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Home Health Care Services Quarterly

Cynthia Williams, Thomas T H Wan
In this study, we examine the cost per outcomes of remote monitoring services in home health care. The methodology followed case matched design via retrospective chart reviews. Results of the chi-square test suggest that there were no significant associations between the intervention and hospital readmissions, X(2) = (1, n = 210, p value = 0.71, phi = 0.71). An independent t-test compared group means of the number skilled nursing visits and agency costs, p-value of 0.002 and 0.000 respectively, favoring the standard of care group...
August 23, 2016: Home Health Care Services Quarterly
Perla Werner, Adi Hess
Studies have shown that courtesy stigma is common among informal caregivers of persons with Alzheimer's disease. Guided by Attribution Theory and using focus group methodology, we examined this topic among 12 foreign health-care workers. Findings revealed that stigma is noticeable in the everyday reality of foreign workers caring for persons with dementia and that its management is shaped by beliefs and knowledge about the disease in their original countries, and by knowledge gained as caregivers. Greater understanding of stigma among foreign workers is crucial for advancing knowledge in the area and for improving the care provided to persons with Alzheimer's disease...
August 23, 2016: Home Health Care Services Quarterly
Aimee Milliken, Ellen K Mahoney, Kevin J Mahoney
The Veteran-Directed Home & Community Based Services Program (VD-HCBS) operates using a participant direction approach, allowing Veterans to self-direct services. Only a small body of literature has explored the impact of these programs on caregivers. This study aimed to explore the experiences of caregivers in VD-HCBS. Telephone focus groups and interviews were conducted with Caregivers (n = 23; 52.2% spouses; 8.7% male). Conventional content analysis revealed five categories: Coming Home & Staying Home; Taking the Pressure Off; Providing Security; Giving Us Time as a Couple; and The Importance of Choice...
August 23, 2016: Home Health Care Services Quarterly
Laurie Bladen, Robin McAtee
Embodied nursing knowledge and its effects on patient outcomes are understudied in home health. The researcher performed a descriptive correlational study, in nine home health agencies in Ohio, to consider the effects of embodied nursing knowledge in expert practice in 107 registered nurses working in Medicare certified home health agencies. While statistical significance was not noted, findings of this study add to the understanding or research and the outcome improvement scores in home health. Findings also pose the question that the concepts used in acute care to improve mortality rates and patient outcome improvements may be different in home health...
August 23, 2016: Home Health Care Services Quarterly
Lisa C Lindley, Sandra J Mixer, Jennifer W Mack
Families desire to bring their children home at end of life, and this creates a variety of unique care needs at home. This study analyzed the child and family factors associated with hospice versus home health care use in the last year of life among children with multiple complex chronic conditions. Using the Andersen Behavioral Healthcare Utilization Model, predisposing, enabling, and need factors of the child and family were shown to be significant predictors of hospice and home health care use. Hospice and home health care have advantages, and families may wish to use the service that best fits their needs...
July 6, 2016: Home Health Care Services Quarterly
April Feld, Rose Madden-Baer, Ruth McCorkle
The Centers for Medicare and Medicaid Services Innovation Center's Episode Based Payment initiatives propose a large opportunity to reduce cost from waste and variation and stand to align hospitals, physicians, and postacute providers in the redesign of care that achieves savings and improve quality. Community-based organizations are at the forefront of this care redesign through innovative models of care aimed at bridging gaps in care coordination and reducing hospital readmissions. This article describes a community-based provider's approach to participation under the Bundled Payment for Care Improvement Initiative and a 90-day model of care for congestive heart failure in home care...
May 9, 2016: Home Health Care Services Quarterly
Jo-Ann Mary Moore
Frequent exacerbations of symptoms and financial penalties for 30-day hospital readmissions of patients with congestive heart failure (CHF) have led to new disease management approaches. A nurse practitioner (NP)-led interdisciplinary program for CHF management that included home telemonitoring and early NP assessments and interventions was piloted by a home health agency. A 4-month evaluation of the efficacy of a clinical pathway for CHF patients resulted in the enrollment of 22 CHF patients in the program...
January 2016: Home Health Care Services Quarterly
Medha Iyer, Grishma P Bhavsar, Kevin J Bennett, Janice C Probst
This study examined the intensity of home health services, as defined by the number of visits and service delivery by rehabilitation specialists, among Medicare beneficiaries with stroke. A cross-sectional secondary data analysis was conducted using 2009 home health claims data obtained from the Centers for Medicare and Medicaid Services' Research Data Assistance Center. There were no significant rural-urban differences in the number of home health visits. Rural beneficiaries were significantly less likely than urban beneficiaries to receive services from rehabilitation specialists...
January 2016: Home Health Care Services Quarterly
Sytske Van Bruggen, Jacobijn Gussekloo, Christina Bode, Dorothea P Touwen, Dick P Engberts, Jeanet W Blom
The care of older persons can have negative impact on the caregiver. The objective of this population-based observational study is to identify problems experienced by informal caregivers, and the extent of related difficulties, in their care of older care-dependent recipients with and without cognitive impairment. Caregivers (n = 2,704) caring for a home-dwelling person aged ≥ 75 years responded to a questionnaire with 23 questions on problems and related difficulties by mail. Prevalence of self-reported problems and related difficulties was calculated...
January 2016: Home Health Care Services Quarterly
Ahyoung Anna Lee, Yuri Jang
Based on the job demands-resources (JD-R) model, this study explored the role of physical injury and organizational support in predicting home health workers' turnover intention. In a sample of home health workers in Central Texas (n = 150), about 37% reported turnover intention. The logistic regression model showed that turnover intention was 3.23 times more likely among those who had experienced work-related injury. On the other hand, organizational support was found to reduce the likelihood of turnover intention...
January 2016: Home Health Care Services Quarterly
Mary H Wilde, Dianne Liebel, Eileen Fairbanks, Paula Wilson, Margaret Lash, Shivani Shah, Margaret V McDonald, Judith Brasch, Feng Zhang, Eileen Scheid, James M McMahon
A process fidelity assessment was conducted as a nested study within a home-based randomized clinical trial teaching self-management to 101 long-term indwelling urinary catheter users in the treatment group. Our hybrid model combined external assessments (outside observations and tape recordings) with internal evaluation methods (through study nurse forms and notes) for a comprehensive process fidelity assessment. Barriers, patient-related issues, and nurse perspectives were identified demonstrating the complexity in home care intervention research...
April 2015: Home Health Care Services Quarterly
Marieke van Wieringen, Marjolein I Broese van Groenou, Peter Groenewegen
This study explores the link between management characteristics of home care agencies and the involvement of informal caregivers in caregiving. Based on a study of policy documents of two agencies and semi-structured interviews with five team managers and 31 formal caregivers, we conclude that, although the importance of involving informal caregivers is emphasized in official documentation, actual contact with informal caregivers is often lacking. Comparison of the work processes of the two agencies shows that contact with informal caregivers and their potential involvement are enhanced by smaller teams, less task division, and clarity about the responsibilities of formal caregivers...
April 2015: Home Health Care Services Quarterly
Keith A Anderson, Holly I Dabelko-Schoeny, Noelle L Fields, James R Carter
Adult day services (ADS) are the leading provider of community-based care for persons with dementia and their caregivers. While the provision of caregiver respite is well-documented, little is known about the provision of other forms of dementia caregiver support. Logistic regression analyses of ADS providers (N = 297) in the MetLife Study indicated that the number of hours of social work support was a significant predictor of case management services, while nonprofit status was a significant predictor of caregiver education and support groups...
April 2015: Home Health Care Services Quarterly
Michin Hong, Banghwa Lee Casado
This study examined how state expenditure on home- and community-based services (HCBS) and individual factors are associated with caregiver stress. A total of 1,849 cases from the 2004 National Long-Term Care Survey were included. Gender, education, perceived physical strain, and economic hardship, as well as the number of limitations in instrumental activities of daily living (IADL) for the care recipient, were associated with caregiver stress. The cross-level interaction between service utilization and state expenditure on HCBS was significant, suggesting that living in states with a higher expenditure on HCBS is associated with reduced stress regardless of service utilization...
April 2015: Home Health Care Services Quarterly
Anh-Luu T Huynh-Hohnbaum, Lia Marshall, Valentine M Villa, Gi Lee
The American Heart Association estimates that 81% of people who die of coronary heart disease are 65 years old or older. The leading risk health behaviors include physical inactivity, poor diet, smoking, and binge drinking. Using the 2011-2012 California Health Interview Survey (CHIS), this study looked at how self-management, which includes a plan developed by a medical professional and the confidence to manage one's disease, may decrease negative risk behaviors in older adults. The presence of a plan and increased self-efficacy decreased engagement in negative dietary behaviors and low physical activity...
2015: Home Health Care Services Quarterly
Eunhae Kim, Zvi D Gellis, Vicki Hoak
This pilot survey study explores current telehealth use among home health care agencies for chronic illness and depression care, and identifies factors associated with agencies' perception and intention to use telehealth. Between June and August 2014, 73 directors and 13 staff nurses (N = 86) from the Pennsylvania Homecare Association member agencies participated in an online survey. Eighty-five percent of telehealth provider agencies reported utilizing telehealth for monitoring health status while only 7...
2015: Home Health Care Services Quarterly
Debra G Morgan, Julie G Kosteniuk, Norma J Stewart, Megan E O'Connell, Andrew Kirk, Margaret Crossley, Vanina Dal Bello-Haas, Dorothy Forbes, Anthea Innes
Community-based services are important for improving outcomes for individuals with dementia and their caregivers. This study examined: (a) availability of rural dementia-related services in the Canadian province of Saskatchewan, and (b) orientation of services toward six key attributes of primary health care (i.e., information/education, accessibility, population orientation, coordinated care, comprehensiveness, quality of care). Data were collected from 71 rural Home Care Assessors via cross-sectional survey...
2015: Home Health Care Services Quarterly
Eric A Coleman, Sung-Joon Min
The aims of this study were to (a) describe the nature of patients' goals upon discharge from hospital, family caregivers' goals for their loved ones, and family caregivers' goals for themselves; (b) determine the degree of concordance with respect to the three elicited goals; (c) ascertain goal attainment across the three elicited goals; and (d) examine factors predictive of goal attainment. Our findings support the position that eliciting patient and family caregiver goals and promoting goal attainment may represent an important step toward promoting greater patient and family caregiver engagement in their care...
2015: Home Health Care Services Quarterly
Isabelle van Riesenbeck, Kathrin Boerner, Adrita Barooah, Orah R Burack
This study explored the experiences of 80 home health aides (HHAs) whose client died within the last 2 months. Data collection involved comprehensive semi-structured in-person interviews to try to better understand characteristics of HHAs and their clients associated with preparedness for death. Among those, personal end-of-life (EOL) care preferences of HHAs and having knowledge of preferences and decisions regarding client's EOL care showed significant links to preparedness. Findings suggest that HHAs' preparedness for client death could be enhanced both by addressing their personal views on EOL care and by providing more information about the client's EOL care plans...
2015: Home Health Care Services Quarterly
Mahiyar Nasarwanji, Nicole E Werner, Kimberly Carl, Dawn Hohl, Bruce Leff, Ayse P Gurses, Alicia I Arbaje
Older adults discharged from the hospital to skilled home health care (SHHC) are at high risk for experiencing suboptimal transitions. Using the human factors approach of shadowing and contextual inquiry, we studied the workflow for transitioning older adults from the hospital to SHHC. We created a representative diagram of the hospital to SHHC transition workflow, we examined potential workflow variations, we categorized workflow challenges, and we identified artifacts developed to manage variations and challenges...
2015: Home Health Care Services Quarterly
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