谁在退伍军人事务部医疗寄养家庭中接受护理？
Who Receives Care in VA Medical Foster Homes?
作者信息
Magid Kate H, Manheim Chelsea, Haverhals Leah M, Thomas Kali S, Saliba Debra, Levy Cari
机构信息
is a Health Science Specialist; is a Research Social Worker; is a Health Research Scientist and Investigator; and is the Co-Director, all at the Rocky Mountain Regional Veterans Affairs (VA) Medical Center, Denver-Seattle Center of Innovation in Aurora, Colorado. is an Investigator at Center for Innovation in Long-Term Services and Supports at the Providence Veteran Affairs Medical Center; and an Associate Professor at the Department of Health Services, Policy & Practice, and Center for Gerontology and Health Care Research, School of Public Health, Brown University in Rhode Island. is a Physician Scientist at the Geriatric Research Education and Clinical Center and HSR Center of Innovation at the VA Greater Los Angeles Healthcare System; a Director and Professor of Medicine at the University of California Los Angeles Borun Center; and a Senior Natural Scientist at RAND. Cari Levy is a Professor in the Division of Health Care Policy and Research, School of Medicine, University of Colorado, Aurora.
出版信息
Fed Pract. 2021 Mar;38(3):102-109. doi: 10.12788/fp.0102.
OBJECTIVE
The Veterans Health Administration (VHA) Medical Foster Home (MFH) program was created to give veterans a community-based alternative to institutional long-term care (LTC). This study describes demographic, clinical, and functional characteristics of veterans in MFHs.
METHODS
Findings from in-home assessments of veterans in MFHs tied to 4 VHA medical centers for ≥ 90 days between April 2014 and December 2015 were collected. Trained nurses completed Minimum Data Set (MDS) 3.0 assessments for 92 veterans in MFHs. The assessment included demographic characteristics, cognition, behaviors, depression, pain, functional status, mobility, and morbidity.
RESULTS
MFH veterans were primarily male (85%), aged > 65 years (83%), cognitively impaired (55%), and had a diagnosis of depression (52%). Overall, 22% had caregiverreported aggressive behaviors and 45% self-reported pain. More than half used a wheelchair (56%). Of the 11 activities of daily living (ADLs) assessed, MFH residents were most likely to require assistance with bathing and least likely to require assistance with bed mobility and eating, although more than half required eating assistance.
CONCLUSIONS
Veterans residing in MFHs have a wide range of care needs, including some veterans with high needs for help with ADLs and others who are completely independent in performing ADLs. These results provide insights about which veterans are staying in MFH care. Future studies should explore how VHA care providers refer veterans to LTC settings.
目的
退伍军人健康管理局（VHA）的医疗寄养家庭（MFH）项目旨在为退伍军人提供一种基于社区的机构长期护理（LTC）替代方案。本研究描述了医疗寄养家庭中退伍军人的人口统计学、临床和功能特征。
方法
收集了2014年4月至2015年12月期间与4个VHA医疗中心相关联、在医疗寄养家庭中居住≥90天的退伍军人的居家评估结果。经过培训的护士为医疗寄养家庭中的92名退伍军人完成了最低数据集（MDS）3.0评估。评估内容包括人口统计学特征、认知、行为、抑郁、疼痛、功能状态、活动能力和发病率。
结果
医疗寄养家庭中的退伍军人主要为男性（85%），年龄>65岁（83%），存在认知障碍（55%），且被诊断患有抑郁症（52%）。总体而言，22%的人有照护者报告的攻击性行为，45%的人自述有疼痛。超过一半的人使用轮椅（56%）。在评估的11项日常生活活动（ADL）中，医疗寄养家庭的居民最需要在洗澡方面获得帮助，在床椅转移和进食方面最不需要帮助，不过超过一半的人在进食方面需要帮助。
结论
居住在医疗寄养家庭中的退伍军人有广泛的护理需求，包括一些在ADL方面需要大量帮助的退伍军人和其他在ADL方面完全独立的退伍军人。这些结果为哪些退伍军人接受医疗寄养家庭护理提供了见解。未来的研究应探讨VHA护理提供者如何将退伍军人转介到长期护理机构。
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