2.50
Hdl Handle:
http://hdl.handle.net/10755/158286
Type:
Presentation
Title:
I get to do it my way: An evaluation of self-directed care in Washington State
Abstract:
I get to do it my way: An evaluation of self-directed care in Washington State
Conference Sponsor:Western Institute of Nursing
Conference Year:2003
Author:Young, Heather
P.I. Institution Name:University of WashingtonCommunity Health Care Systems
Title:Research Assistant Professor
Contact Address:, Seattle, WA, 98195-0005, USA
Co-Authors:Sikma, S. K.
Consumer direction in community based long-term care services is a growing nationwide trend, reflecting the philosophy of the independent living movement for persons with disabilities. Washington State enacted Self-Directed Care in 1998, enabling persons with disabilities to hire, train, and supervise individual providers to perform health care tasks. This study evaluated Self-Directed Care, including consumer satisfaction, service quality, and consumer safety. Naturalistic and quantitative methods were used, including surveys and interviews with early participants in the program. Interviews were conducted in English and Spanish early in the program, with follow-up one year later. All eligible consumers (n=231), case managers (CM) (n= 173) and individual providers (IP) (n=350) were invited to participate in satisfaction surveys, with response rates of 54.1%, 19.7% and 16.8% respectively. Consumers ranged in age from 20-87 years (mean=51.9, SD = 14.7), were 51.7% female, and of the following ethnic groups: 2.4% African American, 1.7% Hispanic, 4% Native American, 1.6% Asian American, and 83.9% Caucasian. Most common self-directed tasks included: medications (over 50%), injectables (20%), bowel, catheter and wound care (approximately 35% each), and blood glucose testing (20%). Thirty participating consumers were selected (representing a range of self-directed tasks and region of the state) along with their associated CM and IP for in-depth interviews. Major themes included quality of life, quality of care, philosophy of the program, and staffing. All allegations of abuse or neglect reported to Adult Protective Services were reviewed to evaluate consumer safety. During the study period, over 1000 consumers were enrolled in Self-Directed Care, and 18,000 investigations were conducted by APS. Five investigations related to self-directed care, two of which were substantiated as abuse or neglect by the IP. The most significant findings include: a) No negative outcomes attributable to Self-Directed Care. Benefits included improvements in quality of life and quality of care for consumers; b) High satisfaction with Self-Directed Care and strong endorsement for the program; c) Self-directed care supports autonomy and choice – people value staying at home and want to have control over their lives and care; d) Self-Directed Care offers another alternative for persons with functional and health needs; e) Consumers and case managers believe that this program is preventing utilization of more expensive services (e.g., nursing homes, Emergency Rooms for routine care); and, f) The biggest challenge to implementation is assuring adequate staffing, a reflection of a broader labor issue affecting consumers in all long term care settings. This program expands community-based options for persons with disabilities who have the cognitive ability to direct their own care, and the desire to remain at home. It supports the independent living philosophy and disability rights, and has the potential to prevent unnecessary utilization of higher cost alternatives. Barriers to implementation are existing attitudes about self-determination for persons with disabilities and the availability of competent and qualified staff. Further research could establish relative costs and savings of the program, and explore interventions to improve the labor force for long-term care. This research was funded by the Washington State Department of Social and Health Services.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleI get to do it my way: An evaluation of self-directed care in Washington Stateen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158286-
dc.description.abstract<table><tr><td colspan="2" class="item-title">I get to do it my way: An evaluation of self-directed care in Washington State </td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Young, Heather</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of WashingtonCommunity Health Care Systems</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Research Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Seattle, WA, 98195-0005, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Sikma, S. K. </td></tr><tr><td colspan="2" class="item-abstract">Consumer direction in community based long-term care services is a growing nationwide trend, reflecting the philosophy of the independent living movement for persons with disabilities. Washington State enacted Self-Directed Care in 1998, enabling persons with disabilities to hire, train, and supervise individual providers to perform health care tasks. This study evaluated Self-Directed Care, including consumer satisfaction, service quality, and consumer safety. Naturalistic and quantitative methods were used, including surveys and interviews with early participants in the program. Interviews were conducted in English and Spanish early in the program, with follow-up one year later. All eligible consumers (n=231), case managers (CM) (n= 173) and individual providers (IP) (n=350) were invited to participate in satisfaction surveys, with response rates of 54.1%, 19.7% and 16.8% respectively. Consumers ranged in age from 20-87 years (mean=51.9, SD = 14.7), were 51.7% female, and of the following ethnic groups: 2.4% African American, 1.7% Hispanic, 4% Native American, 1.6% Asian American, and 83.9% Caucasian. Most common self-directed tasks included: medications (over 50%), injectables (20%), bowel, catheter and wound care (approximately 35% each), and blood glucose testing (20%). Thirty participating consumers were selected (representing a range of self-directed tasks and region of the state) along with their associated CM and IP for in-depth interviews. Major themes included quality of life, quality of care, philosophy of the program, and staffing. All allegations of abuse or neglect reported to Adult Protective Services were reviewed to evaluate consumer safety. During the study period, over 1000 consumers were enrolled in Self-Directed Care, and 18,000 investigations were conducted by APS. Five investigations related to self-directed care, two of which were substantiated as abuse or neglect by the IP. The most significant findings include: a) No negative outcomes attributable to Self-Directed Care. Benefits included improvements in quality of life and quality of care for consumers; b) High satisfaction with Self-Directed Care and strong endorsement for the program; c) Self-directed care supports autonomy and choice &ndash; people value staying at home and want to have control over their lives and care; d) Self-Directed Care offers another alternative for persons with functional and health needs; e) Consumers and case managers believe that this program is preventing utilization of more expensive services (e.g., nursing homes, Emergency Rooms for routine care); and, f) The biggest challenge to implementation is assuring adequate staffing, a reflection of a broader labor issue affecting consumers in all long term care settings. This program expands community-based options for persons with disabilities who have the cognitive ability to direct their own care, and the desire to remain at home. It supports the independent living philosophy and disability rights, and has the potential to prevent unnecessary utilization of higher cost alternatives. Barriers to implementation are existing attitudes about self-determination for persons with disabilities and the availability of competent and qualified staff. Further research could establish relative costs and savings of the program, and explore interventions to improve the labor force for long-term care. This research was funded by the Washington State Department of Social and Health Services. </td></tr></table>en_GB
dc.date.available2011-10-26T20:41:43Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:41:43Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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