This study employs a longitudinal design to examine rural-urban differences in home care service use over time, drawing on data from the Manitoba Study of Health and Aging (MSHA). Characteristics of community-dwelling, cognitively intact adults aged 65 years or older not receiving home care services in the province of Manitoba (n = 855) were…

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: The Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality sponsored a nationwide study to evaluate the federal paid feeding assistant (PFA) regulation that allows nursing homes to hire single-task workers to provide feeding assistance to nursing home residents. Organizers designed the PFA regulation…

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…

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…

Purpose: As funds have increased for the provision of in-home care, so too have concerns about the quality of services. In response, care management agencies and home-care providers have developed an array of monitoring activities designed to ensure the quality of services. In this article, we show how an area agency on aging both collected and…

Intended for trainee use, the manual is in notebook format with a curriculum corresponding to the trainers' manual (VT 007 909), a related document. Part I, Basic Health Curriculum, deals with (1) the roles of health service aides, (2) Biological Potential and Equilibrium, (3) Professionals in the Health Field, (4) Public Health Administration,…

Conducted interviews with 54 home care clients (over half of whom were age 60+) and their home health aides and personal care attendants. Interviews revealed home care relationships tended to be both formal and informal, in that job responsibilities tend to be diffusely defined and home care workers often became involved in the…

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)

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…

The first of three booklets on attendant care of severely disabled persons is addressed to the personal care attendants (PCAs). An introductory section reviews the basic concepts of independent living, noting the role of PCAs in promoting independence. Discussions of congenital and acquired disability are followed by information on equipment and…