@article{24a40a599a424b2aa1f02da1e4932deb,
title = "The Role of Dementia and Residential Service Agency Characteristics in the Care Experiences of Maryland Medicaid Home and Community-Based Service Participants and Family and Unpaid Caregivers",
abstract = "In Maryland, residential service agencies deliver Medicaid Home and Community-Based Services (HCBS) to older adults with disabilities through direct care workers (e.g., personal care aides). Leveraging survey data from residential service agency administrators, linked to interRAI Home Care assessments for 1144 participants, we describe agency characteristics, and participant and family caregiver experiences by participant dementia status. Most (61.7%) participants experienced low social engagement, and roughly 10.0% experienced a hospitalization or emergency room visit within 90 days. Few (14.4%) participants were served by agencies requiring dementia-specific direct care worker training, and most were served by agencies offering supplemental services, or in which direct care workers helped with health information technology (81.2% and 72.8%, respectively). Few caregivers reported negative care experiences. Participants with dementia and those served by agencies with training and support more often reported negative care experiences. Findings lay the foundation for future longitudinal and embedded interventions within Medicaid HCBS.",
keywords = "dementia, home and community-based services, home care",
author = "Fabius, {Chanee D.} and Roberto Millar and Erick Geil and Ian Stockwell and Christin Diehl and Deirdre Johnston and Gallo, {Joseph J.} and Wolff, {Jennifer L.}",
note = "Funding Information: Dawn Seek, Maryland National-Capital Homecare Association The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funds to support this pilot study were provided by the National Institute on Aging (NIA) IMPACT Collaboratory (U54AG063546) the Johns Hopkins University Alzheimer{\textquoteright}s Disease Resource Center for Minority Aging Research (P30AG059298; CDF), the Hopkins{\textquoteright} Economics of Alzheimer{\textquoteright}s Disease & Services (HEADS) Center under award number P30AG066587 (CDF and JLW), award number R35AG072310 (CDF and JLW), and the Johns Hopkins Bloomberg School of Public Health (CDF). Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funds to support this pilot study were provided by the National Institute on Aging (NIA) IMPACT Collaboratory (U54AG063546) the Johns Hopkins University Alzheimer{\textquoteright}s Disease Resource Center for Minority Aging Research (P30AG059298; CDF), the Hopkins{\textquoteright} Economics of Alzheimer{\textquoteright}s Disease & Services (HEADS) Center under award number P30AG066587 (CDF and JLW), award number R35AG072310 (CDF and JLW), and the Johns Hopkins Bloomberg School of Public Health (CDF). Publisher Copyright: {\textcopyright} The Author(s) 2022.",
year = "2023",
month = apr,
doi = "10.1177/07334648221128286",
language = "English (US)",
volume = "42",
pages = "627--638",
journal = "Journal of Applied Gerontology",
issn = "0733-4648",
publisher = "SAGE Publications Inc.",
number = "4",
}