Perceptions of the Role of Living Alone in Providing Services to Patients With Cognitive Impairment.

Importance: The potential role of living alone in either facilitating or hampering access to and use of services for older adults with cognitive impairment is largely unknown. Specifically, it is critical to understand directly from health care and social services professionals how living alone creates barriers to the access and use of supportive health care and social services for racially and ethnically diverse patients with cognitive impairment.

Objective: To identify the potential role of living alone in the access and use of health care and social services for diverse patients with cognitive impairment by investigating professionals' perceptions of caring for such patients who live alone in comparison with counterparts living with others.

Use of Home-Based Clinical Care and Long-Term Services and Supports Among Homebound Older Adults.

Objectives: Describe use of home-based clinical care and home-based long-term services and supports (LTSS) using a nationally representative sample of homebound older Medicare beneficiaries.

Design: Cross-sectional study.

Setting And Participants: Homebound, community-dwelling fee-for-service Medicare beneficiaries participating in the 2015 National Health and Aging Trends Study (n = 974).

Severe neighborhood deprivation and nursing home staffing in the United States.

Background: Low nursing home staffing in the United States is a growing safety concern. Socioeconomic deprivation in the local areas surrounding a nursing home may be a barrier to improving staffing rates but has been poorly studied. Thus, the objective of this paper was to assess the relationship between neighborhood deprivation and nursing home staffing in the United States.

"It Makes You Feel Good to Help!": An Exploratory Study of the Experience of Peer Mentoring in Long-Term Care.

Social isolation and loneliness in long-term care settings are a growing concern. Drawing on concepts of social citizenship, we developed a peer mentoring program in which resident mentors and volunteers formed a team, met weekly for training, and paired up to visit isolated residents. In this article, we explore the experiences of the resident mentors.

The Imperative to Reimagine Assisted Living.

Assisted living (AL) has existed in the United States for decades, evolving in response to older adults' need for supportive care and distaste for nursing homes and older models of congregate care. AL is state-regulated, provides at least 2 meals a day, around-the-clock supervision, and help with personal care, but is not licensed as a nursing home. The key constructs of AL as originally conceived were to provide person-centered care and promote quality of life through supportive and responsive services to meet scheduled and unscheduled needs for assistance, an operating philosophy emphasizing resident choice, and a residential environment with homelike features.

Federal requirements for nursing homes to include certified nursing assistants in resident care planning and interdisciplinary teams: A policy analysis.

Starting in 2016, Centers for Medicare and Medicaid Services implemented the first phase of a 3-year multi-phase plan revising the manner in which nursing homes are regulated. In this revision, attention was placed on the importance of certified nursing assistants (CNAs) to resident care and the need to empower these frontline workers. Phase II mandates that CNAs be included as members of the nursing home interdisciplinary team that develops care plans for the resident that are person-centered and comprehensive and reviews and revises these care plans after each resident assessment.

'It makes life worthwhile!' Peer mentoring in long-term care-a feasibility study.

Loneliness and depression are of increasing concern in long-term care homes made more urgent by viral outbreak isolation protocols. An innovative program called Java Mentorship was developed that engaged community volunteers and resident volunteers (mentors) as a team. The team met weekly, received education, and provided visits and guidance in pairs to socially disengaged residents (mentees).

The Demographics and Economics of Direct Care Staff Highlight Their Vulnerabilities Amidst the COVID-19 Pandemic.

An estimated 3.5 million direct care staff working in facilities and people's homes play a critical role during the COVID-19 pandemic. They allow vulnerable care recipients to stay at home and they provide necessary help in facilities.

The Impact of Peer Mentoring on Loneliness, Depression, and Social Engagement in Long-Term Care.

Loneliness, depression, and social isolation are common among people living in long-term care homes, despite the activities provided. We examined the impact of a new peer mentoring program called Java Mentorship on mentees' loneliness, depression, and social engagement, and described their perceptions of the visits. We conducted a mixed-methods approach in 10 homes in Ontario, Canada, and enrolled residents as mentees ( = 74).

Home And Community-Based Workforce For Patients With Serious Illness Requires Support To Meet Growing Needs.

Home health and personal care aides are one of the largest groups of health care workers in the US, with nearly three million people providing direct care for people with serious illness living in the community. These home care workers face challenges in recruitment, training, retention, and regulation, and there is a lack of data and research to support evidence-based policy change. Personal care aides receive little formal training, and they experience low pay and a lack of respect for the skill required for their jobs.

Beyond Functional Support: The Range Of Health-Related Tasks Performed In The Home By Paid Caregivers In New York.

Paid caregivers (for example, home health aides and personal care attendants) are formally tasked with helping older adults with functional impairment meet their basic needs at home. This study used thirty semistructured interviews with dyads of patients or their proxies and their paid caregivers in New York City to understand the range of health-related tasks that paid caregivers perform in the home and determine whether these tasks are taught in the New York State Department of Health's curriculum. We found that patients, proxies, and paid caregivers all reported that paid caregivers performed a wide range of health-related tasks that were often not part of their formal training.

The Future of the Home Care Workforce: Training and Supporting Aides as Members of Home-Based Care Teams.

Home health, home care, and personal care aides provide most of the paid hands-on care delivered to seriously ill, functionally impaired individuals in their homes, assisted living, and other noninstitutional settings. This workforce delivers personal care, assistance with activities of daily living, and emotional support to their patients. They are often the eyes and ears of the health system, observing subtle changes in condition that can provide important information for clinical decision making and therapeutic intervention.

Person-Centered Care as Facilitated by Kansas' PEAK 2.0 Medicaid Pay-for-Performance Program and Nursing Home Resident Clinical Outcomes.

Purpose Of The Study: Person-centered care (PCC) is intended to improve nursing home residents' quality of life, but the closer bonds it engenders between residents and staff may also facilitate improvements to residents' clinical health. Findings on whether adoption ameliorates resident clinical outcomes are conflicting, with some evidence of harm as well as benefit. To provide clearer evidence, the present study made use of Kansas' PEAK 2.

The housing challenges of low-income older adults and the role of federal policy.

Adequate housing is critical for low-income older adults, who face affordability and accessibility challenges that affect their quality of life, health, and ability to live independently in their communities. This article examines the federal policy role in meeting the housing and housing-related needs of the low-income elderly population, which is expected to grow as a proportion of all older adults over the next two decades. The availability of publicly subsidized units and vouchers is woefully inadequate to assist the current low-income elderly population in need of rental assistance.

Does Person-Centered Care Improve Residents' Satisfaction With Nursing Home Quality?

Objective: Person-centered care (PCC) is meant to enhance nursing home residents' quality of life (QOL). Including residents' perspectives is critical to determining whether PCC is meeting residents' needs and desires. This study examines whether PCC practices promote satisfaction with QOL and quality of care and services (QOC and QOS) among nursing home residents.

The impact of health care reform on the workforce caring for older adults.

This article summarizes the Patient Protection and Affordable Care Act (ACA) provisions that have a direct or indirect impact on the workforce caring for the elder population, explores the challenges to developing the workforce, and critiques the adequacy of the ACA provisions in meeting those challenges. The ACA is the first comprehensive federal legislation to acknowledge gaps in the workforce caring for the elder population. However, its provisions are inadequate given insufficient supply in the number and types of workers necessary both to meet the caregiving demand of the growing elder population and to implement the delivery system reforms instituted by the ACA.

Implementation and Evaluation of LVN LEAD. A leadership and supervisory training program for nursing home charge nurses.

Licensed practical/vocational nurses (LVNs) play an important role in U.S. nursing homes, with primary responsibility for supervising unlicensed nursing home staff.

Supporting culture change: working toward smarter state nursing home regulation.

The traditional nursing home regulatory approach, which uses survey and enforcement to achieve performance improvement, has created tensions between providers and surveyors. It has had limited success in improving quality overall and not necessarily allowed innovation to flourish. This has been the perception of many homes wanting to undergo transformative "culture change" reforms.

Tenure, certification, and education of nursing home administrators, medical directors, and directors of nursing in for-profit and not-for-profit nursing homes: United States 2004.

Objectives: To understand key characteristics of the leadership team, and to examine if differences in these factors exist between for-profit (FP) and not-for-profit (NFP) nursing homes (NHs).

Design: Cross sectional.

Setting: US nursing homes.