What Can Be Done To Better Support Older Adults To Age Successfully In Their Homes And Communities?

Herbert, Christopher; Molinsky, Jennifer

doi:10.1377/hlthaff.2019.00203

Cited by 21 publications

(9 citation statements)

References 8 publications

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“…Family members (informal caregivers), often assume this responsibility and serve as an interface between the PWD and health services [7, 8]. However, the responsibility of caregiving is also taken up by formal caregivers who often are paid for their services [9]. It is reported that informal caregivers are more likely motivated by emotional ties, cultural, spiritual, and religious responsibilities [2], while financial incentives motivate the formal caregivers [9].…”

Section: Introductionmentioning

confidence: 99%

What motivates informal caregivers of people with dementia (PWD): a qualitative study

et al. 2019

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BackgroundThe burden of caring for People with Dementia (PWD) is heavy; identifying incentives that motivate them in providing care is essential in facilitating and optimizing care. This study aims to explore and describe these motivating factors.MethodsWe conducted this qualitative study between January 2016 and January 2017 in Isfahan, Iran. Data were extracted through in-depth, semi-structured interviews with 19 caregivers of PWD. These data were then examined through thematic content analysis.ResultsWe identified four categories of psychological motives based on the caregivers’ feedback and experience. These include 1) Moral-based motives, 2) Religious, and spiritual motives; 3) Financial motives, and 4) Wicked motives.ConclusionsOur results revealed several aspects of caregivers’ motives. They include moral, religious, and spiritual aspects; sharing housing accommodations, and the likelihood of inheriting a portion of the patient’s assets based on unspoken rules and informal arrangements in the family, and wicked and immoral aspects. These findings can inform future efforts in enhancing the experiences of caregivers of PWD, and subsequently, the quality of care these patients receive. It further suggests that family members, members of a religious and spiritual organization, as well as social media, could play important roles in setting the stage.

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Section: Introductionmentioning

confidence: 99%

What motivates informal caregivers of people with dementia (PWD): a qualitative study

et al. 2019

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“…The multiple preparedness phases implemented by the VA's HBPC programs demonstrate the efforts required to invest in the types of antecedent conditions that enhance a community's absorptive capacity. Prior research has shown that the older old and their caregivers are often isolated from their communities [28,29] and unprepared for disasters [8]. By talking with patients about emergency plans, providing information and support for shelter registration, and heightening medication management during the hurricane season, HBPC program staff bridge this essential gap between patients and their communities.…”

Section: Discussionmentioning

confidence: 99%

Preparedness and response activities of the US Department of Veterans Affairs (VA) home-based primary care program around the fall 2017 hurricane season

et al. 2020

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Background Large-scale natural disasters disproportionally affect both the medically complex and the older old, groups that are responsible for most medical surge after a disaster. To understand how to ameliorate this surge, we examined the activities of the nine US Department of Veterans Affairs (VA) Home Based Primary Care (HBPC) programs impacted during the 2017 Fall Hurricane Season. Methods Convergent mixed methods design, incorporating independently conducted qualitative and quantitative analyses. Phase One: 34 clinical staff were interviewed from the nine VA HBPC programs impacted by Hurricanes Harvey, Irma, and Maria to examine the experiences of their HBPC programs in response to the Hurricanes. Phase Two: Secondary quantitative data analysis used the VA’s Corporate Data Warehouse (CDW) to examine the electronic health records of patients for these same nine sites. Results The emergency management activities of the HBPC programs emerged as two distinct phases: preparedness, and response and recovery. The early implementation of preparedness procedures, and coordinated post-Hurricane patient tracking, limited disruption in care and prevented significant hospitalizations among this population. Conclusions Individuals aged 75 or older, who often present with multiple comorbidities and decreased functional status, typically prefer to age in their homes. Additionally, as in-home medical equipment evolves, more medically vulnerable individuals are able to receive care at home. HBPC programs, and similar programs under Medicare, connect the homebound, medically complex, older old to the greater healthcare community. Engaging with these programs both pre- and post-disasters is central to bolstering community resilience for these at-risk populations.

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“…Instead, most communities are organized to accommodate active, non-disabled adults without attention to the supportive social and physical environment needed by older adults. (Herbert, 2019). Over 40 percent of the housing units occupied by older adults were built in 1969 or earlier, and often the supportive qualities of these homes receive little attention.…”

Section: Challenges To Aging In Placementioning

confidence: 99%

“…Over 40 percent of the housing units occupied by older adults were built in 1969 or earlier, and often the supportive qualities of these homes receive little attention. Only 3.5 percent of homes in the US offer single-floor living, a no-step entry, and extra wide halls and doorways that can accommodate a wheelchair and other mobility devices (Herbert, 2019).…”

Section: Challenges To Aging In Placementioning

confidence: 99%

“…At the same time, the number of family members available to care for elders at home has declined, and the number of professional and paraprofessional workers trained to care for elders at home has fallen. Although most(84 percent) of older adults depend on family members for care (Herbert 2019), the projected decline in family caregiver support, referred to as the family-care gap, raises additional questions about who will care for the growing number of older adults hoping to age in their homes (Gaugler 2020). Changes in family composition and geographic dispersion have resulted in many older adults living alone as they age, hoping to remain in their homes as long as possible (Mather 2015).…”

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confidence: 99%

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Aging in Place: The Role of Public-Private Partnerships

Hodgson

2020

SSRN Journal

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Declining public resources necessitate collaboration between public and private investors in order to meet the demands of an aging society to 'age in place.' Aging in place is a term that has emerged in the past ten years to describe older people's desire to stay in their home and community. This paper presents an overview of aging in place and the role of public-private partnerships in finding solutions. Examples illustrate the common elements of successful existing partnership models for future replication. Additional opportunities for innovation demonstrate that much more can be done to meet the needs of the aging population and honor their preference to age in place.

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What Can Be Done To Better Support Older Adults To Age Successfully In Their Homes And Communities?

Cited by 21 publications

References 8 publications

What motivates informal caregivers of people with dementia (PWD): a qualitative study

What motivates informal caregivers of people with dementia (PWD): a qualitative study

Preparedness and response activities of the US Department of Veterans Affairs (VA) home-based primary care program around the fall 2017 hurricane season

Aging in Place: The Role of Public-Private Partnerships

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