Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services
Objectives: This study used validated physical performance measures to examine function, risk of adverse health outcomes, and the relationship with allocated hours of weekly caregiving assistance among older adults receiving home and community-based services through a Medicaid waiver program. Method...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2015-11-01
|
| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/2050312115614588 |
| _version_ | 1817989238882304000 |
|---|---|
| author | Margaret K Danilovich Daniel M Corcos David X Marquez Amy R Eisenstein Susan L Hughes |
| author_facet | Margaret K Danilovich Daniel M Corcos David X Marquez Amy R Eisenstein Susan L Hughes |
| author_sort | Margaret K Danilovich |
| collection | DOAJ |
| description | Objectives: This study used validated physical performance measures to examine function, risk of adverse health outcomes, and the relationship with allocated hours of weekly caregiving assistance among older adults receiving home and community-based services through a Medicaid waiver program. Methods: Older adults (n = 42) completed physical performance measures including grip strength, 30-s chair rise, Timed Up and Go, and gait speed. Demographic information including age, gender, and allocated hours of weekly caregiving assistance were also collected. Results: A majority, 72% of females and 86% of males, had weak grip strength, 57% met criteria for fall risk based on their Timed Up and Go score, 83% had lower extremity strength impairments, and 98% were unable to ambulate more than 1.0 m/s. Frailty was prevalent in the sample with 72% of clients meeting Fried’s frailty criteria. The most significant predictors of allocated hours of weekly caregiving assistance approved for clients were race and gait speed. Conclusion: Based on scores on physical performance measures, clients are at risk of falls, hospitalization, and mortality, and scores indicate an urgent need to assess performance in addition to self-reported activities of daily living limitations for this population. Performance measures associated with quantifiable risk of adverse outcomes can be critical indicators for referrals and services needed to enhance the safety and improve care outcomes for homebound older adults. |
| first_indexed | 2024-04-14T00:44:38Z |
| format | Article |
| id | doaj.art-babcb3a2e39a4ca8a2d41dd11f2ff940 |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-04-14T00:44:38Z |
| publishDate | 2015-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-babcb3a2e39a4ca8a2d41dd11f2ff9402022-12-22T02:22:05ZengSAGE PublishingSAGE Open Medicine2050-31212015-11-01310.1177/205031211561458810.1177_2050312115614588Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based servicesMargaret K Danilovich0Daniel M Corcos1David X Marquez2Amy R Eisenstein3Susan L Hughes4Department of Physical Therapy & Human Movement Sciences, Northwestern University, Chicago, IL, USADepartment of Physical Therapy & Human Movement Sciences, Northwestern University, Chicago, IL, USACenter for Research on Health and Aging, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USADepartment of Medical Social Sciences, Northwestern University, Chicago, IL, USACenter for Research on Health and Aging, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USAObjectives: This study used validated physical performance measures to examine function, risk of adverse health outcomes, and the relationship with allocated hours of weekly caregiving assistance among older adults receiving home and community-based services through a Medicaid waiver program. Methods: Older adults (n = 42) completed physical performance measures including grip strength, 30-s chair rise, Timed Up and Go, and gait speed. Demographic information including age, gender, and allocated hours of weekly caregiving assistance were also collected. Results: A majority, 72% of females and 86% of males, had weak grip strength, 57% met criteria for fall risk based on their Timed Up and Go score, 83% had lower extremity strength impairments, and 98% were unable to ambulate more than 1.0 m/s. Frailty was prevalent in the sample with 72% of clients meeting Fried’s frailty criteria. The most significant predictors of allocated hours of weekly caregiving assistance approved for clients were race and gait speed. Conclusion: Based on scores on physical performance measures, clients are at risk of falls, hospitalization, and mortality, and scores indicate an urgent need to assess performance in addition to self-reported activities of daily living limitations for this population. Performance measures associated with quantifiable risk of adverse outcomes can be critical indicators for referrals and services needed to enhance the safety and improve care outcomes for homebound older adults.https://doi.org/10.1177/2050312115614588 |
| spellingShingle | Margaret K Danilovich Daniel M Corcos David X Marquez Amy R Eisenstein Susan L Hughes Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services SAGE Open Medicine |
| title | Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services |
| title_full | Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services |
| title_fullStr | Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services |
| title_full_unstemmed | Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services |
| title_short | Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services |
| title_sort | performance measures hours of caregiving assistance and risk of adverse care outcomes among older adult users of medicaid home and community based services |
| url | https://doi.org/10.1177/2050312115614588 |
| work_keys_str_mv | AT margaretkdanilovich performancemeasureshoursofcaregivingassistanceandriskofadversecareoutcomesamongolderadultusersofmedicaidhomeandcommunitybasedservices AT danielmcorcos performancemeasureshoursofcaregivingassistanceandriskofadversecareoutcomesamongolderadultusersofmedicaidhomeandcommunitybasedservices AT davidxmarquez performancemeasureshoursofcaregivingassistanceandriskofadversecareoutcomesamongolderadultusersofmedicaidhomeandcommunitybasedservices AT amyreisenstein performancemeasureshoursofcaregivingassistanceandriskofadversecareoutcomesamongolderadultusersofmedicaidhomeandcommunitybasedservices AT susanlhughes performancemeasureshoursofcaregivingassistanceandriskofadversecareoutcomesamongolderadultusersofmedicaidhomeandcommunitybasedservices |