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,…

The paper discusses two reforms in Ontario's long-term care. The first is the commercialization of home care as a result of the implementation of a "managed competition" delivery model. The second is the Ministry of Health and Long-Term Care's privileging of "health care" over "social care" through changes to which…

A review of the kinds of jobs available in services developed to help the homebound elderly: Home health care, homemaker-home health aide, chore service, home repair and maintenance, home-delivered meals, telephone reassurance, and friendly visiting. (JT)

The social service and health care occupation of homemaker-home health aide is described including job information, employment outlook, and benefits and drawbacks. (JT)

Examined type of service, volume, and mix of services provided to 270 poor and frail elders. Predictors of use and volume of service differed depending on type of service. The most prescribed service combinations included nursing, home health, and homemaker; homemaker only; nursing and home health; nursing and homemaker; and nurse only. (RJM)

Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)

Examined the utilization patterns of caregivers (N=597) to dementia victims when services were available. Identified and examined factors influencing service utilization, including amount of burden experienced by the caregiver, the degree of involvement in the care of the patient, and the amount of resources available. Respite-oriented services…

While many health care delivery systems are criticized for the dehumanizing way they treat patients, hospice care presents a refreshing alternative to health care for the terminally ill. Patients appropriate for hospice care are those with six months or less to live. Interpersonal communication education is an important component of hospice care…

The Home Health Assisting (HHA) program was developed specifically for use by educational agencies which offer a program in HHA upon approval granted by New York State Education Department through the Joint State Agency review and approval process. It is designed to prepare adults for work in the home under supervision of a health-care agency. A…

Characteristics of the target population, services, and potential source of helpers are determining factors in the cost effectiveness of home health services. Welfare of patients in the experimental group was improved, and lower probability of residential care helped keep costs down. (JAC)

The results of a reivew by the United States General Accounting Office (GAO), this paper examines the Title XX Program of the Social Security Act and makes suggestions for its improvement. The Title XX Program provides funds to states to enable them to tailor social services programs to fit the needs of local communities. Such services are…

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…

Purpose: We estimated the effect of a voucher benefit on the demand for personal assistance by Medicare beneficiaries aged 65 years or older who had functional disabilities. Design and Methods: We performed a secondary data analysis on 645 Medicare beneficiaries from the Medicare Primary and Consumer-Directed Care Demonstration (a randomized…

TRaining women for homemaker service is an important function of every agency that provides such services. The Homemaker Service of the National Capital Area, Inc. designed a training manual to be used with either a single new employee or with a group as large as 15. Informal discussions, lectures, practice, and demonstration are methods of…

Federal legislation and programs affecting personal assistance services for persons with disabilities are examined. Personal assistance services may be provided for activities of daily living, communication, cognitive tasks, or mobility, depending on the needs of the individual. The population in need of attendant services has increased with…