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“This Case Is Closed”: Family Caregivers and the Termination of Home Health Care Services for Stroke Patients
Author(s) -
LEVINE CAROL,
ALBERT STEVEN M.,
HOKENSTAD ALENE,
HALPER DEBORAH E.,
HART ANDREA Y.,
GOULD DAVID A.
Publication year - 2006
Publication title -
the milbank quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 101
eISSN - 1468-0009
pISSN - 0887-378X
DOI - 10.1111/j.1468-0009.2006.00449.x
Subject(s) - medicaid , family caregivers , home health , anxiety , case management , nursing , medicine , depression (economics) , long term care , agency (philosophy) , family medicine , psychology , health care , psychiatry , political science , sociology , social science , law , economics , macroeconomics
Policies promoting home‐ and community‐based services and disease management models implicitly rely on family care, still the bedrock of long‐term and chronic care in the United States. The United Hospital Fund studied family caregivers of stroke and brain injury patients when home care cases were opened and closed and found that even with short‐term formal services, family caregivers provided three‐quarters of the care. Patients' mobility impairments and Medicaid eligibility were the main factors in determining the amount and duration of formal services. Between one‐third and one‐half of family caregivers reported being inadequately prepared for the case closing. At all stages, family caregivers expressed significant isolation, anxiety, and depression. Therefore, home care agency practice and public policies should provide better education, support, and services for family caregivers.