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Home Care Worker Continuity in Home-Based Long-Term Care: Associated Factors and Relationships With Client Health and Well-Being.

Authors :
Reckrey JM
Russell D
Fong MC
Burgdorf JG
Franzosa EC
Travers JL
Ornstein KA
Source :
Innovation in aging [Innov Aging] 2024 Feb 23; Vol. 8 (3), pp. igae024. Date of Electronic Publication: 2024 Feb 23 (Print Publication: 2024).
Publication Year :
2024

Abstract

Background and Objectives: Despite the importance of provider continuity across healthcare settings, continuity among home care workers who provide hands-on long-term care is understudied. This project describes home care worker continuity, identifies factors associated with increased continuity, and examines associations between continuity and client outcomes.<br />Research Design and Methods: We conducted a retrospective cohort study of clients receiving Medicaid-funded home-based long-term care ( n = 3,864) using insurance plan and home care agency data from a large nonprofit organization. We estimated home care worker continuity for clients between 6-month clinical assessments using Bice-Boxerman scores. We then used generalized estimating equations to model associations between home care worker continuity and (1) client characteristics (e.g., cognitive impairment), and (2) client functional, health, and psychosocial outcomes.<br />Results: While home care worker continuity was lowest for clients receiving the most weekly care hours, a range of continuity existed across all levels of care need. Those who were male, older, Asian/Pacific Islander/Native American, cognitively impaired, and functionally impaired had lower continuity. Higher home care worker continuity was significantly associated ( p < .05) with fewer falls, a higher likelihood of functional improvement/stabilization, and fewer depressive symptoms.<br />Discussion and Implications: The finding that home care worker continuity is associated with the health and well-being of home-based long-term care clients underscores the importance of building high-quality relationships in long-term care. Continued efforts are necessary to understand and advance home care worker continuity and to identify other aspects of the home care experience that benefit those receiving long-term care at home.<br />Competing Interests: None.<br /> (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Details

Language :
English
ISSN :
2399-5300
Volume :
8
Issue :
3
Database :
MEDLINE
Journal :
Innovation in aging
Publication Type :
Academic Journal
Accession number :
38505005
Full Text :
https://doi.org/10.1093/geroni/igae024