary Janevic ◽

Sheria Robinson-Lane ◽

Afton Hassett ◽

Rebecca Courser

Keyword(s):

Older Adults ◽

African American ◽

Pain Management ◽

Health Workers ◽

New Music ◽

Participant Engagement ◽

Management Intervention ◽

Phone Calls ◽

Positive Memories ◽

African American Older Adults

Abstract Music has a known analgesic effect. Our multidisciplinary team is developing a music-focused module for Positive STEPS, a pain self-management intervention based on principles of positive psychology. The priority population is African American older adults with disabling chronic pain. Positive STEPS is delivered via website and phone calls from community health workers. To inform program design, we conducted two focus groups with older adults in Detroit (n=16; 100% female and African American; 75% age 70+). All participants said they would enjoy using music to cope with pain. Content analysis revealed the following themes regarding music for pain management: it elicits positive memories, reduces stress, motivates exercise and daily activities, and promotes relaxation. Participants offered ideas for music-focused activities, including learning about unfamiliar genres and using music for meditation/relaxation. Findings will inform the design of a new music module, to be pilot-tested for its effect on participant engagement and pain-related outcomes.

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Quality of Diet Among Community-Dwelling Elders Participating in the Mobility and Vitality Lifestyle Program

Innovation in Aging ◽

10.1093/geroni/igaa057.3081 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 841-841

Author(s):

Jessica Cheng

Keyword(s):

Older Adults ◽

Disease Prevention ◽

Diet Quality ◽

Group Intervention ◽

Health Workers ◽

Effective Means ◽

Quality Score ◽

Community Dwelling ◽

Total Quality ◽

One Year

Abstract Dietary choices play an important role in disease prevention both through its effect on weight and independent of it. Improving diet can be an effective means of disease prevention among older adults. Participants (n=303) were recruited from the Allegheny County, PA area and received nutritional education in group sessions led by trained community health workers over one year. Diet quality was captured at baseline and final endpoint (either 9 or 13 months) using the Rate Your Plate (RYP) instrument for assessing healthfulness of diet and includes 24 items that can be summed to generate a total quality score. The mean RYP diet quality score improved from baseline (RYP=50.87) to endpoint (RYP=54.85) (p<.001). Over the course of the intervention, 30.9% of participants made enough improvement in diet to move to a better RYP category. A community-based group intervention for older adults was effective in inducing improvements in diet quality.

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Exploring the Association between Multimorbidity and Cognitive Impairment in Older Adults Living in the Community: A Review of the Literature

Home Health Care Management & Practice ◽

10.1177/10848223211030468 ◽

2021 ◽

pp. 108482232110304

Author(s):

Grace F. Wittenberg ◽

Michelle A. McKay ◽

Melissa O’Connor

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Assessment Tool ◽

Adult Population ◽

Home Health ◽

Adverse Outcomes ◽

Community Dwelling ◽

Cognitive Screening ◽

Review Of The Literature ◽

Increased Risk

Two-thirds of older adults have multimorbidity (MM), or co-occurrence of two or more medical conditions. Mild cognitive impairment (CI) is found in almost 20% of older adults and can lead to further cognitive decline and increased mortality. Older adults with MM are the primary users of home health care services and are at high risk for CI development; however, there is no validated cognitive screening tool used to assess the level of CI in home health users. Given the prevalence of MM and CI in the home health setting, we conducted a review of the literature to understand this association. Due to the absence of literature on CI in home health users, the review focused on the association of MM and CI in community-dwelling older adults. Search terms included home health, older adults, cognitive impairment, and multimorbidity and were applied to the databases PubMed, CINAHL, and PsychInfo leading to eight studies eligible for review. Results show CI is associated with MM in older adults of increasing age, among minorities, and in older adults with lower levels of education. Heart disease was the most prevalent disease associated with increased CI. Sleep disorders, hypertension, arthritis, and hyperlipidemia were also significantly associated with increased CI. The presence of MM and CI was associated with increased risk for death among older adults. Further research and attention are needed regarding the use and development of a validated cognitive assessment tool for home health users to decrease adverse outcomes in the older adult population.

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Policy Changes in Medicare Home Health Care: Challenges to Providing Family-Centered, Community-Based Care for Older Adults

Journal of Family Social Work ◽

10.1080/10522150903321264 ◽

2009 ◽

Vol 12 (4) ◽

pp. 291-308 ◽

Cited By ~ 7

Author(s):

Joan K. Davitt

Keyword(s):

Older Adults ◽

Health Care ◽

Home Health Care ◽

Home Health ◽

Policy Changes ◽

Community Based ◽

Family Centered

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Work as a Root Cause of Home Health Workers’ Poor Health

American Journal of Public Health ◽

10.2105/ajph.2021.306582 ◽

2022 ◽

Vol 112 (1) ◽

pp. 9-11

Author(s):

Sherry L. Baron ◽

Emma K. Tsui ◽

Margaret M. Quinn

Keyword(s):

Health Workers ◽

Home Health ◽

Poor Health ◽

Root Cause

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Exploring the Role of Community Health Workers in Providing Cancer Navigation: Perceptions of African American Older Adults

Oncology Nursing Forum ◽

10.1188/12.onf.e288-e298 ◽

2012 ◽

Vol 39 (3) ◽

pp. E288-E298 ◽

Cited By ~ 6

Author(s):

Jennifer Wenzel ◽

Randy Jones ◽

Rachel Klimmek ◽

Sarah Szanton ◽

Sharon Krumm

Keyword(s):

Older Adults ◽

African American ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

African American Older Adults

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“You get three different hats on and try to figure it out:” home based care provision during a disaster

BMC Nursing ◽

10.1186/s12912-021-00676-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sue Anne Bell ◽

Sarah Dickey ◽

Marie-Anne Rosemberg

Keyword(s):

Older Adults ◽

Health Care ◽

Focus Groups ◽

Home Health ◽

Care Provision ◽

Care Providers ◽

Home Based ◽

Health Agencies ◽

Home Health Agencies ◽

Home Based Care

Abstract Background Home based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home based care remains a vital source of support for older adults. The purpose of this paper is to qualitatively understand the barriers and facilitators of both patients and providers that influence the provision of home based care activities in two hurricane affected communities. Methods Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home based care providers (n = 25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65 % were registered nurses, 20 % were Licensed Vocational Nurses (LVN), and 15 % were other types of health care providers. 12 % of the sample was male and 88 % was female. Five themes were identified in the analysis: barriers to implementing preparedness plans, adaptability of home based care providers, disasters exacerbate inequalities, perceived unreliability of government and corporations, and the balance between caring for self and family and caring for patients. Conclusions This study provides qualitative evidence on the factors that influence home based care provision in disaster-affected communities, including the barriers and facilitators faced by both patients and providers in preparing for, responding to and recovering from a disaster. While home based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and holistic models of care in the immediate period after the disaster were emphasized. We recommend greater inclusion of home health agencies in the community planning process. This study informs the growing body of evidence on the value of home based care in promoting safety and well-being for older adults during a disaster.

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