The escalating demand for trained direct long-term care (DLTC) workers, those individuals with the most sustained direct contact with vulnerable older adults in homes and facilities, is a consequence of our rapidly aging population. Research documents the present and projected shortages of DLTC workers, and developed nations are increasingly…

This paper presents a complex, but realistic, picture of the lived experience in assisted living (AL), and provokes thoughtful reflection about the operational and ethical challenges faced in the delivery of care to an increasingly frail population in a typical AL facility. Developed from the findings of a two-year qualitative research project,…

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…

Intended for trainee use, the manual is in notebook format with a curriculum corresponding to the trainers' manual (VT 007 909), a related document. Part I, Basic Health Curriculum, deals with (1) the roles of health service aides, (2) Biological Potential and Equilibrium, (3) Professionals in the Health Field, (4) Public Health Administration,…

Conducted interviews with 54 home care clients (over half of whom were age 60+) and their home health aides and personal care attendants. Interviews revealed home care relationships tended to be both formal and informal, in that job responsibilities tend to be diffusely defined and home care workers often became involved in the…

Estimated effect of variety of factors on the utilization of home help among the elderly in Sweden using a sample (n=421) of people 75 years and older. Results indicated physical functioning (instrumental activities of daily living) and living alone were most important. (Author/ABL)

This study employs a longitudinal design to examine rural-urban differences in home care service use over time, drawing on data from the Manitoba Study of Health and Aging (MSHA). Characteristics of community-dwelling, cognitively intact adults aged 65 years or older not receiving home care services in the province of Manitoba (n = 855) were…

Objective: Data are presented from a pilot research program initiated to develop, refine, and test the outcomes of problem-solving therapy that targets the needs of older adults with minor depression in home care settings. Method: A pilot randomized clinical trial compares the impact of problem-solving therapy for home care to treatment as usual…

The first of three booklets on attendant care of severely disabled persons is addressed to the personal care attendants (PCAs). An introductory section reviews the basic concepts of independent living, noting the role of PCAs in promoting independence. Discussions of congenital and acquired disability are followed by information on equipment and…

Alliances for academic home care offer a new approach to advance the knowledge base related to home care, to improve quality and cost effectiveness of home care services, to prepare the next generation of providers to manage and deliver care in a restructured practice paradigm, and to influence health and social policy. (JOW)

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…

Context: The Balanced Budget Act (BBA) of 1997 and other recent policies have led to reduced Medicare funding for home health agencies (HHAs) and visits per beneficiary. Purpose: We examine the staffing characteristics of stable Medicare-certified HHAs across rural and urban counties from 1996 to 2002, a period encompassing the changes associated…

The final manual of a series on attendant care for severely disabled persons is intended to help persons with a disability to hire and manage personal care attendants (PCAs). Models--private and shared systems--are reviewed, and advantages and disadvantages of each noted. Suggestions for interviewing and hiring PCAs include guidelines for…

A review of the kinds of jobs available in services developed to help the homebound elderly: Home health care, homemaker-home health aide, chore service, home repair and maintenance, home-delivered meals, telephone reassurance, and friendly visiting. (JT)

The social service and health care occupation of homemaker-home health aide is described including job information, employment outlook, and benefits and drawbacks. (JT)