“This Case Is Closed”: Family Caregivers and the Termination of Home Health Care Services for Stroke Patients
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.
Author(s): Carol Levine; Steven M. Albert; Alene Hokenstad; Deborah E. Halper; Andrea Y. Hart; David A. Gould
Keywords: family caregivers; home health care; transitions; Medicare; Medicaid; stroke
Volume 84, Issue 2 (pages 305–331)
Published in 2006