Quality of care for frail older persons in a homecare setting: what is it and how can it be measured?

Unlabelled: ABSTRACTBackground:As more older persons opt to age in place, there is a growing trend to hire migrant workers as live-in caregivers to care for them. This raises the need to examine the quality of care they receive within this unique care setting. The objective of this pilot study was to establish the components of quality of care as provided by migrant live-in caregivers.

Social Engagement Care for Frail Older Persons: Desire for It and Provision by Live-In Migrant Caregivers.

Objectives: To describe social engagement care (SEC) provided by live-in migrant caregivers for frail older adults compared with care recipients' and families' wishes for such care.

Method: Interviews with care recipients, family members, and migrant caregivers assessed preferences for and provision of five types of SEC activities: knowing the older person as a person, knowing their main concerns, having personal conversations, going for walks, and sharing social or leisure activities.

Results: Care recipients and family proxies reported a moderate desire for SEC from migrant caregivers, except for sharing leisure activities, for which there was only a slight preference.

Psychometric Characteristics of the Hebrew Version of the Professional Quality-of-Life Scale.

Context: Exposure to human suffering may have ramifications for the professional quality of life (ProQol) of palliative care teams. The ProQol scale was designed to assess both negative and positive work-related outcomes and has been used recently for the evaluation of work-related outcomes among palliative care workers. However, the assessment of ProQol among Israeli hospice workers is scant.

Live-in Care Workers in Sheltered Housing for Older Adults in Israel: The New Sheltered Housing Law.

Supportive housing schemes were historically aimed to provide group accommodation for older adults. With the aging of residents, facilities were required to enable them to receive care services in order to allow them to age in place. Thus, different countries and different facilities developed different models of housing with care, reflecting cultural and policy diversities.

Socio-Spatial Integration of Older Adults in Four Types of Residential Environments in Israel.

The socio-spatial integration of older people in different types of residential environments is a key factor affecting the well-being of older people. This study, which included a convenience sample of 565 participants, examined the socio-spatial integration of older people living in two different regional areas (central and peripheral) and four different residential environments (metropolitan hub, city, and town and rural settlements) in Israel. Willing participants were asked to complete a self-administered questionnaire.

Agism and burnout among nurses in long-term care facilities in Israel.

Objectives: The extent to which agism and professional qualifications are associated with nurses' burnout in long-term care facilities for older adults has been barely examined. This study is aimed to examine the extent to which agism, professional education, and geriatric training explain work burnout.

Method: The study included a convenience sample of 154 nurses working in 17 long-term care facilities in the Tel Aviv area in Israel.

Do caregiving burden and satisfaction predict loneliness in older care recipients?

Objectives: The goal of this study was to assess the extent to which caregiving burden and satisfaction of primary family caregivers in Israel predict loneliness among their older care recipients.

Method: The study included a convenience sample of 325 dyads of respondents. The short version of Zarit Caregiving Burden Interview and Lawton Caregiving Appraisal measures were used to assess caregiving burden and satisfaction; the de Jong Gierveld Loneliness Scale was used to assess care recipient's loneliness.

The Association Between Older Israelis' Quality of Relationships With Their Family and Migrant Live-in Caregivers and Their Loneliness.

Objectives: (a) To assess the extent to which there are ambivalent dyadic relationships between older care recipients and their primary family caregivers (PFCs) and migrant care workers (MCWs) and (b) to examine the extent to which ambivalence explains loneliness among the care recipients.

Method: A sample of 279 triads of respondents (care recipients, their PFCs, and their MCWs) was used and interviewed face-to-face. The Dyadic Relationship Scale was used to assess quality of relationships and ambivalence.

Factors explaining the job satisfaction of home care workers who left their older care recipients in Israel.

There are high levels of turnover among home care workers. The study goal was to examine factors connected with job satisfaction of home care workers who resigned from their jobs. A survey (self-administered questionnaire) was conducted of 197 home care workers who resigned from their jobs with a home care agency in Jerusalem.

Hospital policies and nurses' attitudes in Israel towards paid carers' tasks during patient hospitalization.

Many hospitalized older patients are functionally dependent and, during their hospitalization, employ paid caregivers to perform various tasks. This study examined nurses' attitudes regarding the tasks these care workers should or should not be allowed to perform in providing care during hospitalization, and the factors underlying nurses' attitudes towards these paid carers. The study involved interviews of five key informants such as head nurses and medical directors in two general hospitals and surveys of 265 nurses in internal medicine and geriatric wards.

Practices used in Israel by nurses who care during hospitalization for older patients with dementia or who are bedridden.

The study's purpose was to examine (a) bedside nurses' care practices when providing care to patients with dementia or those who are physically disabled and (b) the extent to which these actions vary by type of hospital, type of ward, and nurse's characteristics. The sample included 265 nurses in internal medicine and geriatric wards in 2 general hospitals in Israel. The results showed that the most prevalent practices were giving greater attention to these patients, locating them in a room near the nurses' station and asking family members to stay with the patient or to hire paid carers.

Tasks performed by migrant live-in care workers during hospitalization of their older care recipients.

The goals of the study were to examine: (a) the tasks that migrant live-in care workers are expected to perform and actually perform during the hospitalization of their care recipients, and (b) the factors that explain the level of involvement by care workers in caring for hospitalized care recipients. A sample of 535 dyads of family caregivers and care workers of hospitalized care recipients in two general hospitals in Israel was interviewed. Results showed a high level of congruence between the care workers' and family caregivers' perceptions of the roles that the paid carers should perform.

Concordance between self-reported and physician-reported chronic co-morbidity among disabled older adults.

Discordance between self-reports and medical records reflects patient and provider factors that have implications for management and research. This study investigated discordance and socio-demographic factors that explain concordance. A purposive sample of 402 disabled older persons was interviewed using a structured questionnaire.

Attendance in adult day care centers of cognitively intact older persons: reasons for use and nonuse.

The article aims to (a) examine the reasons for nonuse of ADCC, and (b) explore the reasons for use of adult day care centers (ADCCs) among users. The sample includes 819 respondents of whom 417 are users of 13 day care centers and 402 are nonusers, matched by age, gender, and family physician in the southern region of Israel. Data collection includes interviews that used a structured questionnaire.

Health, body image, gender, and migration status: their relationship to sexuality in old age.

Background: The aim of this study was to assess the relationships between gender, migration status, perceived health, body image, and sexual activity and satisfaction among older adults. It was hypothesized that men and those who are long-standing residents in Israel will report better perceived health, a positive body image, and these will be associated with greater sexuality, compared with women, new immigrants with poorer perceived health and a negative body image.

Methods: The sample included 200 respondents who were 60 years and older, functionally independent and living with a spouse or a partner for at least one year, heterosexual, and living in the community in Israel.

Ageism and social integration of older adults in their neighborhoods in Israel.

Purpose: The article aims to examine the extent to which ageism is connected with the social integration of older adults in their neighborhoods and to identify factors that explain social integration.

Design And Methods: A convenience sample that included 300 older adults aged 65 and older and 300 younger people under the age of 65 who resided in 3 neighborhoods in Tel-Aviv with varied socioeconomic status were interviewed. Kogan's Attitudes toward Old People scale was used to probe ageism.

Sense of threat and coping strategies of Israeli older adults during a military operation.

To examine what levels of sense of threat functionally disabled older people experience during war and the coping strategies they use to protect themselves; to examine factors that explain their sense of threat and coping strategies. A convenience sample that included 138 respondents who were functionally disabled older adults and received homecare services. Face-to-face interviews were conducted using a structured questionnaire.

Use of adult day care centers: do they offset utilization of health care services?

Purpose: Based on the medical offset effect, the goal of the study was to examine the extent to which users and nonusers of adult day care centers (ADCC) differ in frequency of use of out-patient health services (visits to specialists) and in-patient health services (number of hospital admissions, length of hospitalizations, and visits to emergency departments).

Design And Methods: A case-control study was used with a sample of 800 respondents, of whom 400 were users of 13 day care centers in the southern region of Israel and 400 were nonusers, matched by age, gender, and active family physician. Data collection included face-to-face interviews using a structured questionnaire.

The long-term care insurance law in Israel: present and future.

Aging in place is a core component of the policy on aging in Israel. This was well expressed in the Long-Term Care Insurance law enacted in 1986 and implemented in 1988. Under the law, disabled persons can receive in-kind home- and community-based services to enable frail older adults to age in place and to complement or supplement the care provided primarily by family caregivers who are legally responsible for caregiving of their elderly family members.

Attendance in adult day care centers and its relation to loneliness among frail older adults.

Background: Loneliness is widespread among older adults, in particular among those who are chronically ill and functionally limited. The aims of the paper are: (i) to examine the extent to which users of day care centers experience loneliness compared to their peers who are non-users; and (ii) to explore the relationships between length of use and frequency of weekly attendance at day care centers and loneliness among users of day care centers.

Methods: A case-control study was used with a sample of 817 respondents of whom 417 were users of 13 day care centers and 400 were non-users, matched by age, gender, and family physician in the southern region of Israel.

Loneliness, social networks, and mortality: 18 years of follow-up.

We examined the influence of changes in loneliness and social support networks upon mortality during 18 years of follow-up among an elderly cohort and determined the gender-specific nature of this relationship. The study is based on data collected from the Jerusalem Longitudinal Study (1990-2008), which has followed a representative sample of 605 community-dwelling elderly people. Subjects were randomly selected from an age homogenous cohort born 1920-1921 and were aged 70, 78, and 85 when data were collected at baseline in 1990 and at follow-up in 1998 and 2005.

Quality of relationships between care recipients and their primary caregivers and its effect on caregivers' burden and satisfaction in Israel.

Research on the impact of quality of relationships between primary caregivers and their care recipients on burden and satisfaction with caregiving is still rare. The sample included 335 dyads of primary caregivers and care recipients who were cognitively intact. Face-to-face interviews were conducted at the respondents' homes using structured questionnaires.

Psychometric properties of the Hebrew version of the Zarit Caregiver Burden Scale short version.

Objectives: The purpose of this study was to evaluate the reliability and validity of the Hebrew version of the Zarit Burden Interview (H-ZBI) short version.

Method: Cross-sectional research methodology was used to measure the caregiver burden felt by informal family caregivers of cognitively intact but physically frail older family members. Data of this study were drawn from two convenience samples that included altogether 456 dyads of family caregivers and care recipients in Israel.

What makes migrant live-in home care workers in elder care be satisfied with their job?

Purpose: The study aims to examine job satisfaction of migrant live-in home care workers who provide care to frail older adults and to examine the extent to which quality of relationships between the care provider and care recipient and workplace characteristics is associated with job satisfaction. 

Design And Methods: A convenience sample that included 335 dyads of Philippine workers and their frail care recipients were recruited through 2 national home care agencies and snowballing. Multiple regression analyses examined the extent to which workplace characteristics, quality of relationships, care recipient characteristics, and care worker characteristics explain job satisfaction.

Relationships between elderly care recipients and their migrant live-in home care workers in Israel.

In Israel more than 54,000 immigrant live-in home care workers are providing personal care to frail elders. These home care workers emigrate from various countries and different cultures, speak other languages, and have other religions. The purposes of this study were: (a) to examine the patterns of the interpersonal relationships that develop between disabled elderly persons who were being cared for by migrant live-in home care workers, and (b) to explore the factors that best explain the patterns of these relationships.