scholarly journals Personal care and practical support at home: a systematic review of older people’s views and experiences

2019 ◽  
Vol 23 (2) ◽  
pp. 87-106
Author(s):  
Irene Kwan ◽  
Deborah Rutter ◽  
Beth Anderson ◽  
Claire Stansfield

Purpose Considering the views of service users is important to identify their needs as this helps providers to develop appropriate and responsive services. For older people receiving home care, recognising their needs is the first step towards supporting them to maintain independence and promote wellbeing. The paper aims to discuss these issues. Design/methodology/approach A systematic review was conducted in 2014 to explore the personal experiences of older people in England about the care and support they received at home. Studies published between 2004 and 2013 were identified from bibliographic databases and websites. A total of 17 studies satisfied the inclusion criteria. Data were extracted using a standardised coding tool and narratively synthesised. Study quality was evaluated. Findings Nine themes were identified. Older people valued an approach that was person centred, flexible and proactive to respond to their changing needs and priorities, focusing on what they can or would like to do to maintain their independence. Allowing time to build trust between older people and their care workers helped to realise older peoples’ aspirations and goals. Practical help to promote choice and reduce social isolation was perceived to be as important as personal care. Practical implications Evidence from this review contributed to the development of a social care guideline on home care, and informed key practice recommendations for care providers in England. Originality/value This review highlighted the value older people place in person-centred care incorporating practical help both inside and outside the realm of personal care.

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Julie MacInnes ◽  
Jenny Billings ◽  
Alexandra Lelia Dima ◽  
Chris Farmer ◽  
Giel Nijpels

PurposeThe purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice.Design/methodology/approachAn integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis.FindingsTwelve studies were included in the review. Three studies described remote consultations, particularly telemedicine; five studies described tools to support self-management; three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies; co-ordination and integration of services; the implementation of digital technologies; and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers.Originality/valueThis review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred.


2018 ◽  
Vol 32 (5) ◽  
pp. 342-351
Author(s):  
Panita Krongyuth ◽  
Pimpan Silpasuwan ◽  
Chukiat Viwatwongkasem ◽  
Cathy Campbell

Purpose The purpose of this paper is to explore the needs of people with cancer in advanced stages and to analyze factors that influence them. Design/methodology/approach A concurrent mixed-method design was used. Descriptive design was conducted in Ubon Ratchathani Province, Thailand. Data were collected from a convenience sample of patients with advanced cancer of any tissue or organ. Questionnaires were completed by 110 patients aged 60 years and above (response rate 110/130=84.6 percent). In-depth interviews were conducted with a total of eight patients. Content analysis of semi-structured interviews of a sub-sample was subsequently performed to better understand the real needs of patients with advanced stages of cancer at home setting. Findings The majority (77.5 percent) reported a preference to spend their final days at home. The four most common palliative care needs were more information about disease and medical treatment (98.2 percent), more treatment for pain (97.3 percent), health education for family caregivers (95.5 percent) and health volunteers visit at home (95.5 percent). Content analysis of the qualitative data suggested that patient needs health care providers to deliver open communication, pain management and provide psychosocial supports. Originality/value The result showed that patients-related variables are associated with the palliative care needs in patients with advanced stages of cancer. Communication skills and pain management are the key components to support the need for palliative care at home and to benefit the quality of life in terminally ill patients.


2017 ◽  
Vol 40 (10) ◽  
pp. 1522-1542 ◽  
Author(s):  
Jee Young Joo ◽  
Diane L. Huber

The challenges faced by case managers when implementing case management have received little focus. Several qualitative studies have been published that may be able to shed light on those challenges. This study is a systematic review of qualitative literature to identify barriers case managers have when implementing case management. Five electronic bibliographic databases were systematically searched, and 10 qualitative studies were identified for inclusion in the review which were published from 2007 to 2016. Through thematic synthesis of findings, five themes were identified as barriers to case management implementation: unclear scope of practice, diverse and complex case management activities, insufficient training, poor collaboration with other health-care providers, and client relationship challenges. This review study suggested that standardized evidence-based practical protocols and certification programs may help overcome case managers’ barriers and improve case management practices. Health policymakers, case management associations, and health-care management researchers should develop educational and practical supports for case managers.


2015 ◽  
Vol 35 (5/6) ◽  
pp. 419-436 ◽  
Author(s):  
Sue Hollinrake ◽  
Will Thomas

Purpose – The purpose of this paper is to understand the nature of support that helps older people continue living in their own homes for as long as they wish to. Design/methodology/approach – The research made use of a participatory approach in which service users, service providers and commissioners were involved in the design of the approach in addition to contributing to the research as participants in their own right. Findings – This paper presents analysis from the research which focuses on the importance of caring relationships for providing a support mechanism. The authors question whether budget cuts and efficiency drives within statutory care providers preclude the notion of caring relationships. Practical implications – The authors suggest, in the light of the evidence presented, that statutory service providers should acknowledge the role that caring relationships play in providing support for older people. Whilst budget cuts make providing support for caring relationships more challenging, the authors suggest that there is scope for delivering services and support in ways which promote the types of interactions which better support older people living independently. Originality/value – The analysis presented here provides a distinctive, timely and thoughtful insight into support for older people at a time when public sector budgets are under increasing pressure.


Author(s):  
Karen Davies ◽  
Elizabeth Dalgarno ◽  
Colin Angel ◽  
Susan Davies ◽  
Jane Hughes ◽  
...  

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
B Pais ◽  
P Buluschek ◽  
T Nef ◽  
N Schütz ◽  
H Saner ◽  
...  

Abstract Background In Europe, population ageing is increasing the healthcare needs and costs. Both frailty and chronic diseases affecting older people reduce their ability to live independently. However, most older people prefer to age in their own homes. New development of in-home monitoring can play a role in staying independent, active and healthy. Our objective was to evaluate a new in-home monitoring system among home-dwelling older adults (OA), their family caregivers (FC), and their healthcare providers (HCP) for the support of home care. Methods The system continuously monitored OA’s daily activities (e.g., mobility, sleep habits, fridge visits, door events) at home by ambient sensor system (DomoCare®) and health-related events by wearable sensors (Fitbit®, ECG). In case of deviations in daily activities (e.g., changes in mobility), alerts were transmitted to HCP via email. Using specific questionnaires, the opinion of 13 OA, 13 FC, and 20 HCP were collected at the end of 12-month of follow-up focusing on their user experience and the impact of in-home monitoring on home care services. Results These preliminary results underlined that the majority of OA, FC, and HCP consider that in-home sensors can help staying at home, improving home care, reducing family stress, and preventing domestic accidents. The opinion tended to be more favourable toward ambient sensors (80%) than toward Fitbit® (67%) and ECG (64%). On average, OA (80%) and FC (73%) tended to be more enthusiast than HCP (63%). Some barriers reported by HCP were a fear of weakening of the relationship with OA and an excessive surveillance. Conclusions Overall, the opinion of OA, FC and HCP were positive related to in-home sensors, with HCP being more mixed about their use in clinical practice. Key messages In-home monitoring technologies seem to be generally well accepted. In-home monitoring technologies could be help facilitating home care of older people.


2020 ◽  
Vol 34 (7) ◽  
pp. 807-828
Author(s):  
Sascha Kraus-Hoogeveen ◽  
Pascale Peters ◽  
Els Van der Pool ◽  
Beatrice Van der Heijden

PurposeThis mixed-method study aims to contribute to the scholarly debate by outlining an individual-level theoretical framework for public value creation and evaluation that builds upon a social exchange perspective. It provides insights into the normative frames of primary stakeholders in the Dutch care at home sector, that is professionals, managers, clients and informal care providers.Design/methodology/approachA mixed-method design comprising a customized survey among 349 stakeholders, preceded by 31 in-depth interviews was used.FindingsThis empirical work shows differences and similarities in the stakeholders' normative frames revealed via three dimensions of expectations regarding the process of care delivery: personal contact, impact of rules and procedures and communication.Social implicationsThese differences in interpretation have implications for the measurement and evaluation of public value creation.Originality/valueBy statistically and methodologically exploring the different expectations' scales that are developed, we intend to work toward a measure for public value creation, which can be used in future empirical work.


2014 ◽  
Vol 8 (2) ◽  
pp. 51-63 ◽  
Author(s):  
Marja Harjumaa ◽  
Igone Idigoras ◽  
Minna Isomursu ◽  
Ainara Garzo

Purpose – The purpose of this paper is to analyse the adoption of a multimodal medication management system (MMS) targeted on older people and home care professionals. The paper aims to describe the expectations of the system and the user experience findings from an empirical qualitative field trial. The field trial results are used to discuss how MMSs should be designed in order to improve adherence to medications. Design/methodology/approach – The paper suggests that building a multimodal medicine management system targeted on both older users and home care professionals brings many benefits over electronic medicine dispenser systems or general reminder systems. The research process uses an iterative prototyping approach including phases of requirements analysis and concept design, prototype building and evaluation in a field trial. Findings – The study demonstrates how a system that merely satisfied users during the prototype building phase does not necessarily succeed as well as expected in the field trials. It would be important to consider reasons for medication non-adherence and non-technology factors influencing willingness to adopt new assistive devices in order to promote diffusion of new MMSs at home. The paper also discusses how the different persuasive functionalities of the system addressed patient-centred factors influencing non-adherence and how they could be addressed. Research limitations/implications – This study has some limitations. The actual adherence to medications was not measured. However, in the future, it will be important to study how the MMSs influence medication adherence. Also, the user experiences of the home care professionals were not studied in the field trials. Home care professionals who were involved in the user studies and trials merely estimated the value for their patients and not for themselves. Originality/value – This paper analyses design issues relevant when designing systems to help older people manage their medications.


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