Adult Foster Research Articles

Family Involvement among Oregon Adult Foster Home Residents, 2018–2023

ObjectivesTo track the changes that occurred in family involvement among Oregon Adult Foster Home (AFH) residents following the COVID-19 pandemic and to examine the associations between home and resident characteristics and family involvement. DesignRetrospective analysis of repeated cross-sectional data. Setting and ParticipantsA total of 2027 responses from AFH providers that replied to a mailed questionnaire from a sample of eligible licensed Oregon AFH selected to participate annually between 2018 and 2023 (6 waves). MethodsAFH providers filled out a questionnaire containing questions about family involvement (residents who received 6 types of support from family members or friends, such as help with personal care or social visit) and resident characteristics (activities of daily living needs, payer mix, age, gender, dementia status). Additional contextual data (size, rural/urban) were obtained from state agencies. Associations among family involvement and home and resident characteristics were examined using multivariable linear regression models. ResultsBivariate analyses showed statistically significant declines in social visits and outings and help getting to medical appointments during the first 2 years (2021 and 2022) of the COVID-19 pandemic, but little change in help with personal care or taking medications or phone calls. By 2023, social visits had recovered to pre-pandemic levels but remained significantly lower for help getting to medical appointments and going on outings. Multiple regression models that included controls showed that rural AFH and those with higher Medicaid use reported significantly lower family involvement in social visits, outings, and help getting to medical appointments. Conclusions and ImplicationsThe continued decline in assistance for medical appointments and outings portends potential challenges in resident socioemotional well-being and accessing health care services in this setting. Understanding the long-term impacts of the pandemic on quality of life and quality of care for residents living in community-based care settings may require a multifaceted approach to measuring family involvement.

The Association Between Permanency and Length of Time in Foster Care for Children with Older Adult Foster Caregivers: Children Removed Due to Substance Use Behavior

The Association Between Permanency and Length of Time in Foster Care for Children with Older Adult Foster Caregivers: Children Removed Due to Substance Use Behavior

Understanding the Risk of Homelessness for Emerging Adult Foster Care Youth

This publication discusses foster care in the United States, risk of experiencing homelessness among foster care youth, and possible interventions. Written by Francesca Michelini, Randall Cantrell, and Kate Fogarty, and published by the UF/IFAS Department of Family, Youth and Community Sciences, January 2022.

The Resident VIEW in Community-Based Care Residential Settings.

The Resident VIEW is a measure of person-centered care (PCC) from residents' perspectives and was previously studied in nursing homes. The current study presents descriptive data for the Resident VIEW in community-based care settings including assisted living, residential care (AL/RC), and adult foster homes (AFH). Using a two-stage sampling design, we recruited 31 AL/RC and 119 AFH in Oregon and completed face-to-face structured interviews with 227 and 195 residents, respectively. Residents provided ratings for both the importance of and their experience with 66 items that tapped into PCC practices in eight domains. Results are provided for each item, many of which are significantly associated with greater quality of life, better resident satisfaction, and fewer depressive symptoms, especially in the domains of personalized care and being treated like a person. Incongruence between importance and experience ratings indicate many residents experience unmet needs across multiple domains. The Resident VIEW performed well in different types of settings, providing an important tool for researchers and providers who wish to learn about the PCC experience from residents' points of view.

Infection Control in Small Residential Care Settings: Insights From a National Survey and Washington State Data

Peripheral artery disease (PAD) is a chronic, progressive atherosclerotic disease resulting in worse functional status. It is an important factor that affects mobility and quality of life in older adults with PAD. This study aimed to identify the functional status and its associated factors of older adults diagnosed with PAD. We conducted a cross-sectional study among older adults aged 65 above diagnosed with PAD at a tertiary hospital in Seoul, Korea. Participants' functional status was measured using a Walking Impairment Questionnaire (WIQ) which consisted of distance, speed, and stair-climbing. We measured cardiac health behavior, social support, health perception, and clinical manifestation through self-administered questionnaires. Among 94 participants, the mean age was 74.98±6.21 years, and 91.5% were male. The mean score of WIQ was 0.59±0.30 out of 1; the mean scores for distance, speed, and stair-climbing of WIQ were 0.67±0.40, 0.45±0.27, and 0.64±0.37, respectively. Participants' functional status was significantly associated with age (β=-0.012, P=.002), sex (β=-0.284, P=.001), ulcers of the lower extremity (LE) (β=-0.242, P=.031), using a walking-assist device (β=-0.240, P=.002), walking difficulty due to pain of LE (β=-0.142, P=.006), and health behavior about physical activity (β=0.099, P=.021). This regression model predicted 53.5% of participants' functional status (F=8.63, P<.001). This study indicated that younger age, female, independent walking, no ulcers of LE, no walking difficulty, and higher physical activity behavior were significantly associated with better functional status in older adults with PAD. Therefore, healthcare professionals should develop and provide interventions to promote physical activity and alleviate symptoms to enhance functional status.

Infection Control in Small Residential Care Settings: Insights From a National Survey and Washington State Data

Infection control is a vital issue in long-term care, and the increasing popularity of small residential care facilities (SRCF) raises questions about the effectiveness of this model for preventing facility-acquired infections. In SRCF, care is provided in a residential home to a small number of residents. The setting lacks common terminology, and states license SRCF under various titles including Adult Family Homes, Adult Foster Homes and Family Care Homes. To better inform infection control efforts in this unique setting type, DOH staff conducted a comprehensive search to locate states that license SRCF. A total of 24 states were identified and approached to participate in a qualitative research study; 21 responded, three declined and nine were unable to participate due to staff time constraints. Between March 12th and April 15th, 2021, ten public health and regulatory staff from nine states completed semi-structured telephonic interviews on infection control in SRCF. Infection control licensing requirements and public health oversight for SRCF varied significantly across participating states. Data from these interviews was analyzed and compared with two Washington State Adult Family Home (AFH) sources: 1) online survey of AFH providers 2) Infection Control Assessment and Response evaluations conducted by public health staff. Four themes were identified in all three data sets: access to personal protective equipment, environmental safety, staffing issues and knowledge deficits. SRCF are valued by states that license them. Despite the challenges of implementing infection control in the home-like environment, extraordinary opportunities exist for improving care and preventing infections in this setting.

“Home is Home:” Exploring the Meaning of Home across Long-Term Care Settings

To feel “at home” in long term care (LTC) is an important programmatic goal. Few large studies, however, have examined resident perspectives about feeling at home across different types of LTC settings. We asked 632 older adults living in nursing homes, assisted living, and adult foster homes in Oregon whether or not their setting felt “like home” and to describe their experiences with “at-homeness.” Our qualitative analysis revealed five distinct themes that encompassed social connection; autonomy, control, and choice; engagement with the physical environment; organizational environment; and perceptions and coping. Our findings demonstrate how organizational features, interacting with resident characteristics, can facilitate or constrain the experience of home in LTC settings.

“This ‘Family Setting’ Is Not that Anymore”: Rewards and Challenges of Adult Foster Home Owners

ABSTRACT Small residential care settings for older adults and people with disabilities are found throughout the United States. Those with fewer than 25 residents account for half of residential care settings. Adult foster homes (AFH) are under-studied although they provide personal and health-related services to residents, including people with Alzheimer’s disease. This qualitative study collected data from 726 AFH owners over four years. Results provide a contemporary perspective on owners’ experience of the rewards and challenges of operating a small home. These results are relevant since many residents prefer small settings, and because federal regulatory changes affect AFH policies and practices.

Experiences of black women adult foster care providers for aging adults: negotiating power and care

ABSTRACT This study explored experiences of 23 Black women owners and operators of Adult Foster Care (AFC) homes for midlife and older adults. Semi-structured interview data focusing on multiple dimensions of the care context were analyzed using grounded theory methods. Women leveraged their resources as they invested their expertise, time, and relationships to support their residents and embraced the value of residents for their contribution to the success of AFC settings. The findings underline the critical roles of these AFC providers in maintaining safe and home-like care contexts for aging adults, in the face of systemic challenges.

Rural-Urban Differences in Social Connectedness Among Adult Foster Home Residents in Oregon

Social isolation has been linked to negative health outcomes, especially among older adults. Although ability to maintain social contact and existing ties to one’s community is a primary benefit of receiving long-term supports and services in a community-based setting, few studies explored how geography might shape these residents’ access to family members and friends. The current study explores this question in the context of adult foster homes (AFH), a type of family-style residential care licensed for five or fewer unrelated adults. Using cross-sectional data collected annually from 1,500 AFHs between 2015 and 2020, the study examines whether older adults residing in rural and urban AFHs in Oregon differ in terms of levels of distinct types of contact with their existing social networks. AFHs were designated as rural/urban at the zip code level using the definitions provided by the state coordinating organization for rural health. Results from negative binomial regression models show that rural residents were significantly less likely to receive help from their family members and friends in getting to medical appointments or outside activities (e.g., meals, walks, shopping) or receive social visits or phone calls compared to their urban counterparts. Rural and urban residents had similar levels of help with personal care and taking medications. These results remained unchanged after accounting for a set of home (e.g., Medicaid contract) and resident characteristics (e.g., acuity). These findings suggest important public health implications for improving rural residents’ social connectedness and interventions aiming at improving social participation in long-term care residents.

Adult foster care of older people

The focus of this article is to introduce the community-based adult foster care of older people in Finland. Although adult foster care is a public care service, it is organised in a private home, either in the foster carer’s home or in the older person’s home. The foster carer and the county make a commission agreement. Adult foster care can be full-time long-term care or short-term full-time or part-time care.

Time to care? Temporal variations of agency of the Finnish adult foster carers

This article analyses a hybrid form of housing and care service for older people called adult foster care. In Finnish adult foster care model, an older person moves to a foster care home and is cared for by a semi-professional foster carer who is not related to them. A foster care home is thus simultaneously a personal dwelling and a site of intensive care work which also changes the rhythms and routines of both the foster carer and older person. In the article I ask, how do foster carers express their temporal agency and its variations (identity, pragmatic, life course) through time work? By temporal agency I mean individuals' ability to impact on their experience of time, which is done through time work. The article is based on 12 thematic interviews that were analysed using thematic content analysis. The analysis shows that as a resource, time itself was the most valued aspect of foster care work. Being a foster carer was in fact a way of resisting clock-driven, institutional-like care work. The foster carers were able to exercise their professional identity agency, that is, act like ‘a good carer’ should act, but they found it difficult to allocate time for themselves and to their families. This can.endanger their well-being and the continuity of foster care relationship. In order to develop the adult foster care scheme to a real housing and care option for older people and a tenable work option for potential foster carers, several issues should be carefully considered. To ensure foster carers' well-being, their statutory right to days-off should be increased, and the support and substitute system should be enhanced so that foster carers can allocate more time for themselves and their families, even when this would mean more costs to the municipalities. Also, older people in need of care should be placed to foster care much earlier.

Germ Blasters and Gameful Thinking: Saving New Employee Orientation One Mission at a Time

Hospital-based orientations are known for being long and boring, and unfortunately, in the summer of 2016, ours was no different. At Denver Health and Hospital Authority, our new nursing employees attended a 3-day orientation that involved learners sitting and listening exclusively to PowerPoint presentations. Educators and leaders watched with despair as the newest members of their workforce became overwhelmed, glazed-over, and simply downright bored. This format did not incorporate all the adult learning styles or foster engagement and team building. It was also unclear whether the required standard information competencies were being retained by the audience. We knew the orientation must change to ensure new employees were not only prepared for success in their roles, but also inspired and excited to be a part of an organization with a meaningful mission and vision. By integrating gameful thinking into our orientation, we have decreased resource demands, time, and cost while increasing knowledge retention and employee engagement!

Infants help singers of familiar songs

Infants are highly selective in their help to unfamiliar individuals. For example, they offer more help to partners who move synchronously with them rather than asynchronously and to partners who interact with them in a “nice” rather than “mean” manner. Infant-directed song and speech may also encourage infant helping by signaling caregiver quality. In the present study, we investigated the effect of infant-directed song and recitation on 14-month-old infants’ subsequent helpfulness and proximity-seeking in relation to unfamiliar performers. During a 2.5-minute exposure phase, infants sat on their caregiver’s lap opposite an experimenter who sang “The Ants Go Marching” (song condition), recited the lyrics (recitation condition), or remained silent while parents read them a book (baseline condition). After the exposure phase, infants participated in a series of helping tasks that necessitated the return of objects dropped “accidentally”. Infants in the song and recitation conditions helped more than those in the baseline condition, but their helping of singers was moderated by song familiarity. Specifically, the extent of help directed to singers correlated positively with song familiarity. Singing (and to some extent, recitation) also encouraged infants to seek proximity with the experimenter. The findings indicate that rhythmic song and recitation by an unfamiliar adult foster infant affiliative behavior, but familiar songs may have special social importance.

Medical Foster Homes: Can the Adult Foster Care Model Substitute for Nursing Home Care?

To compare characteristics, healthcare use, and costs of care of veterans in the rapidly expanding Veterans Health Administration (VHA) medical foster home (MFH) with those of three other VHA long-term care (LTC) programs. Descriptive, unmatched study. VHA MFHs, home-based primary care (HBPC), community living centers (CLCs), and community nursing homes (CNHs). Veterans newly enrolled in one of the four LTC settings in calendar years 2010 or 2011. Using VA and Medicare data from fiscal years 2010 and 2011, demographic characteristics, healthcare use, and costs of 388 veterans in MFHs were compared with 26,037 of those in HBPC, 5,355 in CLCs, and 5,517 in CNHs in the year before and the year after enrollment. Veterans enrolled in the MFH program were more likely to be unmarried than those in other LTC programs and had higher levels of comorbidity and frailty than veterans receiving HBPC but had similar levels of comorbidity, frailty, and healthcare use as those in CLCs and CNHs. MFH veterans incurred lower costs than those in CNHs and CLCs. MFHs served a distinct subset of veterans with levels of comorbidity and frailty similar to those of veterans cared for in CLCs and CNHs at costs that were comparable to or lower than those of the VHA. Propensity-matched comparisons will be necessary to confirm these findings.

Physical activity assessments in disable adults living in adult foster homes

To draw a questionnaire to estimate physical activity of adult foster home residents. To observe the physical activity's level and available time. To estimate the APA development's interest. We designed a questionnaire allowing to assess the physical activity in a population with motor deficiencies. It was tested among 12 healthy subjects and 25 adult foster home residents. The residents’ stay at this foster home (FH) lasts between a few days and a few weeks. The assessment was made on a typical week at home and on a typical week at the FH. The residents suffered from various acquired neurological disabilities. The results validate reproducibility (Pearson coefficient = 0.66) and temporal estimation of the questionnaire for healthy subjects. We used an error margin of ± 15% for the temporal estimation. The subjects have a lot of free time in their weeks (on average 26.6H of no activity at home and 39.82H at FH), a daily energy expenditure lower than that of healthy sedentary subjects (on average 1960.06 kcals per day for women and 2139.39 kcals for men against 2000 to 2100 kcals for healthy women and 2700 to 3000 kcals for healthy men [1] , a few intense activities and a low physical practice (on average only 0.03H per week to practice moderate intensity activities and 0.09H for high intensity activities). We observe trends of correlations between certain functional factors and energy expenditure ( P = 0.0058 between energy expenditure and motor function's estimation with the multiple regression). APA increases subject's daily energy expenditure (single activity proposed at the FH which has an intensity ≥ 3 METs). To maintain health condition and preserve autonomy for people with a handicap, it is imperative to allow them the access to different physical practices in order to increase their physical activity level. To do so, APA's development is essential. In particular in FH in order to provide education to physical activity during temporary stays.

METODE PENDIDIKAN MENURUT PETUNJUK AL-SUNNAH

&lt;p&gt;Abstract&lt;/p&gt;&lt;p&gt;&lt;span&gt;Education is very vital role in human life. The system of education in which&lt;br /&gt;&lt;span&gt;educational methods is under constant continuous "immortal-conversation",&lt;br /&gt;&lt;span&gt;especially in methods of Islamic education, the epistemology of al-Quran and alSunnah. Science always continues to grow, so did the methods of education in&lt;br /&gt;&lt;span&gt;the interpretation of the al-Qur'an and al-Sunnah. As the principal basis of both&lt;br /&gt;&lt;span&gt;al-Sunnah provides practical translation of articulation over-methodical practice&lt;br /&gt;&lt;span&gt;daily with the companions of the prophet in education. Nevertheless, there is a&lt;br /&gt;&lt;span&gt;problem regarding Muslims repetition educational method that in fact it&lt;br /&gt;&lt;span&gt;tawadlu' relationship between educators and students, education is rare that the&lt;br /&gt;&lt;span&gt;subject and object in the students.&lt;br /&gt;&lt;span&gt;Experts Islamic figures revealed some nuances of Islamic educational methods&lt;br /&gt;&lt;span&gt;on the main source of epistemology. Such as Abu Ali Husain ibn Abd Allah ibn&lt;br /&gt;&lt;span&gt;Hasan ibn Ali ibn Sina (980-1037 AD) method of reward and punishment, Abu&lt;br /&gt;&lt;span&gt;Muhammad al-Ghazali (1058-1111 AD) method of gradual habituation, Abdurrahman Abu Zaid ibn Khaldun (1322-1406 AD) phasing method of repetition &lt;span&gt;(tadarruj wa al-tikrar), ' Abdul Fattah Abu Ghuddah (2009) titled 40 Methods &lt;span&gt;Education &amp;amp; Teaching Prophet, then an-Nahlawi Abdurrahman (1995), Islamic &lt;span&gt;education: at home, school, and community, by dividing 7 methods of&lt;br /&gt;&lt;span&gt;education, M.Thalib (1996), Islamic educational methods 30T, he divided into&lt;br /&gt;&lt;span&gt;30 educational methods that begin with the letter T and many other alternative&lt;br /&gt;&lt;span&gt;methods.&lt;br /&gt;&lt;span&gt;The author analyzes existing educational criticized by giving an inductivedeductive method, an educational method that makes the active, creative, how to &lt;span&gt;make the education of students as actors. Educators here in the position of adult &lt;span&gt;foster children in ushering in meeting the educational goals that address the &lt;span&gt;challenges of life in her future students.&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;br /&gt;&lt;span&gt;Keywoard: &lt;em&gt;metode pendidikan, al-Sunnah&lt;/em&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;br /&gt;&lt;/span&gt;&lt;/p&gt;

Bone marrow mesenchymal stem cell-derived secreted factors promote the proliferation of adult subventricular zone-neural stem cells and foster their stemness in vitro under pathogenic conditions

Bone marrow mesenchymal stem cell-derived secreted factors promote the proliferation of adult subventricular zone-neural stem cells and foster their stemness in vitro under pathogenic conditions

Medical Foster Home: Experience With 16 Veterans

Medical Foster Home (MFH) is a unique partnership of adult foster home and a VA interdisciplinary home care team, providing long term care in a personal home as a non-institutional extended care option. Many veterans live alone, independently for years through the support of assistive devices and home care services. Eventually the veteran may decline to the point that it is no longer safe to remain living alone. Traditionally, this situation is resolved by nursing home placement. However, the veteran may refuse nursing home care, instead accepting serious risks.

Better Care for Complex, Challenging Clients: Hawaii's Training Program to Improve Residential Long-Term Care

The Kupuna Adult Care Home Project is an innovative training program designed to improve the skills of care home and adult foster home operators in Hawaii. Clients in residential settings are increasingly likely to have complex problems. The project developed nine modules on topics such as dementia care, diabetes, and fall prevention based on stakeholder input and a national scan of best practices. A total of 787 persons were trained. An evaluation indicated that training significantly improved knowledge and that trainees were highly satisfied with the training. A secondary State of the Industry survey indicated that many care home and adult foster home caregivers are aging themselves and their children may not take over the family business. By combining practical knowledge and active learning strategies to work through real-life scenarios, the Kupuna Adult Care Home project is a promising training model.