Regenstrief Center for Healthcare Engineering

Research Project

Help at Home

homemaker seniorThe saying goes that, “Home is where the heart is.” So it’s not hard to understand why older adults with disabilities want to remain in their homes as long as possible. And studies show homecare can be less expensive than assisted living facilities. Staying healthy at home requires the right amount of help at the right time.

For older adults with disabilities like dementia, daily tasks can be a challenge — from making good meals and tidying the house, to bathing and other personal care matters. Their disability increases their risk of being admitted to the hospital. Assisted living facilities can provide the extra daily help they need to live safely and stay out of the hospital, but many would prefer to remain in their homes. Indiana Medicare’s home- and community-based services (HCBS) waiver program allows eligible patients to receive at-home services that allow them to remain independent. Family members can still visit and help, but the program complements that with additional homemaking, daily living, or meal help.

There is no formula for determining how much extra assistance a patient might need. The final number of hours per week are determined jointly by the case worker and the family. Laura Sands, the Katherine Birck Professor of Nursing, used Indiana Medicaid data to explore the relationship between the number of hours of care received through the HCBS program and the risk of hospitalization. The study showed that an increase in hours of care was related to a decrease in the risk of hospitalization. Companies providing HCBS services have used Sands’ research in their training to remind caseworkers of the need for a very thorough discussion with the family about patient needs.

About the project:

Project: Prognostic Significance of Insufficient ADL Help on Health Outcomes/Utilization
PI: Laura Sands, Katherine Birck Professor of Nursing
Partners: Indiana Medicaid, Regenstrief Institute
Funding: National Institutes of Health
Core competencies: Statistical analysis, gerontology


Publications and presentations

Xu H, Weiner M, Paul S, Thomas III J, CraigBA, Rosenman M, Carney Doebbeling C, Sands LP. Volume of home- and community-based Medicaid Waiver services and risk of hospital admissions, Journal of the American Geriatrics Society, 58(1):109-115,2010.

About RCHE

Applying academic research to transform healthcare delivery.