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https://www.readbyqxmd.com/read/28634565/home-based-telepsychiatry-in-us-urban-area
#1
Alireza Amirsadri, Jaclynne Burns, Albert Pizzuti, Cynthia L Arfken
Telepsychiatry expands access to psychiatric care. However, telepsychiatry for elderly adults is only reimbursed in the US if the patient is assessed while in a clinical setting. This case study presents a homebound older woman previously hospitalized for schizophrenia who had not seen a psychiatrist in over 20 years. Care was provided with hybrid telepsychiatry (team-based practice with social worker traveling to the home with electronic tablet for connection with psychiatrist). The intervention resulted in detecting unrecognized depression and complex trauma...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28591975/an-overview-of-home-based-primary-care-learning-from-the-field
#2
Sarah Klein, Martha Hostetter, Douglas McCarthy
ISSUE: Homebound and functionally limited individuals are often unable to access office-based primary care, leading to unmet needs and increased health care spending. GOAL: Show how home-based primary care affects outcomes and costs for Medicare and Medicaid beneficiaries with complex care needs. METHODS: Qualitative synthesis of expert perspectives and the experiences of six case-study sites. FINDINGS AND CONCLUSIONS: Successful home-based primary care practices optimize care by: fielding interdisciplinary teams, incorporating behavioral care and social supports into primary care, responding rapidly to urgent and acute care needs, offering palliative care, and supporting family members and caregivers...
June 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28558857/how-s-your-health-at-home-frail-homebound-patients-reported-health-experience-and-outcomes
#3
Margaret J McGregor, Jay Slater, John Sloan, Kimberlyn M McGrail, Anne Martin-Matthews, Shannon Berg, Alyson Plecash, Leila Sloss, Johanna Trimble, Janice M Murphy
We used a web-based mixed methods survey (HowsYourHealth - Frail) to explore the health of frail older (78% age 80 or older) adults enrolled in a home-based primary care program in Vancouver, Canada. Sixty per cent of eligible respondents participated, representing over one quarter (92/350, 26.2%) of all individuals receiving the service. Despite high levels of co-morbidity and functional dependence, 50 per cent rated their health as good, very good, or excellent. Adjusted odds ratios for positive self-rated health were 7...
May 31, 2017: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/28558509/examining-fall-recurrence-risk-of-homebound-hispanic-older-adults-receiving-home-care-services
#4
Guillermina R Solis, Jane Dimmitt Champion
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...
March 2017: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
https://www.readbyqxmd.com/read/28548888/an-interdisciplinary-intervention-for-fear-of-falling-lessons-learned-from-two-case-studies
#5
James B Robinson, Julie Loebach Wetherell
This article describes two case studies using an interdisciplinary intervention for homebound older adults who experience fear of falling, resulting in debility and isolation. The patients discussed received separate home visits from a physical therapist (two and four visits) and psychologist (six and eight visits) and intervention components included an initial assessment of physical ability, prescription of home exercise program, exposure therapy, and cognitive restructuring. Both patients reported satisfaction with the fear of falling intervention and showed improved ability to walk, both in distance and in requiring less assistance...
May 12, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28452676/telephone-delivered-cognitive-behavioral-therapy-for-older-rural-veterans-with-depression-and-anxiety-in-home-based-primary-care
#6
Terri L Barrera, Jeremy P Cummings, Maria Armento, Jeffrey A Cully, Amber Bush Amspoker, Nancy L Wilson, Michael J Mallen, Srijana Shrestha, Mark E Kunik, Melinda A Stanley
OBJECTIVES: Rural, homebound older adults are at increased risk for anxiety and depression and have limited access to mental health services. These individuals face many barriers to receiving evidence-based mental health treatment and would benefit from interventions that increase access to and efficiency of care. The aim of this study was to evaluate use of a telephone-delivered, modular, cognitive behavioral therapy (CBT) intervention for both late-life depression and anxiety delivered to rural, homebound Veterans...
March 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28386536/the-otago-exercise-program-innovative-delivery-models-to-maximize-sustained-outcomes-for-high-risk-homebound-older-adults
#7
Tiffany E Shubert, Lavinia Spring Goto, Matthew Lee Smith, Luohua Jiang, Holly Rudman, Marcia G Ory
BACKGROUND: It is estimated one in two adults age 80 and over fall each year, resulting in substantial morbidity and mortality rates among this oldest-old population. The Otago Exercise program (OEP) is an evidence-based fall prevention program shown to reduce falls by 35% among high-risk older adults. The OEP was designed to be delivered in the home by physical therapists. This model has encountered multiple implementation challenges in the United States health-care system, which has resulted in the development and testing of innovative models to support a broader reach and dissemination of this program...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28380701/falls-risks-and-prevention-behaviors-among-community-dwelling-homebound-and-non-homebound-older-adults
#8
Carri Casteel, Jennifer Jones, Paula Gildner, James M Bowling, Susan J Blalock
The objectives were to examine falls risk factors to determine how the magnitude of risk may differ between homebound and non-homebound older adults, and to describe falls prevention behaviors and participation in falls prevention education. A cross-sectional survey was conducted with convenience samples of community-dwelling older adults recruited through Meals on Wheels programs (homebound, n = 80) and senior centers (non-homebound, n = 84) in North Carolina. Data were collected during home visits and included an interview and medication inventory...
October 1, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28303327/rotational-error-in-path-integration-encoding-and-execution-errors-in-angle-reproduction
#9
Elizabeth R Chrastil, William H Warren
Path integration is fundamental to human navigation. When a navigator leaves home on a complex outbound path, they are able to keep track of their approximate position and orientation and return to their starting location on a direct homebound path. However, there are several sources of error during path integration. Previous research has focused almost exclusively on encoding error-the error in registering the outbound path in memory. Here, we also consider execution error-the error in the response, such as turning and walking a homebound trajectory...
March 16, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28285039/the-lawrence-d-dorr-surgical-techniques-technologies-award-differences-in-postoperative-outcomes-between-total-hip-arthroplasty-for-fracture-vs-osteoarthritis
#10
Charles D Qin, Mia M Helfrich, David W Fitz, Kevin D Hardt, Matthew D Beal, David W Manning
BACKGROUND: Hip fracture is an increasingly common expanded indication for total hip arthroplasty (THA) and warrants outcome analysis so as to best inform risk assessment models, public reporting of outcome, and value-based reimbursement schemes. METHODS: The National Surgical Quality Improvement Program data file from 2011 to 2014 was used to identify all patients undergoing THA via current procedural terminology code 27130. Propensity score matching in a 1:5 fashion was used to compare 2 cohorts: THA for osteoarthritis and THA for fracture...
February 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28212250/economic-impact-of-nonmodifiable-risk-factors-in-orthopaedic-fracture-care-is-bundled-payment-feasible
#11
Siddharth A Mahure, Lorraine Hutzler, Richard S Yoon, Joseph A Bosco
OBJECTIVES: To determine whether bundled payments are feasible in the orthopaedic fracture setting, and the potential economic implications of this reimbursement structure. DESIGN: Prospective. SETTING: Multicenter. PATIENTS/PARTICIPANTS: Between 2004 and 2014, a total of 23,643 operatively treated patients with fracture and 544,067 patients with total joint arthroplasty (TJA) were identified using the New York State Statewide Planning and Research Cooperative System database...
March 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28185311/the-association-between-hope-and-mortality-in-homebound-elders
#12
Andrea Q Zhu, Christine Kivork, Linh Vu, Meenakshi Chivukula, Joanna Piechniczek-Buczek, Wei Qiao Qiu, Mkaya Mwamburi
OBJECTIVE: Despite high rates of mortality and depression, there is limited knowledge of how depressive symptoms, especially feeling of hopefulness, affect mortality in the homebound elderly. METHODS: We conducted a secondary analysis of data from a community sample of 1034 adults, age 60 years and older. The Center for Epidemiologic Studies Depression Scale was used to evaluate the mood symptoms and feeling of hopefulness at baseline. The death data were collected within an 8-year follow-up period...
February 10, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28174455/factors-affecting-the-quality-of-life-of-homebound-elderly-hemiparetic-stroke-patients-with-cognitive-impairment
#13
Seiichi Takemasa, Ryoma Nakagoshi, Masayuki Uesugi, Yuri Inoue, Makoto Gotou, Hideki Koeda, Susumu Naruse
[Purpose] This study examined the quality of life of homebound elderly hemiparetic stroke patients with cognitive impairment and the factors affecting their quality of life. [Subjects and Methods] The subjects of the study were 17 home-based elderly hemiparetic stroke patients with cognitive impairment (8 males and 9 females, average age: 76.3 ± 10.5 years old). Their physical and psychological conditions, quality of life and other items were investigated. Nishimura's Mental State Scale for the Elderly was used for the cognitive impairment assessment...
December 2016: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28129087/correlates-of-depressive-symptoms-among-homebound-and-semi-homebound-older-adults
#14
Xiaoling Xiang, Jessica Brooks
This study aimed to provide a national profile of homebound and semi-homebound older adults with depressive symptoms and to compare risk factors of depressive symptoms by homebound status. A sample of 1,885 homebound and semi-homebound older adults were selected from Round 1 of the National Health and Aging Trends Study. The prevalence of depressive symptoms was 43.9% in homebound older adults and 28.1% in semi-homebound older adults, representing over 830,000 and 1.4 million individuals in the population, respectively...
January 27, 2017: Journal of Gerontological Social Work
https://www.readbyqxmd.com/read/28068988/disability-support-and-long-term-social-care-of-an-elderly-spanish-population-2008-2009-an-epidemiologic-analysis
#15
J Almazán-Isla, M Comín-Comín, E Alcalde-Cabero, C Ruiz, E Franco, R Magallón, J Damián, J de Pedro-Cuesta, L A Larrosa-Montañes
BACKGROUND: Though poorly known, relationships between disability, need of help (dependency) and use of social services are crucial aspects of public health. The objective of this study was to describe the links between disability, officially assessed dependency, and social service use by an industrial population, and identify areas of inequity. METHODS: We took advantage of a door-to-door survey conducted in the Cinco Villas district, Spain, in 2008-2009, which provided data on disability, morbidity, and service use among 1216 residents aged ≥50 years, and officially assessed dependency under the 2006 Dependency Act (OAD)...
January 9, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28033165/developing-an-adapted-cardiac-rehabilitation-training-for-home-care-clinicians-patient-perspectives-clinician-knowledge-and-curriculum-overview
#16
Jodi L Feinberg, David Russell, Ana Mola, Kathryn H Bowles, Terri H Lipman
PURPOSE: There is limited evidence that home care clinicians receive education on the core competencies of cardiac rehabilitation (CR). This article describes the development and implementation of a CR training program adapted for home care clinicians, which incorporated the viewpoints of homebound patients with cardiovascular disease. METHODS: Literature and guideline reviews were performed to glean curriculum content, supplemented with themes identified among patients and clinicians...
December 28, 2016: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28029709/increasing-role-of-nurse-practitioners-in-house-call-programs
#17
Nengliang Aaron Yao, Karen Rose, Virginia LeBaron, Fabian Camacho, Peter Boling
OBJECTIVES: Residence-based primary care provides homebound frail patients with a care plan that is individually tailored to manage multiple chronic conditions and functional limitations using a variety of resources. We (1) examine the visit volume and Medicare payments for residence-based health care provided by nurse practitioners (NPs) in the Medicare fee-for-service environment; (2) compare NP's residential visits to those of internists and family physicians; and (3) compare the geographical service area of full-time house call NPs versus NPs who make nursing facility visits a major portion of their work...
April 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27984445/economic-impact-of-non-modifiable-risk-factors-in-orthopaedic-fracture-care-is-bundled-payment-feasible
#18
Lorraine Hutzler, Richard S Yoon, Siddharth A Mahure, Joseph A Bosco
OBJECTIVES: To determine if bundled payments are feasible in the orthopaedic fracture setting and the potential economic implications of this reimbursement structure. DESIGN: Prospective SETTING:: Multicenter PATIENTS/PARTICIPANTS:: Between 2004 - 2014, A total of 23,643 operatively treated fracture patients and 544,067 total joint arthroplasty patients were identified using the New York State SPARCS Database. INTERVENTIONS: Severity of Illness (SOI), hospital charges ($USD), length of stay (days), discharge disposition (homebound vs not) were collected...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27897466/homebound-patients-perspectives-on-technology-and-telemedicine-a-qualitative-analysis
#19
Kristin T L Huang, Tracy J Lu, Forootan Alizadeh, Arash Mostaghimi
Telemedicine holds promise in bridging the gap between homebound patients and high quality health care, but uptake of such technology remains limited. Qualitative interviews conducted with 17 homebound patients found two major barriers to telemedicine. First, participants who lack familiarity with technology are hesitant about telemedicine, as baseline use of technology in the home is limited, participants did not feel capable of learning, and the advantages of telemedicine were unclear. Second, homebound patients place a high value on in-office visits due to therapeutic benefit, face-to-face communication, and the social aspect of medical appointments...
July 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27876403/characterizing-the-high-risk-homebound-patients-in-need-of-nurse-practitioner-co-management
#20
Masha G Jones, Katherine A Ornstein, David M Skovran, Theresa A Soriano, Linda V DeCherrie
By providing more frequent provider visits, prompt responses to acute issues, and care coordination, nurse practitioner (NP) co-management has been beneficial for the care of chronically ill older adults. This paper describes the homebound patients with high symptom burden and healthcare utilization who were referred to an NP co-management intervention and outlines key features of the intervention. We compared demographic, clinical, and healthcare utilization data of patients referred for NP co-management within a large home-based primary care (HBPC) program (n = 87) to patients in the HBPC program not referred for co-management (n = 1027)...
May 2017: Geriatric Nursing
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