Abstract
Objectives
To estimate the proportion of family caregivers assisting older adults during Medicare
home health who have an identified need for activity-specific training and identify
characteristics associated with caregiver training needs.
Design
Nationally representative retrospective cohort study.
Setting and Participants
1758 (weighted n = 8,477,990) Medicare beneficiaries who participated in the National
Health and Aging Trends Study (NHATS) and received Medicare-funded home health care
between 2011 and 2016.
Measures
Older adult and caregiving network characteristics before home health (sociodemographic
factors, caregiver assistance, older adult health and function) were drawn from NHATS;
characteristics during home health (family caregiver training needs, older adult health
and function) were drawn from home health patient assessments. Weighted proportions
of family caregivers with an identified need for activity-specific training were estimated.
Weighted, multivariable logistic regressions modeled associations between older adult/caregiving
network characteristics and family caregivers’ identified activity-specific training
needs during home health.
Results
More than 1 in 3 (35.7%) family caregivers assisting older adults during Medicare
home health had an identified training need with at least 1 caregiving activity. Rates
of need for training varied widely, from 8.6% among caregivers helping with advocacy
to 48.2% among caregivers helping with medical procedures. In weighted analyses that
adjusted for older adults’ health and function, family caregivers were less likely
to have identified training needs when assisting older adults with ongoing disability
or who received caregiver assistance before home health admission.
Conclusions and Implications
Findings highlight the pervasiveness of family caregivers' training needs, particularly
with medically oriented activities, and indicate that escalations in older adults’
care needs are linked to caregiver training needs. Therefore, transitions of care
may present critical opportunities to connect family caregivers with training resources.
Keywords
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Article info
Publication history
Published online: July 05, 2020
Footnotes
This work was supported by the National Institute on Aging under Grant R01AG047859 and by the Agency for Healthcare Research and Quality under Grant T32HS0000029.
The authors declare no conflicts of interest.
Identification
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
