Community access and participation for people with intellectual and developmental disabilities (IDD) depends in part on competent, committed direct support professionals (DSPs) who support people with IDD. With knowledge of the person's communication preferences, support needs, and environments where supports are provided, DSPs can support their…

Classroom training sessions for new home care workers (HCWs) are often brief and ad hoc, varying in format and content. Yet the application of this training may be central to worker and client safety. A qualitative approach was adopted for this inquiry, comprising two separate but related practical studies. In the first, exploratory study,…

Purpose: The purpose of this paper is to examine the learning climate in elderly care, its potential improvements after the "Steps for skills," and its influence on knowledge from formal training. The assumptions were: the different activities of the Steps for skills should enhance the perceived learning climate; differences in working…

Purpose: To examine the impact of an experimental consumer-choice voucher benefit on the selection of independent and agency personal assistance services (PAS) providers among rural and urban Medicare beneficiaries with disabilities. Methods: The Medicare Primary and Consumer-Directed Care Demonstration enrolled 1,605 Medicare beneficiaries in 19…

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…

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…

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…

Pressure for greater accountability is being exerted on programs for care of terminally ill and increasing demand for evaluation research. Components, implications, and limitations of evaluation systems are discussed, and their application in the terminal care setting addressed. Buckingham evaluation of hospice home care service is cited as a…

States' policies vary widely on paying friends and family rather than home care agencies to care for the elderly. This analysis explored two state programs which exemplify different payment options: Michigan, which pays clients' informal caregivers, and Illinois, which generally pays agencies to provide services. It asked how different payment…

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…

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)

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…

The development of four paper-and-pencil tests, useful in assessing the effectiveness of inservice training provided to either nurses aides or home health aides, was described. These tests were designed for utilization in employment selection and case assignment. Two tests of 37 multiple-choice items and two tests of 10 matching items were…