The Home Health Aide Experience: Opportunities for Occupational Therapy

Introduction: Home health aides undergo significantly increased physical stress in their work with minimal support which may contribute to decreased satisfaction with a home health aide position (Czuba et al., 2012). Providing frequent assistance with hands-on self-care tasks and transfers has been correlated with an increased occurrence of physical injury (National Institute for Occupational Safety and Health, 2010). Occupational therapists have specialized skills in task-adaptation, environmental modification, and proper body mechanics that can assist home health aides in maximizing their client’s function and decreasing risk of injury such as back strain. However, little is known about how home health aides perceive the daily physical challenges and risk of injury facing them. Objectives: This study sought to gain detailed information about the daily experiences of home health aides, to identify physical challenges within their work, and to determine if there was a potential role for occupational therapy in injury prevention through education. Methods: A qualitative descriptive approach was implemented using semi-structured phone interviews that were recorded and transcribed for analysis. Colaizzi’s descriptive phenomenological method was used to guide data analysis procedures. Triangulation of data, member-check, and a reflexive journal were utilized to strengthen validity. Participants were recruited through convenience sampling. Individuals were excluded from the study if they were not actively working as a home health aide at the selected agency or had not worked as a home health aide within the past year (2018) for the selected agency. Individuals who reviewed and signed a consent form were able to participate. The study was approved by a university institutional review board. Results: Participants included eight female home health aides with an age range of 35-65 years. The average experience of the participants was 6.25 years. The following themes were identified: home health aides valued the use of a client-centered approach with their clients (Know the rules and know your clients even better), home health aides assisted their clients with a wide range of ADL and IADL activities to support their independence within their home (More than Activities of Daily Living), transferring clients was considered the most physically demanding task (Would you like a hand with your transfer?), and study participants believed new home health aides could benefit from training in client positioning, appropriate use of adaptive equipment, and proper lifting mechanics in various contexts (Let’s get physical!). Discussion: Study results provided descriptive information regarding the daily occupations home health aides assisted their clients with including a combination of ADL and IADL activities. Many of these responsibilities coincided with areas that occupational therapists address within their skilled services. This demonstrates areas in which occupational therapist knowledge corresponds with the problem-solving skills home health aides implement with their clients as their needs change daily. Educational support from occupational therapists in correct body mechanics and methods for safe transfers could assist with reducing physical strain for home health aides. In addition, occupational therapists could provide recommendations to home health aides on proper equipment to utilize for facilitation of independence for clients (Guay et al., 2013). Practice Implications: The areas of overlap between home health aides and occupational therapists identified in the research study provide an opportunity for occupational therapy consultation with home health agencies in the role as educator

Performance analysis and optimisation of stochastic flow lines with limited material supply

We consider stochastic flow lines with limited buffer sizes and limited material supply. In these systems, the configuration of the flow line parameters and the configuration of the material supply determine the system output. Shortages of material supply can limit the performance of the production system. We use flexible (mixed-integer) linear programming approaches to evaluate and optimise the performance of long stochastic flow lines with limited material supply in discrete and continuous time. The approaches are used to quantify the impact of material shortages on the system output. Further, they are applied to determine the minimum material levels that are required to prevent material shortages of a given flow line configuration. The results of the numerical study reveal insights on the approximation accuracy of the linear programs as well as on the dependence of optimal material levels on flow line characteristics such as the presence of bottleneck machines and the system variability. The contribution of this paper consists of both, integrated models for stochastic flow lines with limited material supply and new insights on the optimal material supply of stochastic flow lines

The Home Health Aide Experience: Opportunities for Occupational Therapy

The author would like to acknowledge her faculty advisor Dr. Shirley O\u27Brien, OTR/L, FAOTA, and her committee member Dr. Leah Simpkins, OTR/L, CPAM, for their guidance and ongoing support throughout this research study. She would also like to thank the agency and the home health aides who made this project possible through their participation. Finally, she would like to thank her family, especially her mother for their encouragement and unwavering belief in her. Without these individuals, this study would not have been possible. She is forever grateful for this learning experience