Providing Home Care For Older Adults

A practical guide to providing home-based mental health services, Providing Home Care for Older Adults teaches readers how to handle the unique aspects of home-based care and apply and adapt evidence-based assessment and treatment within the home-based setting. Featuring contributions from experienced, board-certified home care psychologists, social workers, and psychiatrists, the book explains the multifaceted role of a home-based provider, offers concrete and practical considerations for working within the home, and highlights adaptations to specific evidence-based methods used in treating homebound older adults. Also covered are special topics related to hoarding, safety, capacity evaluations, caregivers, case management, and use of technology. Each chapter includes engaging case examples with practical tips that illustrate what it is like to work in this new and exciting frontier. Psychologists, counselors, and other mental health practitioners in home settings will be able to use this guide to provide effective home-based care to older adults.

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

As the population of older adults in the U.S. continues to grow, medical house calls are increasingly part of a system of comprehensive home-based care for patients who have difficulty accessing office-.based care. Clinicians who have been trained mostly in office and hospital settings must adapt their usual approaches to accommodate a wide range of environmental, social, and physical circumstances that impact home-limited patients. Ideally, a comprehensive team of clinicians proficient in multiple domains of functional, social, and medical care can work together to address potential gaps in any one clinician’s expertise. Unfortunately, such teams are still rare. This book aims to equip individual clinicians with the interdisciplinary knowledge, skills, and perspective they need to provide the best care possible with limited formal interdisciplinary support. This book offers 20 patient cases drawn from the collective experience of experts in home-based medical care from highly respected academic and clinical programs across the United States. Each case demonstrates a scenario that is frequently encountered and/or very important in home-based medical care practice. Each scenario frequently proves to be challenging for many professionals because it requires an approach or leverages aspects of care delivery that most are not trained in. Additionally, each scenario reflects an approach to care that is enhanced by interdisciplinary input. Finally, each case lends itself to a practical problem-solving approach that could be accomplished by most home-based medical care providers, even in the absence of an interdisciplinary team. Written by interdisciplinary experts in geriatric home-based care, this book serves as both an educational tool for learners in all related disciplines as well as a quick reference for experienced clinicians looking to augment their existing house call “toolbox.”

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

The rapid growth of home health care has raised many unsolved issues and will have consequences that are far too broad for any one group to analyze in their entirety. Yet a major influence on the safety, quality, and effectiveness of home health care will be the set of issues encompassed by the field of human factors research-the discipline of applying what is known about human capabilities and limitations to the design of products, processes, systems, and work environments. To address these challenges, the National Research Council began a multidisciplinary study to examine a diverse range of behavioral and human factors issues resulting from the increasing migration of medical devices, technologies, and care practices into the home. Its goal is to lay the groundwork for a thorough integration of human factors research with the design and implementation of home health care devices, technologies, and practices. On October 1 and 2, 2009, a group of human factors and other experts met to consider a diverse range of behavioral and human factors issues associated with the increasing migration of medical devices, technologies, and care practices into the home. This book is a summary of that workshop, representing the culmination of the first phase of the study.

This book explores the meaning of quality of life in care for older persons and introduces the reader to their main concerns when receiving care. Based on qualitative research, it pays particular attention to the needs and requirements of older people, considering their individual family situations, social circumstances, values and lifestyles. Person-centred care is a way of providing nursing care that puts older people and their families at the core of all decisions, seeing each person as an individual, and working together to develop appropriate solutions. Following an introduction to the concept of quality of life in old age, the book reviews essential findings from worldwide research into the experiences of older people with regard to nursing care and the impact of these experiences on their quality of life. It investigates health promotion, care provided in nursing homes and assisted living facilities, and palliative care. Each chapter includes a brief introduction to the respective field of nursing care and the problems it has to deal with, concluding with a discussion of their implications for nursing practice in the respective field of care. In closing, the evidence from qualitative research is discussed in relation to current gerontological theories.