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

项目摘要--项目2 在美国290万住在政府补贴的经济适用房的老年人中，有四分之一的人 基于索赔的ADRD证据。驻地服务协调员(驻地服务协调员)是被分配到获得补贴的工作人员 在社区中管理和提供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，这将破坏成功的老龄化。虽然无数的州和联邦政策要求 和/或激励针对危险建筑条件的经济适用房升级，标准 经济适用房的财务模式使得为RSC提供资金具有极大的挑战性，只有不到一半的 联邦政府资助的为老年人服务的物业目前有一个RSC。这是违反直觉的，因为 有证据表明，社区住房委员会对居民和业主来说都是宝贵的资产，有利于入住率。 以及收取租金，并减少驱逐和维护费用。住房和城市发展部对物业经理的调查发现 他们坚信RSC提高了居民的生活质量，促进了独立生活，防止了 不必要的制度化。关于RSCs对健康和福利的影响，人们知之甚少 患有ADRD的居民。使用HUD的AASC(美国服务协调员协会)的关联数据 (美国住房和城市发展部)、CMS(医疗保险和医疗补助服务中心)、 和有目的抽样的RSC的半结构化访谈，我们将探索RSC对以下方面的影响 使用序贯混合方法对老年居民ADRD的服务和结果的利用 解释性设计。我们的具体目标是：目标1.比较区域干细胞对卫生使用差异的影响 为患有和不患有ADRD的居民提供服务；目标2.评估RSC对不平等使用的影响 为患有和不患有ADRD的居民提供促进老龄化的服务；以及目标3.进一步探讨 阻碍和促进老龄化的障碍和推动者(包括隐性和显性偏见)适用于有条件和无条件的居民 在前两个目标中确定的ADRD。

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.