Resident Services Coordination to Support Aging in Place in Affordable Housing for Persons with Alzheimer's Disease and Related Dementias

居民服务协调，支持阿尔茨海默病和相关痴呆症患者在经济适用住房中就地养老

• 批准号: 10712645
• 负责人: NANCY J BIRKMEYER
• 金额: $ 32.63万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-01 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10712645
• 关键词: Address; Affect; Alzheimer' s disease related dementia; American; Awareness; Caregivers; Case Management; Characteristics; Collaborations; Collection; Communities; Complex; Data; Development; Diagnosis; Disparity; Elderly; Emergency department visit; Family; Funding; General Population; Government Subsidy; Health; Health Policy; Health Promotion; Health Status; Health behavior; Home; Home Nursing Care; Housing; Immunization; Incentives; Independent Living; Inequality; Institutionalization; Interview; Link; Maintenance; Measures; Mediating; Mental Health; Methods; Modeling; Neighborhoods; Outcome; Personal Satisfaction; Persons; Play; Policies; Preventive care; Primary Care; Privatization; Productivity; Property; Quality of life; Reduce health disparities; Retrospective cohort study; Role; Sampling; Services; Social support; Structure; Surveys; U.S. Department of Housing and Urban Development; United States; United States Centers for Medicare and Medicaid Services; acute care; aging in place; care systems; clinical care; community based service; cost; design; evidence base; explicit bias; federal policy; health care disparity; health care service utilization; health service use; implicit bias; improved; informant; innovation; inpatient service; insight; prevent; programs; service coordination; service utilization; social; social determinants; social health determinants; synergism

PROJECT SUMMARY – PROJECT 2 One quarter of the 2.9 million older people living in government-subsidized affordable housing in the U.S. have claims-based evidence of ADRD. Resident services coordinators (RSCs) are staff assigned to subsidized housing who manage and provide access to necessary supportive services in the community, provide case management services, develop programs and assets that support wellness, and address social determinants that would otherwise undermine successful aging in place. While myriad state and federal policies mandate and/or incentivize affordable housing building upgrades that address hazardous building conditions, standard financial models for affordable housing make funding for RSCs extremely challenging and fewer than half of federally funded properties serving older persons currently have an RSC. This is counterintuitive since evidence suggests that RSCs are valuable assets to both residents and property owners, benefiting occupancy and rent collection and reducing evictions and maintenance costs. A HUD survey of property managers found that they strongly believe RSC’s improve residents’ quality of life, promote independent living, and prevent unnecessary institutionalization. Little is known about the influence of RSCs on the health and well-being of residents with ADRD. Using linked data from the AASC (American Association of Service Coordinators), HUD (U.S. Department of Housing and Urban Development), CMS (Centers for Medicare and Medicaid Services), and semi-structured interviews with purposively sampled RSCs, we will explore the effects of RSCs on utilization of services and outcomes for older residents with ADRD using a sequential mixed-methods explanatory design. Our specific aims are: Aim 1. Compare the effects of RSCs on disparities in use of health services for residents with and without ADRD; Aim 2. Evaluate the effects of RSCs on inequality in use of services promoting aging in place for residents with and without ADRD; and Aim 3. Further explore the barriers and facilitators (including implicit and explicit biases) to aging in place for residents with and without ADRD that are identified in the first two aims.

项目概要-项目2 在美国，290万居住在政府补贴的经济适用房中的老年人中，有四分之一 基于ADRD的索赔证据。驻地服务协调员是被派往有补贴的 管理并提供社区必要支持服务的住房提供案例 管理服务，开发支持健康的计划和资产，并解决社会决定因素 否则会破坏成功的原地老化。虽然无数的州和联邦政策要求 和/或激励解决危险建筑条件的经济适用房建筑升级， 负担得起的住房的金融模式使得为区域服务公司提供资金极具挑战性， 联邦资助的为老年人服务的财产目前有一个区域服务中心。这是违反直觉的，因为 有证据表明，区域服务中心对居民和业主来说都是宝贵的资产， 以及收取租金并减少驱逐和维护成本。住房和城市发展部对物业经理的调查发现， 他们坚信RSC提高了居民生活质量，促进了独立生活， 不必要的制度化。关于RSC对健康和福祉的影响知之甚少， ADRD患者。使用来自AASC（美国服务协调员协会）的链接数据，HUD (U.S.住房和城市发展部），CMS（医疗保险和医疗补助服务中心）， 和半结构化访谈的目的抽样RSC，我们将探讨RSC的影响 采用序贯混合方法对ADRD老年居民的服务利用和结果 解释性设计我们的具体目标是：目标1。比较区域服务公司对利用保健服务的差异的影响 为有和没有ADRD的居民提供服务;目标2。评估区域供应链对使用不平等的影响 为有和没有ADRD的居民提供促进就地养老的服务;以及目标3。进一步探索 障碍和促进因素（包括隐性和显性偏见），以老龄化的地方，为居民和没有 在前两个目标中确定的ADRD。