270962 “Person-centered” care in home care: A view from the ground up

Monday, October 29, 2012 : 3:06 PM - 3:18 PM

Kathryn G. Kietzman, PhD, MSW , UCLA Center for Health Policy Research, Los Angeles, CA
Steven P. Wallace, PhD , UCLA Center for Health Policy Research, Los Angeles, CA
Eva M. Durazo, MPH , UCLA Center for Health Policy Research, Los Angeles, CA
Jacqueline M. Torres, MPH, MA , School of Public Health, University of California, Los Angeles, Los Angeles, CA
Anne Soon Choi, PhD , Department of Interdisciplinary Studies, Assistant Professor California State University Dominguez Hills, Los Angeles, CA
Carolyn A. Mendez-Luck, PhD, MPH , College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
A.E. (Ted) Benjamin, PhD , School of Public Affairs, UCLA, Los Angeles, CA
The Affordable Care Act of 2010 (ACA) supports consumer choice, independence, and service integration for persons with disabilities through the delivery of person-centered long-term services and supports (LTSS) in the home and community. Yet, little is known about the meaning and experience of person-centered care from the consumer's point of view and how such definitions change over time. The Helping Older-adults Maintain independencE (HOME) project gathered in-depth qualitative data on the care networks and strategies used by a typical group of older adult consumers of publicly-financed LTSS in California over a one-year period. We investigated how 33 older adults, dually-eligible for Medicare and Medi-Cal, managed a fragmented network of informal and formal care to continue to live independently at home. Interviews with older adults and their caregivers were transcribed and coded to identify key themes and patterns. We found three key dimensions central to consumers' desires to be actively involved in their LTSS. The first is the desire to remain at home as long as possible regardless of level of disability. The second is the meaning of independence and a “good life” that reflects a sense of competence and control. Finally, we describe the challenges they face managing the services and resources needed to remain at home. Policy implications include the need for a national focus on building a more responsive LTSS system that is person-centered and allows persons with disabilities to remain in the least restrictive environments that they prefer.

Learning Areas:
Public health or related public policy
Public health or related research

Learning Objectives:
1.Describe the meaning of person-centered care from the perspective of consumers of community-based long-term services and supports (LTSS). 2.Identify the supports and strategies that LTSS consumers use to continue to live independently at home. 3.Explain how person-centered policies can support a system of LTSS that effectively addresses the needs and preferences of community-dwelling older adults with disabilities.

Keywords: Long-Term Care, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Research Scientist and Project Director of the research study on which this abstract is based. I have been conducting research and engaged in policy work related to geriatric long-term care issues for the past ten years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.