2016 The gerontologist  
a complex healthcare system that is often ill-suited to meet their needs. The paucity of evidence-based programs demonstrating effectiveness represents a gap for this unique group. This study analyzes quasi-experimental evaluation data on four programs through the CMS Innovation Fund. Claims data on over 2500 patients demonstrate improvements in quality of life and care. In addition to self-management education and motivational interviewing, mechanisms driving these favorable findings include
more » ... hanced access and avoidance of acute exacerbations through education and regularly monitoring of new chronic conditions. Each model provides promising lessons on how to facilitate a meaningful aging experience. This study provides evidence that the replication of existing programs is possible, and there is preliminary information to suggest that these programs reduce overall spending. We explored Adult Foster Care (AFC) as a small-setting option for community-based long-term care. Although this option varies greatly in structure and accessibility among states, AFC settings are licensed by each state and typically provide service for 2-6 residents per home. Semi-structured, guided interviews were conducted with 26 providers in North Carolina to understand their experiences with AFC operations and their relationships with residents. Providers served residents across a variety of disability contexts, often with co-occurring disabilities represented among residents. Disabilities experienced by residents included intellectual (9 providers), dementia-or memory-related (19 providers), chronic illness (23 providers), mental illness (19 providers), and mobility challenges (21 providers). Findings revealed provider perceptions of residents across disability contexts, including a vision of residents as human beings, deserving of empathy, family, opportunities for choice and good quality life, as well as individuals capable of reciprocity and able to engage in family or family-like relationships.
doi:10.1093/geront/gnw162.1894 fatcat:eqrsn5ijfbgprpjkcthsitgu74