NIH-NIDA: Administrative Supplement
Background: Home care workers are integral actors in the support of aging in place for persons living with Alzheimer’s disease and Alzheimer’s disease-related dementias (ADRD). Over 3.2 million home care workers across the U.S. provide crucial supportive care, meeting such activities of daily living as bathing and dressing, that allows older Americans with memory care issues to continue to age in place. Despite their critical importance in promoting healthy aging, evidence-based knowledge on the home care workforce remains a gap in the literature. More importantly, there is a dearth of scientifically validated sampling strategies in this high- risk, historically excluded population of direct care workers. The overall goal of the Home Safe study is to conduct pilot interviews, and assess and develop respondent-driven sampling methods (RDS) specifically for home care workers. Our team is uniquely prepared to conduct the proposed study, given our expertise in the study of aging, home-based care and use of RDS methods.
Specific Aims: In Aim 1, we will conduct interviews with dementia home care workers to determine the barriers, facilitators and adaptations to protecting their safety and well-being during the pandemic. In Aim 2, we will determine the feasibility of using respondent- driven sampling methods to establish a longitudinal study of dementia home care workers. Project Methods: This study will conduct semi-structured video interviews with dementia home care workers in Michigan, using an inferential process to determine characteristics of their social network and the barriers and facilitators in acceptability of RDS sampling strategy in order to guide the design of longitudinal survey (Aim 2), and establish a pilot interview to identify 1) barriers home-based care workers faced that impacted their ability to provide safe care, 2) facilitators that allowed them to feel safe at work, and 3) adaptations made to core employment and personal tasks due to COVID-19 risk (Aim 1).
Unique Features and Innovation: This study has several innovations: Home care workers are an understudied group, where our proposed research will contribute to addressing the economic and workforce policy challenges of this group of direct care workers in order to better support individuals with ADRD and their family caregivers. Our study of the feasibility of an RDS sampling strategy will allow us to develop operational knowledge about RDS in the healthcare setting, in particular among direct care workers.
Anticipated Impact: This study will contribute to methodological innovations in the study of hard to sample groups but will more importantly provide needed research data on the home care workforce, and lead to a larger longitudinal study of home care workers. The need for this study is critically important given the key role of home care workers play to support individuals with ADRD to stay in their homes—and out of hospitals or long-term care facilities.