Safety at Home: A Pan-Canadian Home Care Study

The report is the result of a collaborative study between The Canadian Patient Safety Institute, the Canadian Institutes of Health Research (CIHR), Institutes of Health Services and Policy Research (IHSPR), The Change Foundation, and the Canadian Foundation for Healthcare Improvement (CFHI).  

The study examined the reasons for harmful incidents, determined the impact on families and clients and made suggestions on how to make home care safer.

The research team in collaboration with CPSI and national partners such as Canadian Home Care Association, Accreditation Canada, and Victoria Order of Nurses will be developing tools and resources for various audiences including clients, caregivers, Home Care organizations, and policy makers.  

The report can be accessed here: http://www.patientsafetyinstitute.ca/English/research/commissionedResearch/SafetyatHome/Pages/default.aspx

Seniors in need, caregivers in distress

On April 16^th, the Health Council of Canada released the report, Seniors in need, caregivers in distress: What are the home care priorities for seniors in Canada?  

The use of home care services has notably increased in the last decade. This report takes a deeper look at the seniors who are receiving home care, the family caregivers who are lending support, and the overall challenges of home care in Canada.

Along with our analyses of home care data, the report features caregiver stories that take a poignant look at the struggles seniors and their caregivers face, as their health care needs increase.

Also profiled are Canadian innovative practices, as well as some international examples of how home care can be integrated within the wider health care system.

For more information about the report, and associated activities, including nation wide blogging, and webinar, see: http://healthcouncilcanada.blogspot.ca/2012/04/seniors-in-need-caregivers-in-distress.html

Because this is the rainy day: a discussion paper on home care and informal caregiving for seniors with chronic health conditions

Released in February, 2011, by The Change Foundation, an independent policy think tank, intent on changing the health-care debate, health-care practice and the health-care experience in Ontario.

Can we provide good care at home for seniors with chronic health conditions? If so, at what cost? And to whom?

To explore these questions, The Change Foundation commissioned leading home-care expert Dr. John Hirdes, (Professor, University of Waterloo and Scientific Director, Homewood Research Institute), to examine data on Ontario seniors with chronic conditions to help us understand how they use home-care services, what their health-care needs are as they move from hospital to home and/or community care, and what the implications are for their caregivers.

Dr. Hirdes and his research team delved into rich, detailed data about home-care use in Ontario from 2004 to 2008. The picture that emerges illustrates the need for action to address three objectives:

• to better align home-care services to seniors’ needs;
• to realign resources from acute to community care; and
• to use home care more strategically to provide seniors and their informal caregivers with care and support tailored to their needs as well as to help solve health system problems.

 http://www.changefoundation.ca/docs/ElderlyInformal.pdf

The 'GRACE' Model: In-Home Assessments Lead to Better Care for Dual Eligibles

From the Commonwealth Fund, Publications in Brief, March 8, 2011, Summary Writer: Sarah Klein
Health Affairs, March 2011 30(3):431–34, available at http://content.healthaffairs.org/content/30/3/431.extract.
 
The Issue
Fragmentation of care is common among Medicare beneficiaries, half of whom receive treatment for five or more chronic conditions each year. Comprehensive, coordinated care—particularly during transitions in care—has the potential to improve health outcomes and lower the cost of care.
The Innovation

Geriatric Resources for Assessment and Care of Elders (GRACE) conducts in-home assessments using a team with nurse practitioner and a social worker to develop individualized care plans for low-income seniors, many of whom are eligible for Medicare and Medicaid and most of whom have multiple chronic conditions. The team, which is responsible for coordinating patient care on an ongoing basis, collaborates with a broader group of providers including a geriatrician, a pharmacist, a physical therapist, and a mental health worker. A Web-based care management tracking system supports coordination and continuity of care among the health care professionals and sites of care.
Results

The two-year intervention—developed by Wishard Health Services in Indiana—saved $1,500 per enrolled high-risk patient by the second year. For patients at the highest risk of hospitalization, GRACE reduced hospital admission rates by 12 percent and 44 percent in the first and second years of the program. GRACE patients also reported higher quality of life compared with the control group.

Citation

"The 'GRACE' Model: In-Home Assessments Lead to Better Care for Dual Eligibles," Health Affairs, March 2011 30(3):431–34.

Support. Stay. Save. Care and support for people with dementia in their own homes

This report, published by the Alzheimer's Society (UK), provides evidence from over 2,000 carers, people with dementia and home care workers on the aspirations, experiences and outcomes of providing dementia care in the community in England, Wales and Northern Ireland. The evidence and recommendations are for commissioners and service providers and are intended to support good practice in meeting the
needs of people with dementia living in their own homes

http://alzheimers.org.uk/site/scripts/download_info.php?fileID=1030

Home Support Workers in the Continuum of Care for Older People

This In Focus Backgrounder from the Canadian Research Centre for Care in the Community gives an overview of the role of home support workers within the broad continuum of care, their training programs and standards in Canada and other jurisdictions. While there may be some overlap in the issues around home support workers who serve older people and those who care for people with disabilities, there are many issues distinctive to aging or disability.

http://www.ryerson.ca/crncc/knowledge/factsheets/documents/InFocus%20Home%20Support%20Workers.pdf

Dementia Care Practice Recommendations for Professionals Working in a Home Setting

The Alzheimer’s Association released the first practice recommendations for professionals providing home care to people with Alzheimer’s.

Dementia Care Practice Recommendations for Professionals Working in a Home Setting (pdf) is the fourth in the association’s series of evidence-based publications aimed at helping providers and caregivers to administer person-centered, culturally sensitive care for people with dementia.

The recommendations support training that emphasizes relationship-centered care regardless of the stage of the disease.

This manual joins three sets of recommendations that were designed for nursing home and assisted living residences. Combined, the recommendations form the basis of the association’s multiyear Campaign for Quality Care.