This study examines learning in home care visits aimed at systematic facilitation of clients' physical mobility. Building on the theory of expansive learning, we ask what kinds of learning cycles may be identified in home care encounters charged with implementing the new Mobility Agreement practice, what kinds of interplay may be detected between…

Home care staff who provide housekeeping and personal care to individuals with dementia generally have lower levels of dementia care training compared with other health care providers. The study's purposes were to determine whether the professional role of home care staff in a predominantly rural region was associated with preferences for delivery…

Purpose: Although caregivers desire specific information about hospice programs, there is little descriptive information available. We characterized agencies that provide formal or informal hospice care in the United States according to four types of services considered important by caregivers: medications and treatments; rehabilitative care;…

Objective: Data are presented from a pilot research program initiated to develop, refine, and test the outcomes of problem-solving therapy that targets the needs of older adults with minor depression in home care settings. Method: A pilot randomized clinical trial compares the impact of problem-solving therapy for home care to treatment as usual…

This study aimed to examine the implementation, adequacy, and outcomes of discharge planning. The authors carried out a prospective study of 1,426 adult patients discharged from 11 acute care hospitals in Israel. Social workers provided detailed discharge plans on each patient. Telephone interviews were conducted two weeks post-discharge. Findings…

Estimated effect of variety of factors on the utilization of home help among the elderly in Sweden using a sample (n=421) of people 75 years and older. Results indicated physical functioning (instrumental activities of daily living) and living alone were most important. (Author/ABL)

Context: Availability of Medicare-certified home health care (HHC) to rural elders can prevent more expensive institutional care. To date, utilization of HHC by rural elders has not been studied in detail. Purpose: To examine urban-rural differences in Medicare HHC utilization. Methods: The 2002 100% Medicare HHC claims and denominator files were…

Purpose: The U.S. Department of Veterans Affairs has adopted two functional assessment systems that guide care planning: one for nursing home residents (the Resident Assessment Instrument [RAI]) and a compatible one for home care clients (RAI-HC). The purpose of this article is to describe the RAI-HC (often referred to as the Minimum Data Set-Home…

Alliances for academic home care offer a new approach to advance the knowledge base related to home care, to improve quality and cost effectiveness of home care services, to prepare the next generation of providers to manage and deliver care in a restructured practice paradigm, and to influence health and social policy. (JOW)

Purpose: This study analyzed the effect of consumer-directed versus agency-directed home care on satisfaction with paid personal assistance services among Medicaid beneficiaries in Washington State. Design and Methods: The study analyzed a survey of 513 Medicaid beneficiaries receiving home- and community-based services. As part of a larger study,…

Examined trends of publicly owned, for-profit providers of custodial home care. Found that restrictive public payments and lack of private insurance coverage have contributed to financial woes of providers. Suggests that changes are urgently needed which address the financing of home care. (Author/NB)

A United States Senator advocates a national long-term home care program for the elderly and describes the proposed "Senior Citizens Independent Community Care Act." The Act would expand Medicare benefits to include individual assessment and treatment plans, homemaker/home health aid, adult day care services, interim care, and other…

Found clientele of two comprehensive sociomedical home care programs to be similar to clientele of a traditional medical nursing program. The comprehensive programs did not have clientele with more problems and less adequate social supports. To serve their target clientele, these programs need more homemaker and personal services. (Author/ABB)

A retrospective cohort design is used to estimate the effect of urinary incontinence (UI) on the public costs of home care services to elderly individuals. Multivariate analyses controlling for other individual, household, and supply characteristics demonstrate that those with UI generate significantly greater public costs for home care services.…

Purpose: New York City's Medicaid Home Care Services Program provides an integrated program of housekeeping and personal assistance care along with regular nursing assessments. We sought to determine if this program of supportive care offers a survival benefit to older adults. Design and Methods: Administrative data from New York City's Medicaid…