This article presents a process of collective formation of a new concept of mobility between home care workers and their elderly clients, who are at risk of losing physical mobility and functional capacity. A new tool called mobility agreement was introduced to facilitate the inclusion of regular mobility exercises in home care visits and in the…

Medicaid policies that may affect long-term care decisions vary across states and time. Using data from the 1993, 1995, 1998, and 2000 waves of the Assets and Health Dynamics Among the Oldest Old Survey, we estimate a dynamic empirical model of health insurance coverage, long-term care arrangement, asset and gift behavior, and health transitions…

This article uses the concept of continuity of care to examine the implications of health-system restructuring for workers and staff in the BC home support system. Home support primarily serves frail seniors living in poverty and has the potential to provide assistance with tasks like bathing, dressing, and toileting, as well as offer social…

The escalating demand for trained direct long-term care (DLTC) workers, those individuals with the most sustained direct contact with vulnerable older adults in homes and facilities, is a consequence of our rapidly aging population. Research documents the present and projected shortages of DLTC workers, and developed nations are increasingly…

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…

Purpose: This study aimed to develop home care quality indicators (HCQIs) to be used by a variety of audiences including consumers, agencies, regulators, and policy makers to support evidence-based decision making related to the quality of home care services. Design and Methods: Data from 3,041 Canadian and 11,252 U.S. home care clients assessed…

Context: The Balanced Budget Act (BBA) of 1997 and other recent policies have led to reduced Medicare funding for home health agencies (HHAs) and visits per beneficiary. Purpose: We examine the staffing characteristics of stable Medicare-certified HHAs across rural and urban counties from 1996 to 2002, a period encompassing the changes associated…

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…

Evaluated four work life demonstration projects designed to upgrade home aide employment, reduce turnover, and increase continuity of care. Found that projects reduced worker turnover in experimental groups from 10 to 44 percentage points. Where it was measured, continuity of care also significantly improved. Local political, economic, and…

This article identifies home care practitioners' perceptions of the responsibilities, difficulties, and needs for support of caregivers. It is based on a study undertaken in Quebec with 55 practitioners and 10 administrators from 10 CLSCs located in rural, urban, and metropolitan areas. The study had a qualitative, multiple-case design and used…

Careful staff selection, training, and review are among the methods the author recommends to home care agencies striving to provide top-notch services. Discusses measuring the quality of care employees are providing, accreditation, and the benefits of accreditation. (CT)

Purpose: To examine demographic characteristics and work conditions of home care aides, nursing home aides, and hospital aides in the late 1980s and late 1990s. Design and Methods: This study replicated a previous study which examined the Current Population Survey (CPS) March supplement from 1987 to 1989. The present study examined CPS data from…

Tested the Homemakers Home Health Aide Program Evaluation Questionnaire, a management tool for evaluating homemaker/client relationship, job performance and achievement of objectives, for a sample of 40 clients. The questionnaire, which is appended, is valid, reliable, and relatively inexpensive. (Author/JAC)

The objective of this study was to compare enhanced access to geriatric assessment and case management to usual home care service provision for the frail elderly. This was a demonstration project, with randomized allocation to control or intervention groups of frail elderly persons who had been referred to the Home Care service in Winnipeg. Of the…

An Attendant Care Pilot Project, administered by the Home Care Service of New South Wales, Australia, and providing attendant care for 24 permanently severely physically disabled adults for 2 years, was evaluated. The patients were medically stable and intellectually capable of managing their own affairs; all had impairments which required…