A study led by doctoral student Julia Burgdorf with Alicia Arbaje and Jennifer Wolff in Home Health Care Management & Practice analyzes the role of family caregivers during Medicare home health visits. The Centers for Medicare and Medicaid Services (CMS) recently enacted a policy that requires home health providers to assess family caregivers’ abilities and offer training and education. The study finds nearly 9 in 10 Medicare beneficiaries receiving home health care require family caregiver assistance in addition to care from home health care: the majority require assistance with 5 or more health care activities. Study findings support calls to develop training interventions and strengthen the partnership between home health providers and family caregivers.
Family caregivers make important contributions to home health care for older adults, but knowledge of the specific roles they assume is lacking. We analyzed data from 1,758 community-dwelling Medicare beneficiaries aged 65+ receiving Medicare-funded home health care between 2011 and 2016, using linked National Health and Aging Trends Study and Outcomes and Assessment Information Set data. Most (86.7%) beneficiaries receiving home health care had an identified need for family caregiver assistance, and nearly 6 in 10 (57.9%) had identified need for caregiver assistance with five or more tasks. After examining significant associations between older adult characteristics and identified needs for caregiver assistance with specific tasks, we identified three profiles of older adults who demonstrate similar patterns of identified need for family caregiver assistance during home health. These profiles include: (1) older adults with greater functional impairment who more often had identified need for assistance with Instrumental Activities of Daily Living, advocacy, or Activities of Daily Living; (2) older adults with cognitive impairment who more often had identified need for assistance with medication administration or supervision; and (3) older adults with greater clinical severity who more often had identified need for assistance with medical procedures and equipment. Findings support calls to develop training interventions and strengthen the partnership between home health providers and family caregivers. These three profiles present a potential framework for the development of family caregiver training programs.