Models of home care services for persons with dementia: a narrative review

2015 ◽  
Vol 27 (10) ◽  
pp. 1593-1600 ◽  
Author(s):  
Lee-Fay Low ◽  
Jennifer Fletcher
Keyword(s):  
Case Management ◽  
Home Care ◽  
Integrated Care ◽  
Community Dwelling ◽  
Narrative Review ◽  
Nursing Home Admission ◽  
Community Based ◽  
People With Dementia ◽  
The Impact ◽  
Community Based Services

ABSTRACTBackground:Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care.Methods:We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs.Results:Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study.Conclusions:There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.

Agitation and Dementia-Related Problem Behaviors and Case Management in Long-Term Care

2001 ◽  
Vol 13 (1) ◽  
pp. 5-21 ◽  
Author(s):  
Sadhna Diwan ◽  
Victoria L. Phillips
Keyword(s):  
Behavior Problems ◽  
Case Management ◽  
Problem Behaviors ◽  
Long Term Care ◽  
Specific Training ◽  
Community Based ◽  
Term Care ◽  
The Impact ◽  
Community Based Services

Existing data on case management (CM) time were analyzed to investigate the impact of agitation and dementia-related behavior problems on the use of CM time by older clients (N = 242) in a Medicaid waiver-funded home and community-based services program. Among clients with dementia (n = 73), regression analysis revealed that having problem behaviors resulted in increased use of CM time. Among clients with behavior problems, those with greater functional ability consumed greater CM time. Content analysis revealed that most CM activity focused on service coordination rather than on direct attempts to manage problem behaviors. Implications for CM programs include the need to consider case mix when allocating caseload size and provision of specific training on interventions to address behavior problems.

Home First: Exploring the Impact of Community-based Home Care for Older Adults and Their Family Caregivers

2019 ◽  
Vol 39 (3) ◽  
pp. 432-442 ◽  
Author(s):  
Roslyn M. Compton ◽  
Alex Olirus Owilli ◽  
Vera Caine ◽  
Charlotte Berendonk ◽  
Donna Jouan-Tapp ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Family Caregivers ◽  
Adult Population ◽  
Care Home ◽  
Community Based ◽  
Care Processes ◽  
Older Adult Population ◽  
The Impact ◽  
Community Based Services

ABSTRACTGiven the rapidly expanding older adult population, finding health care approaches that support older adults to age in their choice of place, with an accompanying philosophical re-orientation of health services, is becoming more urgent. We studied the Home Care Home First – Quick Response Project to understand how clients over age 75 and their family caregivers perceived the enhanced community-based services delivered through Home First. Using interpretive description as the methodological design, we explored the experiences of eight older adults and 11 family caregivers; all older adults were enrolled in Home First due to a significant change in their health status. We identified four themes: growing older in chosen places with support, philosophy of care, processes of Home First, and the significance of Home First for clients. Overall, clients and family caregivers responded positively to the Home First services. Clients valued their independence and growing older in places they had specifically chosen.

scholarly journals The Impact of Social Distancing Due to the COVID-19 Pandemic on People with Dementia, Family Carers and Healthcare Professionals: A Qualitative Study

2022 ◽  
Vol 19 (1) ◽  
pp. 519
Author(s):  
Hanneke J. A. Smaling ◽  
Bram Tilburgs ◽  
Wilco P. Achterberg ◽  
Mandy Visser
Keyword(s):  
Qualitative Study ◽  
Home Care ◽  
Healthcare Professionals ◽  
Community Dwelling ◽  
Family Carers ◽  
Term Care ◽  
Social Distancing ◽  
People With Dementia ◽  
The Social ◽  
The Impact

Social distancing measures imposed because of the COVID-19 pandemic presented challenges to the health and wellbeing of people with dementia, family carers, and healthcare professionals. This study investigated the impact of these measures on all involved in the care for people with dementia. For this qualitative study, 20 family carers and 20 healthcare professionals from home care and long-term care (LTC) participated in a semi-structured interview. Interviews were analysed using an inductive thematic analysis approach. For people with dementia, the social distancing measures resulted in a deterioration of physical health. The impact on their emotional state and behaviour depended on the stage of dementia. Family carers experienced difficulty coping with visiting restrictions, anxiety regarding safety, and changes in carer burden. Healthcare professionals had an increased workload, and felt guilty about adhering to restrictive measures. Differences between home care and LTC were reported (i.e., societal initiatives focussed on LTC, scarcity of activities for community-dwelling people with dementia, use of personal protective equipment more intrusive for home care). The social distancing measures had a negative impact on persons with dementia, their family carers, and healthcare professionals. More attention is needed for community-dwelling people with dementia and family carers in times of social isolation.

scholarly journals Home and Community Based Services for People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 668-669
Author(s):  
Howard Degenholtz ◽  
Raymond Van Cleve
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Home Care ◽  
Physical Disability ◽  
Personal Care ◽  
Community Based ◽  
The Past ◽  
People With Dementia ◽  
Similar Information ◽  
Community Based Services

Abstract Home and Community Based Services has grown as an alternative to nursing homes over the past 30 years. While there are extensive data on nursing home staffing, there is a dearth of similar information about Medicaid financed home care. We use data from 2014-2016 Pennsylvania Medicaid to examine personal care for elderly with and without dementia across the range of physical disability. One challenge is that even though physical function can be measured in terms of discrete tasks (i.e., limitation in bathing, dressing, toileting), analysis of the amount of care people receive has to take into account the combination of dementia and combinations of ADL limitations. We found that older adults with dementia receive one hour more of personal care per day at the lowest level of disability and 1.5 hours at the highest level. The increased need for caregiving hours should be incorporated into policies that guide HCBS programs.

scholarly journals Impact of the Outbreak of the COVID-19 Pandemic on Formal and Informal Care of Community-Dwelling Older Adults: Cross-National Clustering of Empirical Evidence from 23 Countries

2021 ◽  
Vol 13 (13) ◽  
pp. 7277
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Paolo Fabbietti ◽  
Giovanni Lamura
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Informal Care ◽  
Home Care Services ◽  
Community Dwelling ◽  
European Countries ◽  
Care Services ◽  
The Impact ◽  
Community Dwelling Older Adults ◽  
Informal Help

The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were reported. Seven clusters were identified, reflecting different combinations of changes in the formal/informal care provision. In most countries, informal care is more resilient than home care services that formal providers deliver. Since they are an essential source for sustainable care, their challenges related to care should be addressed. The impact of the pandemic does not follow the traditional characterization of welfare regimes. A clustering effort may yield more understanding of the priorities that future care policies should exhibit at the national level and may identify potential systems for policymakers to enhance sustainability of care for community-dwelling older adults.

scholarly journals The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Anne Marie Mork Rokstad ◽  
Knut Engedal ◽  
Øyvind Kirkevold ◽  
Jūratė Šaltytė Benth ◽  
Geir Selbæk
Keyword(s):  
Nursing Home ◽  
Day Care ◽  
Nursing Home Admission ◽  
Controlled Study ◽  
People With Dementia ◽  
The Impact

scholarly journals Research on Home Care Nursing in Japan Using Geographic Information Systems: A Literature Review

2018 ◽  
Vol 9 ◽  
pp. 117967071881453
Author(s):  
Takashi Kuwayama ◽  
Kenji Hamabata ◽  
Toyomi Kamesaki ◽  
Soichi Koike ◽  
Kazuhiko Kotani
Keyword(s):  
Information Systems ◽  
Geographic Information Systems ◽  
Literature Review ◽  
Home Care ◽  
Integrated Care ◽  
Geographic Information ◽  
Home Nursing ◽  
Community Based ◽  
Home Care Nursing ◽  
Care Nursing

Given Japan’s super-ageing society and its need for developing community-based integrated care system, the role of home care nursing is becoming increasingly important. A central concern in home care nursing is regional/spatial placement of home nursing stations and accessibility for patients. Analysis based on geographic information systems (GIS) may be useful in home care nursing research. We conducted a literature review of home care nursing research based on GIS in Japan. A total of 4 articles were selected following a search of medical literature databases. The first report was published in 2014. Most subjects in the identified studies were older people. Most studies were implemented at a municipal level. Key themes in the identified studies were “placement of specialists and home nursing stations” and “placement of home nursing stations and target patients.” Despite the paucity of research, as all identified studies examined the community areas with an aged population, it may point to the need to consider community-based integrated care systems, including home care nursing, in Japan. More GIS-based research on home care nursing is called for.

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