Key Informants' Visions and Solutions to Improve Home- and Community-Based Services for Older Adults and Persons With Dementia.

IF 1.8 3区社会学 Q2 GERONTOLOGY

Research on Aging Pub Date : 2025-02-01 Epub Date: 2024-08-04 DOI:10.1177/01640275241269991

Daniel Siconolfi, Molly Waymouth, Esther M Friedman, Debra Saliba, Regina A Shih

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引用次数: 0

Abstract

Recent decades have seen state successes in rebalancing Medicaid long-term care from institutional care (e.g., nursing homes) into home and community settings. However, significant barriers can prevent access to home and community-based services (HCBS) among older adults and persons with dementia. Qualitative research on potential innovations and solutions in the contemporary context with attention to a wider range of state-level policy contexts is limited. Drawing on interviews with 49 key informants including state Medicaid officials, HCBS providers, and advocates for persons with dementia across 11 states, we examined perceived solutions to barriers. Key informants articulated a range of potential solutions and innovations, ranging from tangible or realized policy changes to 'magic wand' solutions. Policy research has typically focused on the former; excluding the latter may miss opportunities to envision and design a more effective long-term care system for persons living with dementia and older adults.

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主要信息提供者对改善老年人和痴呆症患者家庭和社区服务的看法和解决方案。

近几十年来，各州成功地将医疗补助长期护理从机构护理（如养老院）调整到家庭和社区环境中。然而，老年人和痴呆症患者在获得家庭和社区服务（HCBS）方面仍面临巨大障碍。在当代背景下，有关潜在创新和解决方案的定性研究十分有限，而且对更广泛的州一级政策背景的关注也十分有限。通过对 11 个州的 49 位关键信息提供者（包括州医疗补助官员、HCBS 提供者以及痴呆症患者的倡导者）进行访谈，我们研究了他们所认为的障碍解决方案。主要信息提供者阐述了一系列潜在的解决方案和创新方法，从有形或已实现的政策变化到 "魔棒 "解决方案，不一而足。政策研究通常侧重于前者；排除后者可能会错失为痴呆症患者和老年人设想和设计一个更有效的长期护理系统的机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Research on Aging GERONTOLOGY-

CiteScore

4.50

自引率

0.00%

发文量

期刊介绍： Research on Aging is an interdisciplinary journal designed to reflect the expanding role of research in the field of social gerontology. Research on Aging exists to provide for publication of research in the broad range of disciplines concerned with aging. Scholars from the disciplines of sociology, geriatrics, history, psychology, anthropology, public health, economics, political science, criminal justice, and social work are encouraged to contribute articles to the journal. Emphasis will be on materials of broad scope and cross-disciplinary interest. Assessment of the current state of knowledge is as important as provision of an outlet for new knowledge, so critical and review articles are welcomed. Systematic attention to particular topics will also be featured.