Training Needs Among Family Caregivers Assisting During Home Health,as Identified by Home Health Clinicians |
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| Institution: | 1. Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA;2. Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, USA;3. Armstrong Institute Center for Health Care Human Factors, Johns Hopkins University School of Medicine, Baltimore, MD, USA;1. Rocky Mountain Regional Veterans Affairs Medical Center, Denver-Seattle Center of Innovation, Aurora, CO, USA;2. Division of Health Care Policy and Research, School of Medicine, University of Colorado, Aurora, CO, USA;1. CIRO+, Department of Research & Development, Horn, the Netherlands;2. NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands;3. Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands;4. Viscovery Software GmbH, Vienna, Austria;5. School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands;6. Ludwig Boltzman Institute for Lung Health, Vienna, Austria;1. Research Unit for General Practice, Aarhus, Denmark;2. Department of Public Health, Aarhus University, Aarhus, Denmark;3. Steno Diabetes Center Aarhus, Aarhus, Denmark;4. Department of Geriatrics, Aarhus University Hospital, Aarhus, Denmark;1. The Cecil G. Sheps Center for Health Service Research, University of North Carolina, Chapel Hill, NC, USA;2. Schools of Social Work and Public Health, University of North Carolina, Chapel Hill, NC, USA;3. Department of Family Medicine, University of North Carolina, Chapel Hill, NC, USA;4. Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA;1. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada;2. Bruyère Research Institute, Ottawa, Ontario, Canada;3. ICES uOttawa, Ottawa, Ontario, Canada;4. ICES McMaster, Hamilton, Ontario, Canada;5. Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada;6. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada;7. Department of Medicine, McMaster University, Hamilton, Ontario, Canada;8. Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada;9. Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada;10. St. Patrick''s Home of Ottawa, Ottawa, Ontario, Canada |
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| Abstract: | ObjectivesTo estimate the proportion of family caregivers assisting older adults during Medicare home health who have an identified need for activity-specific training and identify characteristics associated with caregiver training needs.DesignNationally representative retrospective cohort study.Setting and Participants1758 (weighted n = 8,477,990) Medicare beneficiaries who participated in the National Health and Aging Trends Study (NHATS) and received Medicare-funded home health care between 2011 and 2016.MeasuresOlder adult and caregiving network characteristics before home health (sociodemographic factors, caregiver assistance, older adult health and function) were drawn from NHATS; characteristics during home health (family caregiver training needs, older adult health and function) were drawn from home health patient assessments. Weighted proportions of family caregivers with an identified need for activity-specific training were estimated. Weighted, multivariable logistic regressions modeled associations between older adult/caregiving network characteristics and family caregivers’ identified activity-specific training needs during home health.ResultsMore than 1 in 3 (35.7%) family caregivers assisting older adults during Medicare home health had an identified training need with at least 1 caregiving activity. Rates of need for training varied widely, from 8.6% among caregivers helping with advocacy to 48.2% among caregivers helping with medical procedures. In weighted analyses that adjusted for older adults’ health and function, family caregivers were less likely to have identified training needs when assisting older adults with ongoing disability or who received caregiver assistance before home health admission.Conclusions and ImplicationsFindings highlight the pervasiveness of family caregivers' training needs, particularly with medically oriented activities, and indicate that escalations in older adults’ care needs are linked to caregiver training needs. Therefore, transitions of care may present critical opportunities to connect family caregivers with training resources. |
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| Keywords: | Older adult family caregiver home health home care services Medicare |
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