Project Description
Developing a Toolkit to Empower Medicaid-Paid Caregivers to Manage Common Palliative Care Symptoms
Millions of older adults require in-home care support in
order to remain in their homes. Many of these individuals experience serious
illness and common palliative care symptoms, such as pain and shortness of
breath. Treating symptoms can be especially problematic for older adults with
multi-morbidity who may live alone or who are dependent on others for their
care because of medical and/or psychiatric illness. In-home care workers are a
potentially untapped resource to help support the management of common
palliative care symptoms in medically frail clients. Homecare is available to
disenfranchised older or disabled adults through Medicaid's personal assistance
benefit. In the U.S., 2.2 million workers provide personal assistance services
for 2.7 million frail older adults with complex illness and disabilities. In
California these services are known as In-Home Support Services (IHSS) and over
450,000 Californians receive them. With the aging of the population and the
desire for aging in place, home health workers are expected to be among the
nation’s fastest-growing occupations. We
will leverage existing pilot funds focused on developing a separate IHSS
advance care planning program and use established partnerships with the San
Francisco Palliative Care Committee, the Department of Aging and Adults
Services, and IHSS agencies to design, refine, and pilot test an IHSS-Symptom
Management Support Toolkit for IHSS workers. We will also establish an IHSS
Stakeholder Advisory Board. This project is the first step in a planned
research program that will lead to an R01 and larger implementation studies.
Potential Impact: An IHSS-Symptom Management Support Toolkit could provide a
national model for in-home symptom support for frail, disabled older adults;
reduce unwanted healthcare utilization; develop the capacity of IHSS workers to
provide more comprehensive support for their vulnerable older clients; and
improve job satisfaction and retention of IHSS workers.
Bio
Rebecca
Sudore, MD, is an Associate Professor of Medicine at UCSF, a
clinician-researcher, and a Geriatrician and a Hospice and Palliative Care
physician. She is also a Staff Physician at the San Francisco VA Medical
Center. Her research focuses on the intersection of health literacy,
geriatrics, advance care planning, and informed medical decision making. Her
current research program is focused on designing and testing interactive,
web-based interventions to prepare patients and their surrogate decision makers
to make complex medical decisions over the course of serious and chronic
illness.
Email: rebecca.sudore@ucsf.edu