South Florida Hospital News
Sunday September 22, 2019
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June 2011 - Volume 7 - Issue 12

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Long-Term Home Care for Seniors Presents New Challenges and Opportunities

By all indicators our nation is aging rapidly, and our ability to provide efficacious and cost-effective long-term care services for a growing population living longer with multiple chronic diseases and disabilities is imperative.

Approximately1.4 million older adults live in nursing homes, but it is estimated that the population of frail, community-based older adults requiring long-term care services is up to four times higher. Aging in one’s own home is clearly the preference for many older adults and their families, and supporting this choice is cost saving. However according to United Way’s 2006 report entitled “An Impact Area Brief: Elderly,” 25% of seniors cite health problems or age as a cause of loneliness and isolation, and many find transportation is limited and inadequate to meet their needs.
 
One aspect of home care that proves challenging is the issue of depression among older patients. Research findings have established that depression is twice as prevalent in seniors receiving home care services compared to primary care. Depression is associated with emotional suffering, increases in health expenditures, morbidity, suicide, and mortality from other causes. Correctly identifying depression to prompt early intervention is critical to minimizing these risks. Research has demonstrated that a skills training program can improve depression care. The Training in the Assessment of Depression (TRIAD) program guides home healthcare staff to identify symptoms of depression and direct patients for further evaluation.
 
My colleague, Dr. Dennis McCarthy, a professor in the Occupational Therapy department at Florida International University College of Nursing & Health Sciences, is leading his students on various research projects focused on several aspects of senior mobility. These include investigating the barriers of the built environment (e.g. sidewalks, buildings, roadways) that may prevent physical activities such as walking or biking; determining and documenting the public transportation needs and experiences of seniors; and examining the differences in community mobility between seniors with and without social supports, such as family.
 
Available Resources
The National Council on Aging reports that one in six older Americans live below the poverty line. Closer to home in Miami-Dade County, the United Way reports the number of seniors living in poverty as one in four. Medicaid-covered long-term home care is provided to eligible seniors (age 65 or older) with low incomes and limited assets, suffering from chronic illnesses or impaired function, who require assistance with activities of daily living but who can still be served safely in their own home.
 
There are many community-based resources and services to help seniors live independently while maintaining their own residence, including personal care services, adult day care programs, nutrition programs, home safety modification programs, respite care and transportation. Such services are funded through federal, state and county programs and often administered by local Area Agency on Aging. The Alliance for Aging (www.allianceforaging.org) has been designated by the State of Florida Department of Elder Affairs as the Aging Resource Center for Miami-Dade and Monroe Counties.
 
Although local agencies on aging and home- and community-based providers help older adults maintain their independence and stay in their homes for as long as possible, personal care and support for older adults in the community is oftentimes a responsibility assumed by family members. Supportive services for family caregivers of older adults and working caregivers are beginning to take shape. In the Doral area of Miami, United HomeCare recently opened its Caregiver Resource Center dedicated exclusively to assisting non-professional caregivers for older adults and the disabled. The Caregiver Resource Center aims to relieve caregiver burden, enhance care giving skills and build capacity to manage care giving responsibilities.
 
For information about area services available for older adults and their families in Miami-Dade and MonroeCounties, call the Elder Helpline at (305) 670-HELP (4357) or 1-800-96-ELDER (1-800-963-5337). To learn more about monthly programming at United HomeCare’s CaregiverResourceCenter, contact Blanca Ceballos at (305) 716-0710.
 
Dr. Ellen L. Brown, nursing associate professor at the Florida International University College of Nursing & Health Sciences, can be reached at (305) 348-1312, ebrown@fiu.edu, or visit http://cnhs.fiu.edu.
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