Table 1.
In-Home Supportive Servicesa Symptom Assessment Program Focus Group Outlines
| All focus groups |
|---|
| Overview |
| Introductions, ground rules, consent. |
| Icebreaker: focus group participants describe their IHSS affiliation/role |
| Purpose: to explore possible IHSS Symptom Management Program |
| Define/discuss terms: “palliative care,” “symptoms,” “symptom management,” etc. |
| Administrator focus groups |
|---|
| Opening discussion |
| Discussion of palliative care in the context of the IHSS Program |
| Common symptoms experienced by IHSS consumers |
| Current role of IHSS personnel in palliative care/symptom management |
| Willingness of staff and older consumers to participate |
| Facilitators |
| Agency and workforce strengths |
| Existing mechanisms/infrastructure that could facilitate a program |
| Potential benefits of a program |
| Barriers |
| Potential challenges to a program |
| Possible solutions |
| Implementation logistics |
| Brainstorm about a program in the context of current IHSS infrastructure |
| How to maximize IHSS providers' ability and willingness assist with symptom management |
| Workflow, work rules, payment mechanisms |
| Training and other agency's needs |
| Case management focus groups |
|---|
| Opening discussion |
| Common symptoms experienced by IHSS consumers |
| Current case management procedures/workflow for assessment and reporting of symptoms |
| Consumer and other attitudes toward palliative care |
| Facilitators |
| Need for IHSS Symptom Assessment Program |
| Potential benefit to IHSS consumers/providers/agencies |
| Possibility of leveraging existing training/procedures |
| Barriers |
| Potential challenges to a program |
| Possible solutions |
| Implementation logistics |
| Brainstorm about an ideal IHSS Symptom Management Program in the context of current IHSS infrastructure |
| Training needs for case management staff and IHSS providers |
| Assessment tools and procedures |
| Time and workflow management |
| IHSS provider focus groups |
|---|
| Opening discussion |
| Description of current and past clients (IHSS consumers): age, disability, etc. |
| Time spent with consumers, tasks performed, interaction with case management personnel |
| Common symptoms experienced by consumers, current procedures for symptom management |
| Older adults' attitudes toward IHSS provider assistance with symptom management |
| IHSS provider's attitudes about possible Symptom Management Program. |
| Facilitators |
| Leveraging current training structure/procedures for helping consumers with symptoms |
| Relationship with consumers. |
| Benefits of IHSS Symptom Management Program |
| What IHSS providers would need to enable them to help consumers with symptoms |
| Barriers |
| Potential challenges to a program |
| Possible solutions |
| Implementation logistics |
| Implementation within current IHSS infrastructure |
| Training and other support for IHSS providers |
| Assessment tools and procedures |
| Time and workflow management |
| Consumer focus groups |
|---|
| Opening discussion |
| Symptoms experienced by consumer, and how they are currently managed |
| Current role of case manager and IHSS provider in helping with symptoms/reporting to doctor |
| Willingness to accept help from IHSS providers |
| Facilitators |
| Best ways for IHSS providers to help consumers with symptoms (i.e., medication reminder, call doctors, make/accompany to appointments, call family/friends, etc.?) |
| Training for IHSS providers/consumers, other needs |
| Barriers |
| Potential challenges to a program |
| Possible solutions |
| Implementation logistics |
| How to tailor approach for diverse IHSS consumers/providers |
| How to ensure program consistent with consumer-directed focus and consumer autonomy |
| Opinions about possible tools and procedures for IHSS Symptom Management Program |
a
IHSS, in-home supportive services.