Home And Community Based Care

As older adults and their families opt out of nursing homes, a range of home and community-based services (HCBS) have risen up to provide care. HCBS span platforms and approaches, from home health care to assisted living to community-based hospice to adult day services. These models are, for most, preferable to nursing homes and allow older adults to “age in place”—live longer in their own homes and communities. Home- and Community-Based Services for Older Adults examines the existing and emerging models of HCBS, including the history, theory, research, policy, and practices across care settings. Emphasizing the multidisciplinary and interprofessional practice approaches used to deliver care, this book is an essential learning tool for students interested in medicine, nursing, social work, allied health professions, case management, health care administration, and gerontology. As the population of older adults grows, the authors ask, how can we best meet the needs of older adults and their families in the most effective, cost-conscious way while honoring their care choices?

Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

Make sure your practice skills are up-to-date with the changes brought on by managed care As a result of escalating costs, the focus of health care in the United States has shifted from inpatient, hospital-based care to outpatient care in the community. Social Work Practice in Community-Based Health Care is a comprehensive guide to the knowledge and skills needed to provide effective and efficient practice within a managed-care context that’s focused on a diversified, aging consumer population and high-risk health conditions. This unique book examines the essential elements of community health practice, including logic modeling for planning and evaluation, interdisciplinary collaboration, and the use of technology and telemedicine in social work practice. Social Work Practice in Community-Based Health Care presents practical information for social workers in the wake of the insertion of managed care as a “third party” to the relationship between physicians and their patients, and advances in medical care that are transforming previously acute and life-threatening illnesses to chronic conditions. The book offers a critical analysis of available research and model service delivery innovations, applying evidence-based practice to case studies in a style that’s easily accessible to practitioners, administrators, supervisors, and social work students. The book also includes glossaries at the end of each chapter and appendices that analyze online resources and address cultural background assessment questions. Topics discussed in Social Work Practice in Community-Based Health Care include: the revolution in funding and delivery evolving trends and healthcare needs of the consumer population a conceptual framework for culturally competent practice the nature of social work in ambulatory health a brief history of healthcare social work emerging practice settings the use of new communication technologies in practice methods for evaluating direct practice ethical considerations current community-based programs for culturally diverse and at-risk populations and much more Social Work Practice in Community-Based Health Care is an important resource for social work practitioners, academics, and students.

The U.S. population of older adults is predicted to grow rapidly as "baby boomers" (those born between 1946 and 1964) begin to reach 65 years of age. Simultaneously, advancements in medical care and improved awareness of healthy lifestyles have led to longer life expectancies. The Census Bureau projects that the population of Americans 65 years of age and older will rise from approximately 40 million in 2010 to 55 million in 2020, a 36 percent increase. Furthermore, older adults are choosing to live independently in the community setting rather than residing in an institutional environment. Furthermore, the types of services needed by this population are shifting due to changes in their health issues. Older adults have historically been viewed as underweight and frail; however, over the past decade there has been an increase in the number of obese older persons. Obesity in older adults is not only associated with medical comorbidities such as diabetes; it is also a major risk factor for functional decline and homebound status. The baby boomers have a greater prevalence of obesity than any of their historic counterparts, and projections forecast an aging population with even greater chronic disease burden and disability. In light of the increasing numbers of older adults choosing to live independently rather than in nursing homes, and the important role nutrition can play in healthy aging, the Institute of Medicine (IOM) convened a public workshop to illuminate issues related to community-based delivery of nutrition services for older adults and to identify nutrition interventions and model programs. Nutrition and Healthy Aging in the Community summarizes the presentations and discussions prepared from the workshop transcript and slides. This report examines nutrition-related issues of concern experienced by older adults in the community including nutrition screening, food insecurity, sarcopenic obesity, dietary patterns for older adults, and economic issues. This report explores transitional care as individuals move from acute, subacute, or chronic care settings to the community, and provides models of transitional care in the community. This report also provides examples of successful intervention models in the community setting, and covers the discussion of research gaps in knowledge about nutrition interventions and services for older adults in the community.

In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.

Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.

As a community, aligning efforts across a community to support the safety and well-being of vulnerable and underserved individuals is extraordinarily difficult. These individuals suffer disproportionally from health issues, job loss, a lack of stable housing, high utility costs, substance abuse, and homelessness. In addition to medical care, these individuals often critically need access to community social sector organizations that provide a distinct and complementary set of services, such as housing, food services, emergency utility assistance, and employment assistance. These services are just as vital as healthcare services to these individuals’ long-term health and well-being, with data suggesting that 80–90% of health outcomes can be attributed to factors beyond direct medical intervention. This book proposes a novel approach to the coordination of medicine and social services through the use of people, process, and technology, with the goal being to streamline coordination between medical and Community-Based Organizations and to promote true cross-sector patient and client advocacy. The book is based on the experience of Dallas, TX, which was one of the first metropolitan regions to develop a comprehensive foundation for partnership between a community’s clinical and social sectors using web-based information exchange. In the 5 years since the initial launch, the authors have been able to provide seamless connection, communication, and coordination between healthcare providers and a wide array of community-based social service organizations (a/k/a Community-Based Organizations or CBOs), criminal justice entities, and various other community organizations, including non-collegiate educational systems. This practical how-to guide is the codification of transferrable lessons from successes and challenges faced when working with clinical, community, and government leaders. By reading this playbook, leaders interested in building (or expanding) connected clinical-community services will learn how to: 1) facilitate cross-sector care coordination; 2) enable community care partners to better provide targeted services to community residents; 3) reduce duplication of services across partnering organizations; and 4) help to bridge service gaps in the currently fragmented system. Implementation of services, as recommended in this book, will ultimately streamline assistance efforts, reduce repeat crises and emergency funding requests, help address disparities of care, and improve the health, safety, and well-being of the most vulnerable community residents.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/