The 2007 National Home Health Aide Survey is the first national probability survey of home health aides. 

LeadingAge Center for Applied Research, in partnership with Social and Scientific Systems, Inc. (SSS), will be conducting analyses using this survey to provide technical assistance and policy analysis to the Office of the Assistant Secretary for Planning and Evaluation (ASPE). 

The goals of the analyses are to describe workforce characteristics and to evaluate the interrelationships among workforce characteristics, job quality, and other worker and facility characteristics and quality of care. 

The goal of analyses underpinning the "Workforce Characteristics" report is to understand the supply of workers by demand, geographic location, policy variation, agency characteristics, and recruitment strategies.

The team will prepare reports and manuscripts with results from these analyses.

This project is funded by ASPE and the Center is a subcontractor to SSS.
 

Intro: 

LeadingAge Center for Applied Research, in partnership with Social and Scientific Systems, Inc. (SSS), will be conducting analyses using the 2007 National Home Health Aide survey to provide technical assistance and policy analysis to the Office of the Assistant Secretary for Planning and Evaluation (ASPE). This project is funded by ASPE and the center is a subcontractor to SSS.

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"Palliative Care for Advanced Dementia: A Model Teaching Unit Program" is a program to improve the quality of life for those with dementia and their families. The goal is to create a replicable and practical model of excellent advanced dementia care and to share this model with nursing facilities in Arizona. The project is based at the Beatitudes Campus.

About the Project

LeadingAge conducted a cost study analysis to determine the cost effectiveness of the Palliative Care for Advanced Dementia: A Model Teaching Unit program. Staff developed a survey to collect data at the facility level at Glencroft facility prior to the training program and one year later. In addition, data was collected at Beatitudes for comparison. 

The survey included measures such as cost of training, turnover, registry use, worker compensation, laundry costs, incontinence supplies, and utilization of services.  The analysis examined differences between Beatitudes and Glencroft facilities and changes over time at Glencroft. 

The training program was found to be cost effective; the learning facility and Beatitudes both realized cost savings. 

Intro: 

Cost study analysis to determine the cost effectiveness of a palliative care training program designed to improve the quality of life for people with advanced dementia.

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CFAR conducted a clinical trial to accelerate translation of research on exercise in old age into practice in continuing care retirement communities (CCRC). The trial screened CCRC residents for disability using a short set of performance measures called the Short Physical Performance Battery (SPPB). 

The project resulted in resources to implement the program: 

  1. Implementation guide.
  2. Coaching sessions.
  3. Participant handouts

About the Trial

After identification of persons at risk for disability, 300 CCRC residents were enrolled into a program of moderate exercise or an active control arm focused on general wellness. The primary study endpoint was the SPPB score and secondary endpoints included falls, hospitalizations, and nursing home admissions. 

A key feature of the project was that it extended findings from controlled clinical studies into routine practice in the CCRC setting. This represents true translation of research into practice, and offers providers an evidence base upon which to make informed decisions. 

This project was a collaboration among the Evangelical Lutheran Good Samaritan Society (GSS), Tufts University and the National Institute on Aging. 

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Clinical trial to accelerate translation of research on exercise in old age into practice in a CCRC.

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LeadingAge worked with the Institute for the Study of International Migration (ISIM) at Georgetown University on a project that explored the employment of migrant workers in the delivery of health and social care to older people across the United Kingdom, the United States, Ireland and Canada. 

The ISIM is part of an international collaborative project to examine the future need for migrant care workers in the context of aging societies. 

The project considered the implications of care workers' mobility for source countries and for the international care market. 

The Center for Applied Research recently completed a paper entitled Long-Term Care Policy in the United States: A Contextual Reviewwhich provides an overview of how the workforce issues fit into the U.S. context as a way to help the other participating countries understand cross-national similarities and differences.

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Explored the employment of migrant workers in the delivery of health and social care to older people across the UK, the USA, Ireland and Canada.

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In a previous study of 3 affordable senior housing communities in Colorado, the Center found that residents relied significantly on family caregivers. Interviews with housing staff at the Colorado properties reinforced the fact that family support was crucial to a resident’s general well-being and an essential factor in allowing the resident to maintain his or her independence.

Realizing that family members were a crucial part of the network of support available to help affordable senior housing residents safely age in place, the Center set out to develop and test a program that would expand the capacity of family caregivers to assist residents in affordable senior housing properties. 

The project had 3 objectives:

  • Identify the specific needs and knowledge gaps of family caregivers to inform the development of a training program to help family caregivers and service coordinators collaborate more effectively in supporting residents.
  • Help housing properties and service coordinators recognize family caregivers as an integral part of the service network and offer property staff skills to train and interact with family caregivers.
  • Teach family caregivers about the role housing properties and service coordinators can play in helping residents remain safely in their apartments and how they can partner with  property staff to facilitate their family members’ independent living. 

The project was conducted in 3 affordable senior housing properties located in the Washington, DC, area. A family caregiver training curriculum was created incorporating data and insights collected from family and resident surveys, focus groups and interviews with service coordinators. 

The curriculum was developed as a train-the-trainer model with the idea that service coordinators working in the housing properties would deliver the caregiver-training workshop to family members of residents. While service coordinators may still serve in this function, the Center is currently exploring additional partners who may fill this training role.

The Center partnered with Dr. Rhoda Meador from the Institute for Translational Research on Aging at Cornell University and Dr. Vicky Parker from the Boston University School of Public Health on the creation of the training program. The project was generously supported by the Jacob and Valeria Langeloth Foundation.

To find out more, you can read the project brief or an article that was published in the U.S. Department of Housing and Urban Development's Cityscape journal, Aging in Place Partnerships: A Training Program for Family Caregivers of Residents Living in Affordable Senior Housing.

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Family caregives are a crucial part of the support network to help affordable senior housing residents remain safetly in their homes. The Center for Applied Reserach developed and tested a program that would expand the capacity of family caregivers to support their family members living in affordable senior housing properties.

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Better Jobs Better Care (BJBC) was a $15.5 million research and demonstration program funded by the Robert Wood Johnson Foundation and Atlantic Philanthropies from 2003-2008. 

BJBC was designed to bring about changes in long-term care policy and practice that help reduce high vacancy and turnover rates among direct care staff across the spectrum of long-term care settings and improve workforce quality. 

The BJBC program funded grants for state demonstration and applied research and evaluation projects. As a result of the initiative, a number of resources were developed to help providers build a quality workforce. These resources, available to all providers, highlight the findings and lessons learned from the BJBC program and provide tools to reduce worker instability and improve the workforce.

Resources

A Crisis with a Solution: Tools and Resources for Transforming the Long-Term Care Workforce
Catalogue features descriptions of the tools and resources developed and tested by the BJBC research and demonstration grantees. These tools, used to reduce direct care worker turnover and build a quality workforce, are now available to all providers.

Better Jobs Better Care: New Research on the Long-Term Care Workforce July 2008
Report outlining key BJBC research findings and what they mean to providers.

Gerontologist Special Issue of BJBC
Special Issue of The Gerontologist encapsulates BJBC's research findings and includes Pennsylvania State University's evaluation of the demonstration projects. The articles cover the organizational and management interventions that attracted and kept direct care workers on the job. Available for purchase from Gerontologist Special Issue of BJBC.

FutureAge March/April 2007
The March/April issue of FutureAge magazine is dedicated to the Better Jobs Better Care findings. Each article illustrates the work BJBC has done to support changes in long-term care policy and provider practice that help improve frontline worker retention.

Better Jobs Better Care Issue Briefs

Contact Natasha Bryant about this project.

Intro: 

The recently completed research and demonstration program was designed to bring about changes in long-term care policy and practice that help reduce high vacancy and turnover rates among direct care staff across the spectrum of long-term care settings and improve workforce quality. The goal of the program was to improve recruitment and retention of direct care workers.

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In partnership with the International Association of Homes and Services for the Aging (IAHSA), the Center for Applied Research conducted a cross-national study of the long-term care and home care paraprofessional workforce in countries throughout Europe. 

The project had 2 primary goals: 

  • To describe this sector of the European aging services workforce and better understand the issues these workers face and how these issues differ across countries. 
  • To examine the ways in which health care products and equipment can aid and enhance the daily tasks of this workforce as they care for elders.  

The project consisted of a Web-based survey, focus groups and telephone interviews with long-term care and home care service providers in various countries including the United Kingdom, the Netherlands, Denmark and Germany. 

The project was funded by the Invacare Corporation, the world’s leading manufacturer and distributor of home medical equipment.

The 2009 International Long-Term Care Workforce Study report describes the workforce issues and equipment needs of the participating countries.It features a case study of each country.
 

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Cross-national study on the long-term care and home care paraprofessional workforce in countries throughout Europe.

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Center for Applied Research has worked with the Hua Mei Center for Successful Ageing (HMCSA) to develop a community-based care model of "Ageing in Place."

The project took place in 2009-2010 and was funded by the Tsao Foundation. 

The needs analysis and blueprint included: 

  • Identification of the specific community /neighborhood that will be laboratory for the development and testing of the model.
  • Creation of a community advisory board.
  • Interviews with key stakeholders; development and administration of a resident assessment tool.
  • Design of the specific service cluster interventions for the various populations.
  • Design of transportation improvements and physical design modifications for accessibility and livability.
  • Development of an outreach plan on education of elderly community residents and families about programs; and identification of service coordinators within the housing estates. 
Intro: 

Center for Applied Research has worked with the Hua Mei Center for Successful Ageing (HMCSA) to develop a community-based care model of "Ageing in Place".

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 LeadingAge Center for Applied Research conducted a pilot study to evaluate the acceptability and prognostic value of the Short Physical Performance Battery (SPPB) in older residents and the staff of independent housing and assisted living settings in a CCRC. 

The SPPB measures lower extremity physical performance (tests of balance, rising from a chair, and gait velocity) and has been found in clinical testing to be highly predictive of future functional decline and institutionalization. The utility of the SPPB in residential settings, however, had not been well studied. 

This research project assessed the ability of diverse CCRC staff to be effectively trained in utilization of the SPPB, and the predictive value of these performance tests in terms of onset or progression of disability and transfer to a higher level of care within the CCRC. In addition, this project started to explore staff-to-staff communications within the CCRC that will permit effective communication of findings from SPPB assessments to clinical staff who are positioned to act on this information. 

We partnered with the Evangelical Lutheran Good Samaritan Society's CCRC in Waconia, Minnesota, as the study site. The project was in collaboration with Dr. Jack Guralnik, branch chief of epidemiology, demography and biometry at the National Institute on Aging.

Intro: 

Pilot study to evaluate the acceptability and prognostic value of the Short Physical Performance Battery in older residents and their staff of independent housing and assisted living settings in a CCRC.

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Lutheran Services of America (LSA) and Thrivent Financial for Lutherans collaborated on Aging in Community, a new home and community-based initiative to encourage LSA members to expand their service delivery options and to learn from each other through “Open Source” activities and other shared learning opportunities. 

The Evaluation of the Aging in Community Initiative report highlights the key findings from the study.  

About Aging in Community

Fourteen LSA providers received $40,000 each from Thrivent to engage in new community-based efforts through partnerships and diffusion of best practices.

LeadingAge Center for Applied Research conducted a qualitative, participatory research project that helped LSA and Thrivent to determine which programs appeared the most promising for further evaluation and replication, which specific program elements or practices appeared to be successful or problematic, and which programs were meeting a priority need. 

The Center research team also investigated the effectiveness of the knowledge sharing activities that were developed as part of this LSA/Thrivent collaboration.  

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Aging in Community initiative, sponsored by the Lutheran Services of America, encouraged members to expand their service delivery options and the LeadingAge Center for Applied Research conducted an evaluation of the initiative.

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