The LTSS Center recommends that you put these 5 articles on your reading list.
PEER MENTORING IN LONG-TERM CARE
A new study suggests that mentorship could be a viable approach to reducing loneliness and depression in long-term care settings. Researchers evaluated the Java Mentorship program, through which teams of community volunteers and resident volunteer mentors visited and guided socially disengaged nursing home residents.
The study, published in Aging and Mental Health, found that residents enjoyed and benefited from their role as mentors, despite significant physical and cognitive challenges. There were significant changes in loneliness and depression scores after 6 months of program participation.
“Persons living in residential care settings are physically and mentally capable of participating in meaningful work,” write the authors. “Their participation in civic duties, in this case actively helping to address loneliness and social isolation … destabilize(s) the traditional deficits-based discourse in these settings.”
LIMITS OF SOCIAL SECURITY IN HELPING OLDER ADULTS AFFORD COST OF LIVING
More than half of adults age 65 or older are believed to rely on Social Security for at least 50% of their family income. Nearly a quarter depend on that benefit for 90% or more of their income. But a recently published report found that, on average, Social Security payments covered only 69.7% of the basic cost of living for an older single renter in good health, across the United States. The remaining uncovered annual expenses amounted to $7,850.
The study was conducted by researchers at the Center for Social and Demographic Research on Aging at UMass Boston’s Gerontology Institute. Researchers used the Elder Index™, a free online tool developed at the Gerontology Institute, to calculate the basic cost of living for older adults. They matched this expense data with Social Security payment information.
MAKING CARE WORK PAY
A new blog in Health Affairs summarizes LeadingAge and LTSS Center research showing that raising the pay of direct care workers by 15% would provide concrete benefits for a variety of stakeholders: increased care quality for care recipients, greater financial security for workers, fewer staffing shortages for providers of long-term services and supports (LTSS), and economic growth for local communities.
The authors—Christian Weller, Beth Almeida, and LTSS Center Co-Directors Marc Cohen and Robyn Stone—recommend 3 ways to support efforts to pay direct care workers at least a living wage:
- Target Medicaid reimbursement rates to wages.
- Reform the LTSS financing system.
- Professionalize the direct care workforce.
“Our research makes a clear case for taking action to raise the wages of direct care workers,” conclude the authors. “Our nation’s experience with the coronavirus pandemic sends another clear message: We must act now to stabilize the direct care workforce and professionalize the role of direct care workers. In the process, we will take a critical step toward helping the LTSS field navigate the current pandemic and prepare for the next.”
INTEGRATING FAMILY MEMBERS INTO HEALTH CARE TEAMS
Integrating family caregivers into a patient’s health care team can help improve care quality and quality of life for both patients and their families, according to a new report from RAND Corporation. Yet, family caregivers face significant barriers when trying to coordinate their efforts with the formal health care team.
Researchers suggest the need for new policies and approaches to overcome these hurdles. Here’s a sample:
- Incentivize providers to engage with family caregivers.
- Invest in programs that provide supportive services for these caregivers.
- Expand access to and funding for care coordinators who can support caregivers.
- Train providers and caregivers to communicate more effectively.
- Develop technologies to foster care integration and information-sharing.
RETHINKING DIRECT CARE JOB QUALITY
Would You Stay? Rethinking Direct Care Job Quality, published this fall by PHI, examines how poor job quality has defined the direct care job for decades.
The new report is the fourth installment in PHI’s year-long series, Caring for the Future: The Power and Potential of America’s Direct Care Workforce. The series provides a comprehensive, current-day analysis of the direct care workforce and its critical role in the nation’s system of long-term services and supports (LTSS).
The new report reviews how COVID-19 has endangered the lives of direct care workers and left them unprepared to manage the pandemic. It also explores how PHI’s 5-pillar framework for quality jobs in direct care—which includes quality training, fair compensation, quality supervision and support, respect and recognition, and real opportunity—could help improve those jobs.
The report concludes with 2 immediate opportunities for improving direct care job quality:
- Improve data collection on the direct care workforce to better understand its volume, stability, compensation, training/credentials, and overall level of job quality.
- Strengthen the social safety net for low-wage workers by ensuring that direct care workers have access to paid sick days, paid family and medical leave, free or low-cost childcare, and affordable LTSS.
MOUTH CARE AND PNEUMONIA IN NURSING HOMES
Pneumonia affects more than 250,000 nursing home residents annually, according to the authors of a recent study published in JAMA Network Open. The article reports on a pragmatic cluster randomized trial that evaluated the effectiveness of Mouth Care Without a Battle, a standardized program that trains caregivers to provide mouth care to nursing home residents, including residents who are resistant or in special situations.
The study was conducted over 2 years in 14 nursing homes. Researchers found that, during the study’s first year, the mouth care program was effective in reducing the incidence of pneumonia. However, the program was not effective in reducing the incidence of pneumonia at the study’s 2-year mark.
The authors suggest that the lack of significant results in the second year may indicate that it is possible for nursing home staff to reduce pneumonia through mouth care, but doing so will require sustained efforts.
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