Users of home-care services in a Nordic welfare state under marketisation: the rich, the poor and the sick

The current study explored the differences in the effectiveness of first and second generation long-acting injections and orally administered antipsychotics in reducing the rehospitalization rate among patients with schizophrenia receiving home care services in a medical center in Southern Taiwan. Longitudinal data between 1 January 2006, and 31 December 2015, were collected retrospectively. Patients were classified into three treatment groups: First generation antipsychotic (FGA) long-acting injection (LAI), second generation antipsychotic long-acting injection (SGA) (LAI), and oral antipsychotics. The primary outcomes were the rehospitalization rate and the follow-up time (duration of receiving home care services) until psychiatric rehospitalization. A total of 78 patients with schizophrenia were recruited. The average observation time was about 40 months. The oral treatment group tended to be older with a higher number of female patients and a lower level of education. The FGA treatment group tended to have a higher frequency and duration of hospitalization before receiving home care services. We found no significant differences in the follow-up time or psychiatric rehospitalization rate after receiving home care services among the three treatment groups. We propose that oral and LAI antipsychotics were equally effective when patients received home care services. Our results can serve as a reference for the choice of treatment for patients with schizophrenia in a home care program.

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Who are those most likely to be institutionalized, the elderly who receive comprehensive home care services or those who do not?

Social Science & Medicine ◽

10.1016/0277-9536(85)90009-7 ◽

1985 ◽

Vol 20 (4) ◽

pp. 347-354 ◽

Cited By ~ 7

Author(s):

François Béland

Keyword(s):

Home Care ◽

The Elderly ◽

Home Care Services ◽

Care Services

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‘They just came with the medication dispenser’- a qualitative study of elderly service users’ involvement and welfare technology in public home care services

BMC Health Services Research ◽

10.1186/s12913-021-06243-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Heidi Snoen Glomsås ◽

Ingrid Ruud Knutsen ◽

Mariann Fossum ◽

Kristin Halvorsen

Keyword(s):

Qualitative Study ◽

Home Care ◽

Health Care Quality ◽

Care Service ◽

User Involvement ◽

Home Care Services ◽

Care Quality ◽

Service Users ◽

Care Services ◽

Welfare Technology

Abstract Background Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services. Method This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible. Conclusion The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.

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Enacting person‐centred care in home care services for people with dementia

Journal of Clinical Nursing ◽

10.1111/jocn.16004 ◽

2021 ◽

Author(s):

Ragnhild Hedman ◽

Per‐Olof Sandman ◽

David Edvardsson

Keyword(s):

Home Care ◽

Home Care Services ◽

Care Services ◽

People With Dementia

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Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study

BMC Health Services Research ◽

10.1186/s12913-021-06722-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kari-Anne Hoel ◽

Anne Marie Mork Rokstad ◽

Ingvild Hjorth Feiring ◽

Bjørn Lichtwarck ◽

Geir Selbæk ◽

...

Keyword(s):

Decision Making ◽

Home Care ◽

Shared Decision Making ◽

Care Service ◽

Home Care Services ◽

Shared Decision ◽

Care Services ◽

Person Centered Care ◽

People With Dementia ◽

Centered Care

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

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