title: Abuse and neglect of clients in agency-based and consumer-directed home care.
abstract: Because a growing number of Americans receive long-term care at home, social workers face new challenges in referring clients to either agency-based or consumer-directed care models. Traditional agency-based home care often is considered safer for disabled clients because workers are professionally trained and monitored; newer, client-directed home care models offer more autonomy and flexibility. This study examined differences in worker abuse and neglect of clients across agency and consumer-directed models. Analyses showed that family ties, race or ethnicity, social supports, language compatibility, and provider turnover were more relevant than model of care to understanding worker abuse and neglect of clients. These findings suggest that clients in consumer-directed models are at no higher risk than agency clients. Implications are considered for social work practicitioners.
authors.affiliation: UCLA School of Public Policy and Social Research, 3250 Public Policy Building, Los Angeles, CA 90095-1656, USA. matthias@ucla.edu
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Matthias
authors.forename: A E
authors.initials: AE
authors.lastname: Benjamin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002140:California; D017028:Caregivers / Q000523:psychology; D004552:Elder Abuse / Q000523:psychology*; D005260:Female; D006699:Home Care Services / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008484:Medicaid; D017146:Models, Organizational; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D012947:Social Work / Q000458:organization & administration*