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Quality of care for frail older persons in a homecare setting: what is it and how can it be measured?

  • Jiska Cohen-Mansfield (a1) (a2) (a3), Adi Hannah Sela (a1) (a2), Esther Iecovich (a4) and Hava Golander (a2) (a5)
Abstract
Background:

As more older persons opt to age in place, there is a growing trend to hire migrant workers as live-in caregivers to care for them. This raises the need to examine the quality of care they receive within this unique care setting. The objective of this pilot study was to establish the components of quality of care as provided by migrant live-in caregivers.

Methods:

We interviewed a convenience sample of older persons cared for by migrant live-in caregivers and their relatives. When relatives reported that older persons could not be interviewed due to advanced dementia, only relatives were interviewed. Overall, 72 older persons and 117 relatives were interviewed. We used the Quality of Care Questionnaire (QuCQ) developed for this study to examine the main components of quality of care in this population.

Results:

Factor analysis using older persons’ data revealed two factors. In the first factor, “caretaking,” items concerning provision of prompt care exhibited the highest loadings. Items measuring interpersonal aspects of the care dynamic had the highest loadings in the second factor, thus labeled “relationship.” The factor analysis based on relatives’ data yielded similarities and differences with the one based on older persons’ data. Yet, there were significant correlations between relative and older persons’ responses when using the older persons’ factor structure.

Conclusions:

According to older persons and relatives, quality of care depends on the extent to which older persons’ care-related needs, as well as social ones, are addressed. Appropriate evaluation of quality of care in the live-in setting is important for its improvement.

Copyright
Corresponding author
Correspondence should be addressed to: Jiska Cohen-Mansfield, PhD, Minerva Center for the Interdisciplinary Study of End of Life, Tel-Aviv University, P.O.B. 39040, Ramat Aviv, Tel-Aviv, 6139001, Israel. Phone: +972-3-6407336. Email: jiska@post.tau.ac.il.
References
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Baltussen, R., , Y., Haddad, S. and Sauerborn, R. S. (2002). Perceived quality of care of primary health care services in Burkina Faso. Health Policy and Planning, 17, 4248.
Boris, E. and Klein, J. (2006). Organizing home care: low-waged workers in the welfare state. Politics & Society, 34, 81108.
Boult, C., Kane, R. L., Louis, T. A., Boult, L. and McCaffrey, D. (1994). Chronic conditions that lead to functional limitation in the elderly. Journal of Gerontology, 49, M28–M36.
Braithwaite, J. and Braithwaite, V. (1995). The politics of legalism: rules versus standards in nursing-home regulation. Social & Legal Studies, 4, 307341.
Burbridge, L. C. (1993). The labor market for home care workers: demand, supply, and institutional barriers. The Gerontologist, 33, 4146.
Cangiano, A. (2014). Elder care and migrant labor in Europe: a demographic outlook. Population and Development Review, 40, 131154.
Cleary, P. D. and McNeil, B. J. (1988). Patient satisfaction as an indicator of quality care. Inquiry, 25, 2536.
Cohen-Mansfield, J., Ejaz, F. K. and Werner, P. (2000). Satisfaction Surveys in Long-Term Care. New York: Springer Publishing Company.
Cohen-Mansfield, J., Garms-Homolová, V. and Bentwich, M. (2013). Migrant home attendants: regulation and practice in 7 countries. American Journal of Public Health, 103, e30–e39.
Cohen-Mansfield, J., Golander, H., Iecovich, E. and Jensen, B. (2017). Social engagement care for frail older persons: desire for it and provision by live-in migrant caregivers. The journals of gerontology: Series B, Psychological Sciences and Social Sciences. Epub ahead of print. doi: 10.1093/geronb/gbx052.
Cohen-Mansfield, J., Jensen, B., Golander, H. and Iecovich, E. (2016). Recommended versus. Reported working conditions & current satisfaction levels among migrant caregivers in Israel. Journal of Population Ageing, 121. doi: https://doi.org/10.1007/s12062-016-9170-2.
Devlin, M. and McIlfatrick, S. (2010). Providing palliative and end-of-life care in the community: the role of the home-care worker. International Journal of Palliative Nursing, 16, 195–203.
DiStefano, C., Zhu, M. and Mindrila, D. (2009). Understanding and using factor scores: considerations for the applied researcher. Practical Assessment, Research & Evaluation, 14, 111.
Eustis, N. N. and Fischer, L. R. (1991). Relationships between home care clients and their workers: implications for quality of care. The Gerontologist, 31, 447456.
Fabrigar, L. R., Wegener, D. T., MacCallum, R. C. and Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4, 272.
Geron, S. M., Smith, K., Tennstedt, S., Jette, A., Chassler, D. and Kasten, L. (2000). The home care satisfaction measure a client-centered approach to assessing the satisfaction of frail older adults with home care services. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 55, S259–S270.
Graf, C. (2008). The Lawton instrumental activities of daily living scale. The American Journal of Nursing, 108, 5262.
Hazzan, A. A., Ploeg, J., Shannon, H., Raina, P. and Oremus, M. (2015). Caregiver perceptions regarding the measurement of level and quality of care in Alzheimer's disease. BMC Nursing, 14, 54.
Hoff, A., Feldman, S. and Vidovicova, L. (2011). Migrant home care workers caring for older people: fictive kin, substitute, and complementary family caregivers in an ethnically diverse environment. International Journal of Ageing and Later Life, 5, 716.
Iecovich, E. (2007). Client satisfaction with live-in and live-out home care workers in Israel. Journal of Aging & Social Policy, 19, 105122.
Institute of Medicine (1986). Improving the Quality of Care in Nursing Homes. Washington, DC: National Academy Press.
Katz, S., Downs, T. D., Cash, H. R. and Grotz, R. C. (1970). Progress in development of the index of ADL. The Gerontologist, 10, 2030.
Malley, J. and Fernández, J. L. (2010). Measuring quality in social care services: theory and practice. Annals of Public and Cooperative Economics, 81, 559582.
McDonald, K. et al. (2010). Care Coordination Atlas Version 3. Rockville, MD: AHRQ Publication.
Morse, J. M., Bottorff, J., Anderson, G., O'Brien, B. and Solberg, S. (2006). Beyond empathy: expanding expressions of caring. Journal of Advanced Nursing, 53, 7587.
Redfern, S., Hannan, S., Norman, I. and Martin, F. (2002). Work satisfaction, stress, quality of care and morale of older people in a nursing home. Health & Social Care in the Community, 10, 512517.
Safran, D. G. et al. (1998). The Primary care assessment survey: tests of data quality and measurement performance. Medical Care, 36, 728739.
Salomon, J. A. et al. (2013). Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the global burden disease study 2010. The Lancet, 380, 21442162.
Singer, P. A., Martin, D. K. and Kelner, M. (1999). Quality end-of-life care: patients' perspectives. JAMA, 281, 163168.
Sixma, H. J., van Campen, C., Kerssens, J. J. and Peters, L. (2000). Quality of care from the perspective of elderly people: the QUOTE-elderly instrument. Age and Ageing, 29, 173178.
Sureshchandar, G., Rajendran, C. and Anantharaman, R. (2002). The relationship between service quality and customer satisfaction–a factor specific approach. Journal of Services Marketing, 16, 363379.
Tarricone, R. and Tsouros, A. D. (2008). Home Care in Europe: The Solid Facts. Milan, Italy: WHO Regional Office Europe.
Wiener, J. M. (2003). An assessment of strategies for improving quality of care in nursing homes. The Gerontologist, 43, 1927.
Wilkins, K. (2006). Government-subsidized home care. Health Reports, 17, 39.
Zimmerman, D. R. (2003). Improving nursing home quality of care through outcomes data: the MDS quality indicators. International Journal of Geriatric Psychiatry, 18, 250257.
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International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
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