Perception of integrated practice in home care services

2019 ◽  
Vol 27 (1) ◽  
pp. 73-82 ◽  
Author(s):  
Margret Gudnadottir ◽  
Kristin Bjornsdottir ◽  
Sigridur Jonsdottir
Keyword(s):  
Social Services ◽  
Home Care Services ◽  
Shared Vision ◽  
Study Data ◽  
Framework Analysis ◽  
Care Needs ◽  
Content Type ◽  
Fully Integrated ◽  
Care Services ◽  
Care Workers

PurposeAs a result of demographic changes, older people are increasingly living at home, with multi-morbidity and complex care needs. This calls for enhanced integration of homecare nursing and social services. The purpose of this paper is to describe the clinical collaboration, scope and impact of integration from the perspective of staff in a setting identified as fully integrated.Design/methodology/approachIn this qualitative study, data consisted of interviews with managers and care workers in social services and homecare nursing (n=14) in daily clinical collaboration, followed by five focus group discussions (n=28). Data were analysed using framework analysis.FindingsAlthough the homecare services studied were ostensibly fully integrated, the study showed that the process of integration was incomplete. Interdisciplinary coordination between nursing and social services team managers was described as strong and efficient, but weaknesses were identified in collaboration between care workers. They lacked acquaintance with one another, opportunities for communication and knowledge of the contribution of members of other teams. They felt unclear about their own role in coordinated teamwork and lacked a shared vision.Originality/valueThis paper’s originality lies in the model of integrated care studied and its focus on actual care practices. The findings highlight that integration does not automatically permeate between different levels of service. Time and space must be allowed for conversations between health and social service teams to promote integration.

Challenging times: building a health, housing and social care local workforce strategy

2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith
Keyword(s):  
Service Delivery ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Workforce Planning ◽  
Care Needs ◽  
Fiscal Impact ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.

scholarly journals Impacts of a Care Robotics Project on Finnish Home Care Workers’ Attitudes towards Robots

2020 ◽  
Vol 17 (19) ◽  
pp. 7176
Author(s):  
Teemu Rantanen ◽  
Teppo Leppälahti ◽  
Jaakko Porokuokka ◽  
Sari Heikkinen
Keyword(s):  
Home Care ◽  
Elderly Care ◽  
Test Group ◽  
Home Care Services ◽  
Two Dimensions ◽  
Control Group ◽  
Care Services ◽  
Care Robots ◽  
Care Workers ◽  
Home Care Workers

Technological advances in elderly care have been rapid, and the introduction of robots in care will be a topical issue in the near future. There has been little research into the possibility of influencing care workers’ attitudes towards robots by project activities, and how to make the change easier for work communities. This study focuses on a robotics project that took place in elderly and home care services in one municipality in Finland (total of 45 care workers). During the project, four robotics workshops and one extended pilot session were implemented. The study follows quasi-experimental settings, and it included two measurements (before and after project activities) and a control group, but no randomization. The data were collected by questionnaires and were analyzed statistically. The project under study brought about minor positive changes in home care workers’ attitudes towards the usefulness of care robots. In the final measurement, the difference between the test group and the control group was significant in the two dimensions of positive attitudes. The research supports the hypothesis that project activities can be used to influence home care workers’ attitudes towards robots. This can also facilitate the introduction of care robots in home care services. However, the construction of a technology-positive care culture is a long-term process, which requires training and development, technological development and strong strategic management at various levels.

scholarly journals Unmet care needs are common among community-dwelling older people with memory problems in Finland

2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Community Dwelling ◽  
Care Needs ◽  
Care Services ◽  
Memory Problems ◽  
More Care ◽  
Community Dwelling Older People ◽  
With Memory

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

Advancing the Big Five of user-oriented care and accounting for its variations

2016 ◽  
Vol 29 (2) ◽  
pp. 162-176 ◽  
Author(s):  
Petri Kajonius ◽  
Ali Kazemi
Keyword(s):  
Big Five ◽  
Elderly Care ◽  
Process Quality ◽  
Care Process ◽  
Content Type ◽  
Care Services ◽  
Care Workers ◽  
Wide Range ◽  
Care Worker ◽  
Quality Variation

Purpose – Care process quality (i.e. how care is enacted by a care worker toward a client at the interpersonal level) is a strong predictor of satisfaction in a wide range of health care services. The purpose of this paper is to describe the basic elements of care process quality as user-oriented care. Specifically, the questions of how and why quality in user-oriented care varies were investigated in the context of elderly care. Design/methodology/approach – Two municipalities were selected for in-depth field studies. First, in each municipality, the authors interviewed and observed care workers’ interactions with the older persons in both home care and nursing homes during two weeks (Study 1). Second, in an attempt to gain a deeper understanding of why process quality in terms of user-oriented care varies, the authors conducted interviews with care workers and care unit managers (Study 2). Findings – A new taxonomy for categorizing process quality variation, the Big Five of user-oriented care (task-focus, person-focus, affect, cooperation, and time-use), is proposed. In addition, the perceived reasons for process quality variation are reported in our own developed Quality Agents Model, suggesting that variations in care process evaluations may be explained from different perspectives at multiple levels (i.e., older person, care worker-, unit-, department-, and municipality level). Originality/value – The proposed taxonomy and model are useful for describing user-oriented care quality and the reasons for its variations. These findings are of relevance for future quality developments of elderly care services, but also may be adapted to applications in any other enterprise employing a user-oriented approach.

scholarly journals Variations in user-oriented elderly care: a multilevel approach

2017 ◽  
Vol 9 (2) ◽  
pp. 138-147 ◽  
Author(s):  
Ali Kazemi ◽  
Petri Kajonius
Keyword(s):  
Elderly Care ◽  
Care Quality ◽  
Satisfaction With Care ◽  
Content Type ◽  
National Board ◽  
Care Services ◽  
Care Workers ◽  
Interpersonal Care ◽  
Sources Of Variation

Purpose National Board of Health and Welfare claims that the quality of elderly care services differ considerably between municipalities in Sweden. This study aims to analyze to what extent these variations can be accounted for by the older person’s municipality affiliation (i.e. receiving elderly care in a certain municipality). Design/methodology/approach Addressing this issue, national survey data from 78,538 older respondents receiving elderly care services in Sweden were analyzed using multilevel modeling (MLM). Findings The results showed that municipality affiliation only marginally explained the variance in satisfaction with care, i.e. its variations were larger within than between municipalities. Instead, user-oriented care accounted for the variation in satisfaction with care. Specifically, the way the care workers behave toward the older person proved to be much more crucial for satisfaction with care than municipality affiliation. Moreover, random effects analyses revealed that the effects of user-oriented care on satisfaction with care varied across municipalities. Care setting (i.e. home care or nursing home) only marginally accounted for its variance. Practical implications Developing care quality should start and primarily be discussed at the interpersonal care level, and not, as is customary, at the municipality level. Originality/value The present research is the first in its kind to quantitatively investigate the sources of variation in perceived quality of Swedish elderly care using MLM.

Perception of risk of adverse outcomes of older people: comparison between nursing homes, day centers and home care services

2017 ◽  
Vol 18 (3) ◽  
pp. 212-220 ◽  
Author(s):  
Laetitia Teixeira ◽  
Maria João Azevedo ◽  
Sara Alves ◽  
Cátia L. Pires ◽  
Constança Paúl
Keyword(s):  
At Risk ◽  
Nursing Homes ◽  
Home Care ◽  
Older People ◽  
Perceived Risk ◽  
Home Care Services ◽  
Adverse Outcomes ◽  
Content Type ◽  
Care Services ◽  
Screen Instrument

Purpose In Portugal, the three main kinds of care services available for older people are nursing homes, day centers and home care services. The use of these care services is mostly based on complex socioeconomic and functional criteria; however it is not clear if this placement corresponds to a higher/lower risk of adverse outcomes. The purposes of this paper are: to characterize clients of each type of service; to estimate the proportion of individuals at perceived risk of each adverse outcome according to type of service; to assess the ability of the Risk Instrument for Screening in the Community (RISC) to identify the risk profiles according to type of service. Design/methodology/approach The sample comprised individuals aged 65+ (n=224), receiving care at home, in day centers or in nursing homes. The identification of individuals at risk for three adverse outcomes (institutionalization, hospitalization and death) was performed using a short pre-screen instrument (RISC). Findings The RISC identified mental state issues as the unique factor that differentiated clients according the type of care services (χ2 (6, N=224)=20.96, p=0.002), with day center presenting the lowest percentage of mental health concerns and nursing home presenting the highest percentage (44.44 and 71.91 percent, respectively). Additionally, a gradient was found between perceived risk of adverse outcomes (institutionalization and hospitalization) and care of levels required. Originality/value The RISC can be used to discriminate people in different settings of care and can be helpful in the selection of groups at risk that will benefit more from available services.

scholarly journals ‘Active ageing’: a qualitative study in six Caribbean countries

2009 ◽  
Vol 30 (1) ◽  
pp. 79-101 ◽  
Author(s):  
PATRICK CLOOS ◽  
CAROLINE F. ALLEN ◽  
BEATRIZ E. ALVARADO ◽  
MARIA VICTORIA ZUNZUNEGUI ◽  
DONALD T. SIMEON ◽  
...  
Keyword(s):  
Social Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Social Protection ◽  
Economic Status ◽  
Home Care Services ◽  
Active Ageing ◽  
Socio Economic Status ◽  
Care Services ◽  
Urban And Rural Areas

ABSTRACTThe aim of this study was to document the perceptions of elders in six Caribbean countries about ‘active ageing’ and on the basis of their reports to make recommendations to improve their situation. Data were collected principally through 31 focus group discussions conducted in both urban and rural areas. Comparative analysis was carried out of the qualitative information, focusing on three components of ‘active ageing’: health and social services access and use, social support, and economic circumstances. Most of the participants were women, aged 60–79 years, of lower socio-economic status and from urban areas. Large disparities in the responses of Caribbean societies to population ageing were indicated, as well as unequal opportunities to obtain health care and social services, public transport, income and food by both socio-economic status and location. Home-care services are either insufficient or non-existent. Some elders receive social and financial support from relatives while others fear isolation and face deprivation. Social participation varies by place, physical condition, financial situation, association membership, and transport opportunities. Social protection benefits do not provide adequate income and some older people face food insecurity. It was concluded that a comprehensive and multi-sectoral approach using the ‘active ageing’ framework should be implemented to ensure a healthy ageing process.

scholarly journals Fortunate and fearful: emotions evoked by home-care policies for older people in Ireland

2020 ◽  
Vol 2 (1) ◽  
pp. 61-78
Author(s):  
Luciana Lolich ◽  
Virpi Timonen
Keyword(s):  
Home Care ◽  
Home Care Services ◽  
System Level ◽  
Service Users ◽  
Care Providers ◽  
Term Care ◽  
Care Services ◽  
Care Workers ◽  
Care Policies ◽  
Care Package

This article examines the emotions of fear and feeling fortunate experienced by key actors in home-care services in Ireland. We take a relational approach to emotions; that is to say, an understanding that emotions are produced in social interactions and play an essential part in how people engage with, and respond to, long-term care policies. The study involved focus groups and in-depth interviews with 104 participants. Our findings show that the most vulnerable participants – service users and care workers on precarious contracts – feel fortunate or fearful about outcomes that had, or would have, a direct impact on them: respectively, having a good carer and obtaining job satisfaction, or losing a home-care package and not having enough work. Professionals were more likely to speak about luck and fear, not in relation to what could happen to them directly but in relation to the fate of service users and care workers. The unregulated home-care services in Ireland have influenced actors to construe their own and others’ participation in the system as increasingly individualised, where desired outcomes depend on one’s good luck or strong personal relationships. For the system to work properly trust needs to be present not only at the micro level of individual relationships but also at a system level. This could lead to a decline in emotions that centre on feeling fortunate and fearful, and an increase in expressions of trust and a sense of control by both care providers and care recipients.

scholarly journals Sustainable Care in a Familialist Regime: Coping with Elderly Care in Slovenia

2020 ◽  
Vol 12 (20) ◽  
pp. 8498
Author(s):  
Maša Filipovič Hrast ◽  
Valentina Hlebec ◽  
Tatjana Rakar
Keyword(s):  
Coping Strategies ◽  
Extended Family ◽  
Elderly Care ◽  
Leisure Activities ◽  
Family Care ◽  
Home Care Services ◽  
Policy Support ◽  
Care Recipient ◽  
Care Needs ◽  
Care Services

In countries with prevalent family care and less developed care services, it is important to understand the ways families cope with the care needs of their frail family members as part of policy learning to make care systems more sustainable. Filial care is a vital element of family care, yet is significantly restrained by the involvement of carers in the labour market; unequal gender distribution of the care burden; and insufficient recognition of, and policy support, for family care. This article considered the issue of the sustainability of elderly care in a familialist country, Slovenia, by identifying the coping strategies families adopt for the provision of care. To this end, in-depth qualitative data based on a purposeful sample of 55 community-resident users of social home care services and their 55 family carers were used. We identified five external coping strategies: use of formal care services, use of extended family network, use of wider community network, cohabitation, and home adjustments. Among internal strategies, we detected work-related adjustments; abandoning leisure activities; abandoning vacations; establishing new routines; accepting and finding satisfaction in care; increased psychological distress, such as worries and overburdening; and some unmet care recipient needs. Very few strategies may be described as supported by policy actions, despite such support being essential for increasing the sustainability of the family-based care model.

What actually do Syrian migrant women’s health practices tell us? A qualitative interpretive synthesis from Turkey

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Funda Aslan
Keyword(s):  
Health Care ◽  
Women’S Health ◽  
Women's Health ◽  
Health Care Services ◽  
Health Problems ◽  
Health Practices ◽  
Migrant Women ◽  
Care Needs ◽  
Content Type ◽  
Care Services

Purpose The present qualitative interpretive synthesis (QIS) aimed to re-interpret and understand in detail the findings of the studies related to the health practices of Syrian migrant women living in Turkey. Design/methodology/approach İn this study, the QIS method was used. Three articles were included in the present QIS study from the five electronic databases. Findings Present QIS has once and again emphasized that Syrian immigrant women have health problems, yet face problems accessing health-care services. While the women suffer from various health problems and have health care needs such as pregnancy or maternity, they give priority to the needs of their children and other family members and often postpone taking care of themselves. The most important finding was that migrant women do not want to give up on their cultural teachings. Research limitations/implications There were only a limited number of studies available for review that fit into the inclusion criteria; the low sample sizes across the included studies posed additional limitations. Despite these limitations, these findings suggest important implications, indicating the migrant women’s health practices from a systemic perspective. Social implications All these issues and concerns should be addressed with empathy for developing sustainable health policies and nurturing healthy future generations in Turkey. Originality/value This study is the first study that used the QIS approach to understand and re-interpret qualitative studies findings. Then, this study also emphasized the necessity of looking at the health of migrant women’s health from different perspectives.

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