Personal Support Workers Research Articles

Attributable Risk and Consequences of Bone Mineral Density Deficits in Childhood Cancer Survivors

Data characterizing the severity and changing prevalence of bone mineral density (BMD) deficits and associated nonfracture consequences among childhood cancer survivors decades after treatment are lacking. To evaluate risk for moderate and severe BMD deficits in survivors and to identify long-term consequences of BMD deficits. This cohort study used cross-sectional and longitudinal data from the St Jude Lifetime (SJLIFE) cohort, a retrospectively constructed cohort with prospective follow-up. Participants in SJLIFE are adult survivors of childhood cancer who were diagnosed between 1962 and 2012 and survived 5 years or more from diagnosis. Data were collected from November 2007 to June 2020 and analyzed from January 2021 to November 2023. Childhood cancer therapy exposures, clinically ascertained comorbid conditions, substance use, and sedentary lifestyle. BMD was evaluated using lumbar quantitative computed tomography and classified by age- and sex-specific z scores with moderate (≤-1 SD) or severe (≤-2 SD) deficits. Multivariable logistic regression estimated odds ratios (ORs), attributable fractions (AFs), and associations between BMD deficits and long-term sequelae (social, functional, and quality of life [QOL]). Among 3919 five-year survivors (median [range] age, 31.7 [18.0-69.9] years; 2063 [52.6%] male; 105 [2.7%] Hispanic, 607 [15.5%] non-Hispanic Black, and 3153 [80.4%] non-Hispanic White), prevalence of moderate or severe BMD deficits were 21.7% (95% CI, 20.4%-23.0%) and 6.9% (95% CI, 6.1%-7.7%), respectively. Treatment exposures (including age at diagnosis), comorbid conditions, and smoking and sedentary behavior explained 18.5%, 10.2%, and 7.0% of moderate and 55.4%, 51.1%, and 9.9% of severe deficits. Severe deficits were associated with 30 Gy or greater cranial radiotherapy (CRT) (OR, 5.22; 95% CI, 3.74-7.30; AF, 33.0%), testicular or pelvic radiation (OR, 1.70, 95% CI, 1.19-2.44; AF, 11.5%), hypogonadism (OR, 3.27, 95% CI, 2.35-4.55; AF, 25.1%), growth hormone deficiency (OR, 5.28, 95% CI, 3.68-7.56; AF, 26.0%), smoking (OR, 1.71, 95% CI, 1.21-2.43; AF, 6.7%), and sedentary behavior (OR, 2.06, 95% CI, 1.15-3.69; AF, 6.2%). CRT exposure increased risk for declining BMD (OR, 2.94, 95% CI, 1.46-5.91; AF, 8.8%). Survivors with deficits were less likely to live alone and to be employed and more likely to require personal care assistance and to report depressive symptoms and poor QOL. While treatment exposures were associated with long-term BMD deficits, modifiable risk factors, including smoking, sedentary behavior, hypogonadism, and growth hormone deficiency, suggest feasible targets for intervention.

ASSESSING THE COMPLEXITIES OF LONG-TERM SERVICES AND SUPPORTS FOR OLDER ADULTS OF TEXAS

Abstract Background Long-term services and supports (LTSS) encompass a broad range of medical and personal care assistance needed by individuals who are unable to perform self-care tasks due to aging, chronic illness, or disability. The No Wrong Door (NWD) System is a statewide network that coordinates the system of access to long-term services and supports. As an offshoot of the person-centered planning movement, the NWD System is premised on ensuring that no matter where individuals first interact with the system, they are guaranteed comprehensive information, assessment, and services. This work will help the Texas Health and Human Services Commission create a consumer-driven, cost-effective, and efficient system. Methods A mixed methods approach was constructed to understand the challenges and barriers to accessing LTSS, assess NWD System performance based on stakeholder perspectives, and identify community needs. Results Of 4,153 respondents, 56% identified as an adult 50 years or older and 53% older adults reported a LTSS need in the past year. The top three problems faced when trying to get services include a confusing system, long service wait times, and not knowing where to get help. Unpaid informal caregiver respite services, caregiver education, and caregiver support groups were among the services and supports that inadequately met people’s needs. Conclusions: Our results form the blueprint for facilitating access to care throughout Texas to ensure vulnerable populations obtain a high quality of life. Recommendations for the NWD system include effective community outreach and streamlined application processes for services and supports.

Vulnerability: An Interpretive Descriptive Study of Personal Support Workers' Experiences of Working During the COVID-19 Pandemic in Ontario, Canada.

Personal support workers (PSWs) are important healthcare workers providing essential services to thousands of Canadians. PSWs face many challenges that were exacerbated in the context of the COVID-19 pandemic. In this study we explore experiences of PSWs working through the pandemic in Ontario long-term care (LTC) homes by focusing on the vulnerability of such workers. An interpretive description approach was adopted. Eleven PSWs working in LTC homes in an urban center in Ontario participated in semi-structured interviews between January and May 2022. Thematic analysis of the transcripts was informed by concepts of vulnerability. The results suggest that PSWs experienced inherent, situational, and pathogenic vulnerability. Inherent vulnerability was experienced in relation to risks of contracting the coronavirus working in person with residents, and of experiencing physical and psychological distress in relation to challenging interactions with staff, residents and their superiors. Situational vulnerability was experienced in relation to demanding workloads, which were intensified in the context of the pandemic. Participants expressed feeling undervalued, unappreciated, and disrespected, reflecting experiences of pathogenic vulnerability. The narratives shared by PSWs highlighted how the COVID-19 pandemic added new, and magnified pre-existing, challenges and vulnerability, affecting their health and well-being. Understanding risks faced by PSWs in LTC settings is crucial for developing targeted interventions and policies to support PSWs' health and well-being, mitigate factors that contribute to their vulnerability and promote the long-term sustainability of this caregiving workforce, ultimately enhancing the quality of care provided to residents in LTC facilities.

A Qualitative Evaluation of The Little Things Training for Diverse Background PCAs in Aged Care

Most direct residential aged care is provided by personal care assistants (PCAs), with western societies increasingly relying on culturally diverse aged care workers. In Australia and internationally, studies have reported that the level of training in both instrumental and relational care for PCAs is insufficient and inconsistent. This study evaluated the impact of The Little Things training program, designed for culturally diverse PCAs and students training to become PCAs. A modified Most Significant Change process, comprising a group-based qualitative analysis of narratives, was used to gain a rich understanding of the impacts and outcomes of the training. Narratives supplied by 29 PCAs and students were reviewed with aged care and training organization managers, who identified six themes: Increased confidence; Taking time; Building rapport and collaboration; Awareness of new skills; Seeing the whole person; and Positive impact on the resident. These themes reflected two key aims of The Little Things training: improving PCAs’ communication with residents and increasing PCAs’ confidence in communicating with residents. The study findings showed that The Little Things training program can improve the confidence of PCAs to communicate with aged care residents and may improve their capacity to form relationships.

Supporting resident-centred decision-making about transitions from long-term care homes to hospital: a qualitative study protocol

IntroductionBurdensome care transitions may occur despite clinicians’ engagement in care planning discussions with residents and their family/friend care partners. Conversations about potential hospital transfers can better prepare long-term care (LTC)...

Identified needs to enhance life for people with spinal cord injury: a part of the Swedish Needs Assessment Project

Purpose To identify factors that contribute to the enhanced life of people with spinal cord injury (SCI) in Sweden. Materials and methods This cross-sectional study combined workshops (n = 38) and survey data (n = 243) from people living with SCI and their relatives, health professionals, and personal care assistants working with people living with SCI. The data were first categorized using Bronfenbrenner’s bioecological model, followed by a conventional content analysis. Results The factors that contribute to an enhanced life for people living with SCI are similar to those of the general population, including relationships, leisure activities, and occupation within the mesosystem. However, the unique components of the exosystem and macrosystem are specifically associated with people living with SCI. The exosystem, particularly in healthcare, plays a major role for medical reasons but also tends to obtrude and minimize the mesosystem. The macrosystem is essential, as it sets the rules that govern the actors in the other layers, creating prerequisites for meeting the needs of the mesosystem and exosystem. Conclusions The needs that contribute to an enhanced life are multifaceted and individualized. Therefore, these systems must be flexible throughout the lifespan of individuals with SCI.

Fine Motor Impairment and Its Impact on Social Outcomes in Survivors of Pediatric Acute Lymphoblastic Leukemia: St. Jude Lifetime Cohort Study.

The impact of fine motor impairment among adult survivors of childhood acute lymphoblastic leukemia (ALL) on life after treatment is unknown. This study evaluated prevalence and utilized multivariate logistic regression to identify risk factors for fine motor impairment among survivors of ALL, and associations with educational attainment and social independence. Latent class analysis defined social independence (independent, moderately independent, dependent), using employment, independent living, personal care assistance, routine need assistance, driver's license status, and marital status inputs. Among 875 survivors who were ≥ 25years old (age when most adults achieve independence) and ≥ 5years from diagnosis (mean = 28.97years), 33.6% had fine motor impairment, with scores at or below the 10th percentile of the scores of community controls (n = 460) on fine motor components of the physical performance test and the grooved peg-board test. Survivors exposed to cranial radiation had more fine motor impairment than those without (45.8% vs 20.2%). Male sex (exposed: odds ratio [OR] = 2.55, 95% confidence interval [CI] = 1.65-3.92; unexposed: OR = 3.02, 95% CI = 1.69-5.38) and lower scores on the Wechsler abbreviated scale of intelligence (exposed: OR = 0.46, 95% CI = 0.36-0.58; unexposed: OR = 0.43, 95% CI = 0.31-0.58) were risk factors for neuropathy. A 1-point-higher total neuropathy score was associated with 8% (95% CI = 1%-17%) increased odds of fine motor impairment. Fine motor impairment was associated with less than a college education (less than high school: OR = 2.23, 95% CI = 1.20-4.14; high school diploma/general equivalency diploma: OR = 2.66, 95% CI = 1.65-4.30; vocational education: OR = 2.07, 95% CI = 1.38-3.13) and less social independence (moderately independent: OR = 1.80, 95% CI = 1.15-2.83; dependent: OR = 2.65, 95% CI = 1.25-5.64). Fine motor impairment in survivors of childhood ALL may interfere with optimal educational attainment and social independence. Early identification of survivors at risk for fine motor impairment, with timely intervention, may improve long-term outcomes.

Disability rights and disability justice in prison: the limits of state-protected rights and the possibilities of mutual support

Disabled persons are grossly overrepresented among incarcerated persons in U.S. prisons and likely to continue to grow as a group. Prisons are increasingly responsible for protecting the rights of incarcerated persons with disabilities, which includes the provision of accommodations and care. On the basis of thirteen qualitative interviews with persons with disabilities, personal care assistants, and others in a California state prison, the research subjects not only revealed the limits of disability rights in prison, but ways in which corrections officers used accommodations and personal assistance as means of harassing disabled inmates. Despite the failure of rights, persons with disabilities and their allies found ways to access care through mutual relationships and informal networks. This finding supports a disability justice perspective that argues that argues state-sponsored rights have failed specifically marginalized persons with disabilities, but also argues that disability emancipation can be found through peer-based mutual care.

How High-Performing Personal Support Workers Set and Maintain Boundaries When Providing Care: A Case Study in Ontario, Canada.

Personal support workers (PSWs) provide a large proportion of in-home care services for Canadians. PSWs must negotiate with clients and their family on how prescribed care is delivered. How PSWs set and maintain professional and personal boundaries during care is poorly understood, and failure to manage boundaries can expose both PSWs and clients to risk. High-performing PSWs (n = 9) and supervisors (n = 4) within an Ontario, Canada, home care agency were engaged in workshops (n = 3) to identify field-tested strategies and tactics for identifying, managing, and supporting PSW boundaries. A boundary-management framework was generated, including types of boundary challenges; decision-making principles (e.g., consider the purpose of home care); response strategies (e.g., work with the client on an alternative solution); and tactics for action (e.g., use proactive reminders). Supervisory and organizational supports (e.g., enabling "shop-talk") were identified. The framework can inform teaching and practice materials for PSWs in Canada and other countries.

“I Figured It Might Be Because We Are Rural”: A Qualitative Study of Barriers and Opportunities Related to Home-Based Personal Assistance Services

Personal care assistance (PCA) provides vital support so rural disabled people and older adults can live in their communities. Currently, the state of home and community-based services in the United States is dire, with major shortfalls in access and utilization of these services. Moreover, little is known about the experiences of people living in rural areas who need paid, in-home assistance with activities of daily living. Because rural areas are often underserved and under-resourced, this study aimed to understand the experiences of rural users of personal care assistance services to inform the development of a training for rural people. Between February and November of 2021, 38 semi-structured qualitative interviews were conducted with 40 self-identified rural-dwelling people across the United States who use paid PCAs. Interview topics included finding, hiring, and training workers; worker qualities; and how living in a rural place impacted PCA services. Using thematic coding, results highlight how rurality intersected with participants’ daily experiences. Respondents identified 3 barriers to getting PCA services: (1) lack of transportation and travel distance, (2) worker shortages, and (3) fewer local community services; and one facilitator of obtaining PCA services: strong community connection. Additionally, some aspects of rural culture—such as valuing a slower pace of life, independence, and rugged individualism—presented both barriers and opportunities for rural PCA recipients. As the home care worker shortage crisis in the United States is expected to worsen in coming decades, rural people needing PCA services face unique circumstances related to place and culture.

Technology, Aging and Home and Community Care: Picking the Right Problems to Solve.

As the Canadian population ages, the imperative to support aging in the community grows increasingly urgent. In this commentary, we build on Kokorelias et al.'s (2024) article to address the ethically appropriate role of digital technologies in supporting aging at home. We argue that a nuanced perspective on this topic is crucial. Focusing on the pivotal role of personal support workers in home and community care, we highlight the multiple challenges they face, from precarious employment to safety concerns. While digital innovations offer promise, we suggest that a holistic approach blending policy initiatives with technological advancements is imperative.

Prevalence of Late-Stage Parkinson's Disease in the US Healthcare System: Insights from TriNetX.

Patients in late-stage Parkinson's disease (PDLS) are caregiver-dependent, have low quality of life, and higher healthcare costs. To estimate the prevalence of PDLS patients in the current US healthcare system. We downloaded the 2010-2022 data from the TriNetX Diamond claims network that consists of 92 US healthcare sites. PD was identified using standard diagnosis codes, and PDLS was identified by the usage of wheelchair dependence, personal care assistance, and/or presence of diagnoses of dementia. Age of PDLS identification and survival information were obtained and stratified by demographic and the disability subgroups. We identified 1,031,377 PD patients in the TriNetX database. Of these, 18.8% fitted our definition of PDLS (n = 194,297), and 10.2% met two or more late-stage criteria. Among all PDLS, the mean age of PDLS identification was 78.1 (±7.7) years, and 49% were already reported as deceased. PDLS patients were predominantly male (58.5%) with similar distribution across PDLS subgroups. The majority did not have race (71%) or ethnicity (69%) information, but for the available information >90% (n = 53,162) were White, 8.2% (n = 5121) Hispanic/Latino, 7.8% (n = 4557) Black, and <0.01% (n = 408) Asian. Of the PDLS cohort, 71.6% identified with dementia, 12.9% had personal care assistance, and 4.8% were wheelchair-bound. Late-stage patients are a significant part of the PD landscape in the current US healthcare system, and largely missed by traditional motor-based disability staging. It is imperative to include this population as a clinical, social, and research priority. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Factors influencing self-reported facial-protective equipment adherence among home care nurses and personal support workers: A multisite cross-sectional study

Facial-protective equipment (FPE) use increased during the SARS-CoV-2 pandemic. This study explored factors influencing home care personal support workers' (PSWs) and nurses' self-reported adherence to FPE. A cross-sectional, electronic, survey was distributed to PSWs and nurses (1,108 complete responses) at 3 home care agencies in Ontario, Canada, in May to June 2022. Descriptive, bivariate, and multivariable analysis were used to assess individual, environmental, and organizational factors influencing adherence. Among participants (786 PSWs, 322 nurses), 64% reported being adherent to both respiratory and eye FPE (Respiratory: 96%, Eye: 64%). Higher adherence was associated with facility-based work; better knowledge of FPE; prepandemic FPE use; good availability and convenient access; strong organizational support for health and safety; and Caribbean identity. Lower adherence was found for men; nurses with 2-year diplomas; shorter length of employment; communal transportation; and experiencing negative mental health effects from workplace infectious disease exposure. Agencies should prioritize increasing providers' knowledge of FPE, supporting mental well-being, fostering a supportive culture, and ensuring availability of FPE. The influences of gender, ethnicity, and role require further exploration. FPE adherence may be improved by addressing modifiable factors and developing population-specific strategies.

A Good Investment: Expanding Capacity to Care for Older Adults in the Home and Community Care Sector Through Increased Personal Support Worker Wages.

Most older adults prefer to age in place, which for many will require home and community care (HCC) support. Unfortunately, HCC capacity is insufficient to meet demand due in part to low wages, particularly for personal support workers (PSWs) who provide the majority of paid care. Using Ontario as a case study, this paper estimates the cost and capacity impacts of implementing wage parity between PSWs employed in HCC and institutional long-term care (ILTC). Specifically, we consider the cost of increased HCC PSW wages versus expected savings from avoiding unnecessary ILTC placement for those accommodated by HCC capacity growth. The expected increase in HCC PSW retention would create HCC capacity for approximately 160,000 people, reduce annual health system costs by approximately $7 billion, and provide an 88 per cent return on investment. Updating wage structures to reduce turnover and enable HCC capacity growth is a cost-efficient option for expanding health system capacity.

#2310 Economic and societal benefits of teledialysis in ASL Lecce, Italy

Abstract Background and Aims The number of patients in chronic hemodialysis with a high demand for socio-economic resources is growing worldwide. Home HemoDialysis (HHD), particularly when aided by Information Technology, may help in decreasing unnecessary travels, reducing costs and promoting the active role of patient and caregiver. Nevertheless, it remains significantly underused (Europe: &amp;lt;2% of dialysis patients). The inability or unwillingness of patients and their families to participate in their own treatment is one of the most important barriers to HHD. It is already known that HHD delivered by a paid caregiver and supported by public funds is well accepted by patients. As a step forward, we decided to combine assisted HHD with teledialysis (TD) to encourage patients to transition towards self-assisted HHD. Since 2018, our Department has been providing HHD with the assistance of Personal Support Workers (PSW). In 2023, a TD platform was built, to promote the empowerment and incorporate patients in HHD into the daily management at the central institution. Herein we present a preliminary economic analyses to determine the direct and indirect cost savings of HHD, implemented with TD, compared to in-person care. Method Currently, in the ASL Lecce, the Regional Health System of the province of Lecce, Puglia, Italy, 800 patients undergo haemodialytic treatment. A telehealth hub&amp;spoke model of dialysis care across a distributed network was created to connect facilities within the hospital, satellite dialysis units, and patients receiving HHD. The HHD program started in June 1st, 2018; since then, 123 patients have been treated. During pandemic restrictions, HHD provided an effective renal care model for 39 patients with COVID-19. On 1st September 2023, the 29 patients receiving HHD were involved in the telemedicine-assisted dialysis model that was implemented on a tender basis (clinical-demographic data in Table 1). The TD platform is intended as a set of infrastructural, software and hardware components functional for continuous monitoring dialysis treatments, as depicted in Fig. 1, requiring the availability of real-time consultations with nephrologists. Results We report the costs related to self-assisted HHD, PSW-assisted HHD and TD programs as awarded in the call for tender. The overall costs of the TD platform are listed in Table 2. In Table 3 the effective costs, indicated as direct (in center hemodialysis or HHD) and indirect (mainly travels, only for in-center hemodialysis), are reported. As a consequence, the TD program will allow to save the annual costs related to transport as follows: A similar evaluation may be proposed for all in-center dialytic techniques compared to HHD plus TD service. Conclusion Given the growing need for economic and environmental sustainability, the expected savings related to a higher numbers of patients attracted to HHD, particularly self-assisted, are noteworthy. Since patients involved in TD program are mostly elderly and suffer from multiple comorbidities, the high cost of the TD-assisted modalities may be justified by the reduced complications and hospitalizations and the promotion of the patient empowerment. At the end of a 5-years period, a cost-minimization analysis of the project will be performed to investigate on the effective utility of TD in increasing the number of HHD eligible patients and ameliorating the overall quality of life.

“If I Do not Go to Work, They Will Die!” Dual Roles of Older-Adult Personal Support Workers’ Contributions During the COVID-19 Pandemic

AbstractWhen COVID-19 devastated older-adult organizations (long-term care homes and retirement homes), most public attention was directed toward the older-adult residents rather than their service providers. This was especially true in the case of personal support workers, some of whom are over the age of 55, putting them in two separate categories in the COVID-19 settings: (1) a vulnerable and marginalized group who are disproportionately impacted by COVID-19; and (2) essential healthcare workers. Since the current disaster-driven research, practice, and policy have primarily focused on generalized assumptions that older-adults are a vulnerable, passive, and dependent group rather than recognizing their diversity, expertise, assets, and experiences, this study aimed to identify their contributions from the perspective of older-adult personal support worker (OAPSW). This qualitative study conducted in-depth interviews, inviting 15 OAPSWs from the Greater Toronto Area, Canada. This study uncovered the OAPSWs’ contribution at three levels: individual (enhancing physical health, mental health, and overall well-being), work (improving working environment and service and supporting co-workers), and family (protecting their nuclear and extended families). The outcomes inform the older-adult research, practice, policy, public discourse, and education by enhancing the appreciation of older-adults’ diverse strengths and promoting their engagement and contributions in disaster settings.

Reducing falls among residents of retirement homes: A DNP project.

Falls among older adults (OAs) living in retirement homes (RHs) in Canada are a major public health concern due to high morbidity and mortality as well as significant healthcare expenditures. This quality improvement (QI) initiative, conducted for the author's Doctor of Nursing Practice (DNP) project, aimed to decrease fall rates and ED transfers related to falls among OAs in six RHs across the Greater Toronto Area in Ontario, Canada through a multipart intervention with two primary goals. First, the project aimed to facilitate RH NPs' implementation of a comprehensive fall risk assessment and fall prevention strategy in their practice by incorporating the Stopping Elderly Accidents, Deaths & Injuries (STEADI) toolkit into their armamentarium. Second, it sought to enhance the knowledge of the RHs' registered practical nurses (RPNs), personal support workers (PSWs), and unregulated care providers (UCPs) in assessing fall risk and incorporating fall prevention strategies in their daily practice. By improving NP, RPN, PSW, and UCP knowledge and increasing (by 20%) RPN, PSW, and UCP use of fall prevention strategies, this QI initiative successfully reduced fall rates in the RHs by 40.4%, with no falls requiring transfer to the ED, in the postintervention period. The results of this project highlight the need for an interdisciplinary approach to fall risk reduction in RHs that includes implementation of multifactorial intervention strategies as well as effective organizational policies and procedures for maximum impact.

Supporting the Journey Home: The Process of Co-designing an Education Program to Strengthen Palliative Care Capacity in First Nations Communities

In Ontario, Canada, several training programs have been created to improve home-based palliative care in First Nations communities, though they primarily focus on meeting needs at end-of-life. Therefore, education focused on incorporating an early palliative care approach for community health-related workers is necessary. To address this gap, we tested the CAPACITI curriculum with 12 health care providers working in First Nations communities across Ontario, 11 of which were members of a First Nations community, and engaged them in a collaborative process to co-design an education program that they felt was representative of First Nations values and culture. The co-designers were trained as nurses (n=8), personal support workers (n=2), a social worker (n=1), and a physician (n=1). We met with them for 12 weekly one hour sessions. They completed a workbook of questions and recommendations to tailor the education to a First Nations community context. We incorporated these recommendations into the new education by reviewing existing material, making notes of suggested changes, and adding new content. We redesigned the education according to several themes: incorporating culture, recognizing First Nations health care workers and knowledge, and approaching education wholistically. The resulting program, Supporting the Journey Home: Growing the Community Bundle to Care for those with Serious Illness, gives First Nations health care providers practical resources to operationalize an early palliative care approach with community members. To our knowledge, this is the first study to describe the co-design process of an existing palliative care education program with First Nations health care providers.

Shifting the Safety Culture: Evaluation of a Novel Approach to Understanding and Responding to Workplace Harassment and Violence Experienced by Homecare Workers.

Workplace violence and harassment are commonplace for healthcare workers and most incidents are unreported. Normalization of these experiences, lack of confidence in reporting systems, and fear of the consequences of reporting contribute to the invisibility of these experiences. Challenges are exacerbated in homecare settings and for precarious workforces including Personal Support Workers (PSWs). We created, piloted, and evaluated an intervention to enhance safety culture and encourage reporting of workplace violence and harassment. A multi-stakeholder steering committee designed an intervention combining policy changes, a pre-visit screening tool, education, and brief end-of-visit reporting. This was piloted with a PSW care team which provided >55,000 client visits during the 32-week intervention. Operational metrics characterized screening, education, and reporting uptake. Pre- and post-intervention surveys characterized PSWs' experiences with workplace violence and harassment, reporting experiences, training history and intervention feedback. PSWs reported increased comfort discussing workplace violence and harassment, and increased confidence managing client-to-worker incidents. The screening went smoothly with most clients in private homes. Most PSWs (75%) engaged at least once with end-of-visit reporting and nearly half submitted reports regularly. During the pilot, 21% of PSWs reported incidents and 52% of reports shared client-specific strategies for managing these situations. Changes in comfort and behavior with reporting indicated a shift toward a more open culture surrounding workplace violence and harassment. Tools created for this intervention and lessons for implementation are shared for consideration by occupational health practitioners throughout the homecare sector.

Short Communication on Improving the Sociological, Mental, and Somatic Health Comprising Cases Study: Overview on Seminar Women [Through the Aging Process - The Next Frontiers towards Gender Equality, San Diego, US - January 2024

This short communication provides a descriptive analysis of the seminar titled Women through the Aging Process - The Next Frontiers towards Gender Equality &amp; quot; held in San Diego in January 2024. The seminar aimed to address the sociological, mental, and somatic health issues faced by women as they age and explore strategies for improving gender equality in this context. Key topics discussed included the importance of preventive and curative measures, inclusion of older women in the social community, gender-specific caregiving roles, emotional support and personal care assistance, health advocacy and social engagement, education and training for caregivers, and developing specialized programs for aging women. The seminar emphasized the need to respect autonomy and choice while ensuring the safety and well-being of aging women. In conclusion, the seminar provided valuable insights and recommendations for promoting gender equality in the aging process.