Two Key Journals Feature LTSS Center's Work on Home Care

Workforce | June 24, 2019 | by Geralyn Magan

Robyn Stone, co-director of the LeadingAge LTSS Center @UMass Boston, and Natasha Bryant, the LTSS Center’s managing director/senior research associate, wrote one article and served as co-authors on two others on the opportunities and challenges in the home care workforce. Members working in the home care area will find the results helpful.

The Journal of the American Geriatrics Society (JAGS) published “The Future of the Home Care Workforce: Training and Supporting Aides as Members of Home-Based Care Teams” in its May 2019 edition.
- Stone and Bryant make a strong case for why clinicians should include home health, home care, and personal care aides as active members of home-based care teams.
- Members f this workforce “are often the eyes and ears of the health system, observing subtle changes in condition that can provide important information for clinical decision making and therapeutic intervention.”
- Aides belong on home-based teams because they are a major source of emotional support for many patients with serious illness and are likely to have the most interaction with family members.
- Stone and Bryant recommend standardized competency-based training requirements, expanding nurse delegation across the states, and evaluation, dissemination, and replication of successful programs.
Health Affairs published “Home and Community-Based Workforce for Patients with Serious Illness Requires Support to Meet Growing Needs” in June. Joanne Spetz from the University of California San Francisco (UCSF) was the lead author on the Health Affairs article. Stone, Bryant, and Susan A. Chapman, also from UCSF, were co-authors.
- The article addresses the recruitment, training, retention, and regulatory challenges facing the nearly 3 million people providing direct care for people with serious illness and who receive little formal training, have low pay and get minimal respect for the skills required to do their jobs.
- The article makes numerous recommendations, such as higher reimbursement and required training hours.

Health Affairs also published “Beyond Functional Support: The Range of Health-Related Tasks Performed in the Home by Paid Caregivers in New York” in the same issue. Jennifer Reckrey, from the Department of Geriatrics and Palliative Medicine at Mount Sinai, was the lead author and Stone was a co-author.
- The piece found that the primarily female paid caregivers receive varying amounts of training and supervision and that they address many health-related issues in their seriously ill patients, such as acute medical issues, chronic conditions, general health promotion, and mental health and well-being.
- The article concluded that caregivers frequently perform responsibilities that had not been part of their training, and recommended a greater focus on specific, health-related competencies in training, continuing education, supervision and monitoring to ensure better patient outcomes.