Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-22T18:33:54.606Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  02 November 2017

Jiska Cohen-Mansfield ,
Adi Hannah Sela ,
Esther Iecovich  and
Hava Golander
Jiska Cohen-Mansfield*
Affiliation:
Minerva Center for Interdisciplinary Study of End of Life, Tel-Aviv University, Tel Aviv, Israel The Herczeg Institute on Aging, Tel-Aviv University, Tel Aviv, Israel Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
Adi Hannah Sela
Affiliation:
Minerva Center for Interdisciplinary Study of End of Life, Tel-Aviv University, Tel Aviv, Israel The Herczeg Institute on Aging, Tel-Aviv University, Tel Aviv, Israel
Esther Iecovich
Affiliation:
Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
Hava Golander
Affiliation:
The Herczeg Institute on Aging, Tel-Aviv University, Tel Aviv, Israel Department of Nursing, The Stanley Seyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
*
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: [email protected].
Get access

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.

Keywords

quality of carecaregivinghomecareolder personsimmigrantsfactor analysisfrailty
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 9: Issue Theme: Quality of Care for Frail Older Adults , September 2018 , pp. 1259 - 1267
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baltussen, R., Yé, 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, 42–48.Google Scholar
Boris, E. and Klein, J. (2006). Organizing home care: low-waged workers in the welfare state. Politics & Society, 34, 81–108.Google Scholar
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.Google Scholar
Braithwaite, J. and Braithwaite, V. (1995). The politics of legalism: rules versus standards in nursing-home regulation. Social & Legal Studies, 4, 307–341.Google Scholar
Burbridge, L. C. (1993). The labor market for home care workers: demand, supply, and institutional barriers. The Gerontologist, 33, 41–46.Google Scholar
Cangiano, A. (2014). Elder care and migrant labor in Europe: a demographic outlook. Population and Development Review, 40, 131–154.Google Scholar
Cleary, P. D. and McNeil, B. J. (1988). Patient satisfaction as an indicator of quality care. Inquiry, 25, 25–36.Google Scholar
Cohen-Mansfield, J., Ejaz, F. K. and Werner, P. (2000). Satisfaction Surveys in Long-Term Care. New York: Springer Publishing Company.Google Scholar
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.Google Scholar
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.Google Scholar
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, 1–21. doi: https://doi.org/10.1007/s12062-016-9170-2.Google Scholar
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.Google Scholar
DiStefano, C., Zhu, M. and Mindrila, D. (2009). Understanding and using factor scores: considerations for the applied researcher. Practical Assessment, Research & Evaluation, 14, 1–11.Google Scholar
Eustis, N. N. and Fischer, L. R. (1991). Relationships between home care clients and their workers: implications for quality of care. The Gerontologist, 31, 447–456.Google Scholar
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.Google Scholar
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.Google Scholar
Graf, C. (2008). The Lawton instrumental activities of daily living scale. The American Journal of Nursing, 108, 52–62.Google Scholar
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.Google Scholar
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, 7–16.Google Scholar
Iecovich, E. (2007). Client satisfaction with live-in and live-out home care workers in Israel. Journal of Aging & Social Policy, 19, 105–122.Google Scholar
Institute of Medicine (1986). Improving the Quality of Care in Nursing Homes. Washington, DC: National Academy Press.Google Scholar
Katz, S., Downs, T. D., Cash, H. R. and Grotz, R. C. (1970). Progress in development of the index of ADL. The Gerontologist, 10, 20–30.Google Scholar
Malley, J. and Fernández, J. L. (2010). Measuring quality in social care services: theory and practice. Annals of Public and Cooperative Economics, 81, 559–582.Google Scholar
McDonald, K. et al. (2010). Care Coordination Atlas Version 3. Rockville, MD: AHRQ Publication.Google Scholar
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, 75–87.Google Scholar
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, 512–517.Google Scholar
Safran, D. G. et al. (1998). The Primary care assessment survey: tests of data quality and measurement performance. Medical Care, 36, 728–739.Google Scholar
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, 2144– 2162.Google Scholar
Singer, P. A., Martin, D. K. and Kelner, M. (1999). Quality end-of-life care: patients' perspectives. JAMA, 281, 163–168.Google Scholar
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, 173–178.Google Scholar
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, 363–379.Google Scholar
Tarricone, R. and Tsouros, A. D. (2008). Home Care in Europe: The Solid Facts. Milan, Italy: WHO Regional Office Europe.Google Scholar
Wiener, J. M. (2003). An assessment of strategies for improving quality of care in nursing homes. The Gerontologist, 43, 19–27.Google Scholar
Wilkins, K. (2006). Government-subsidized home care. Health Reports, 17, 39.Google Scholar
Zimmerman, D. R. (2003). Improving nursing home quality of care through outcomes data: the MDS quality indicators. International Journal of Geriatric Psychiatry, 18, 250–257.Google Scholar