Prevalence of Different Combinations of Antiepileptic Drugs and CNS Drugs in Elderly Home Care Service and Nursing Home Patients in Norway

Introduction. Antiepileptic drugs (AEDs) are used to treat different conditions in elderly patients and are among the drug classes most susceptible to be involved in drug-drug interactions (DDI). The aim of the study was to describe and compare use of AEDs between home care service and nursing home patients, as these patients are not included in nationwide databases of drug utilization. In the combined population, we investigate DDI of AEDs with other central nervous system- (CNS-) active drugs and DDIs involving AEDs in general. Materials and Methods. Point-prevalence study of Norwegian patients in home care services and nursing homes in 2009. At the patient level, we screened for different DDIs involving AEDs. Results. In total, 882 patients (7.8%) of 11,254 patients used AEDs and number of users did not differ between home care services and nursing homes (8.2% versus 7.7%). In the combined population, we identified 436 potential DDIs in 45% of the patients. Conclusions. In a large population of elderly, home care service and nursing home patients do not differ with respect to exposure of AEDs but use more AEDs as compared to the general population of similar age. The risk of DDIs with AEDs and other CNS-active drugs should be taken into consideration and individual clinical evaluations are assessed in this population.

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Facilitators and Barriers to Accepting Long Term Care at Home: An Analysis of Licensed Home Care Service Agency Websites

Home Health Care Management & Practice ◽

10.1177/1084822321994779 ◽

2021 ◽

pp. 108482232199477

Author(s):

Tracy Chippendale ◽

Patricia Gentile

Keyword(s):

Home Care ◽

Care Service ◽

Home Care Services ◽

Home Care Service ◽

Service Agency ◽

Term Care ◽

Age In Place ◽

Care Services ◽

Facilitators And Barriers ◽

Website Content

Most people prefer to age in place. However, there is a growing body of literature to suggest a reluctance to accept supportive services in the home due to concerns about trust, privacy, cost, and fear of being a burden. The purpose of this study was to examine potential facilitators and barriers to accepting home care services in the website content of Licensed Home Care Service Agencies (LHSCA). In this linguistic analysis study, the written content from 88 randomly selected LHCSA websites was examined. We used LIWC2015 and Microsoft® Word software to analyze websites for relevant word categories that reflect older adult identified facilitators and barriers to the acceptance of home care services. Results revealed that the summary score for clout (i.e., confidence and leadership reflected in the writing) was high. Some of the most commonly used word categories were positive emotions, present focused, and affiliation. The word category money was included, but to a lesser degree. However, Burden and related words were highly prevalent in the writing sample. In summary, LHCSA website content contains both facilitators and barriers to the acceptance of home care services. Given the importance of home care services in promoting the ability of older adults to age in place, greater attention may be needed regarding the way services are presented and advertised to consumers.

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“There Is a Lot of Community Spirit Going On.” Middle Managers' Stories of Innovation in Home Care Services

SAGE Open Nursing ◽

10.1177/2377960819844367 ◽

2019 ◽

Vol 5 ◽

pp. 237796081984436

Author(s):

Rita Sørly ◽

Martin Sollund Krane ◽

Geir Bye ◽

May-Britt Ellingsen

Keyword(s):

Health Care ◽

Home Care ◽

New Public Management ◽

Middle Managers ◽

Care Service ◽

Research Question ◽

Home Care Services ◽

Home Care Service ◽

Policy Changes ◽

Care Services

Background: There is a need for qualitative studies on imposed innovation in home care services in welfare societies. The municipalities are key actors in the field of innovation in the public sector. As innovations often are interpreted to be in conflict with values in health care, we need knowledge on how policy changes and imposed innovations are understood and handled by middle managers working in the sector. Aim: We aim to explore how middle managers react to imposed innovation in health services through their storytelling. The research question was “What can middle managers' stories of imposed innovation tell us about their role in, and some important prerequisites for, innovation processes in municipal health-care services?” Methods: A narrative study of experiences with municipal innovation among middle managers in Norway. In this article, we do a thematic analysis of interviews with seven female middle managers who work in a home care service department. Findings: The study develops an understanding of which frameworks are required within a home care service to meet constant demands for innovation. Innovations are understood by the managers as results of policy changes and new public management demands and as a troublesome burden. We find the prerequisites for implementing innovations to be (1) trust-based management, (2) flexibility and dynamics, (3) continuity of care, and (4) emphasis on competence. These prerequisites are further interpreted in relation to dominant discourses on innovation at the macro, meso, and micro levels within the storytelling contexts. Conclusion: Imposed innovations require a negotiating practice in cross-disciplinary environments at all levels in the organization.

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People diagnosed with dementia in Sweden: What type of home care services and housing are they granted? A cross-sectional study

Scandinavian Journal of Public Health ◽

10.1177/1403494818755600 ◽

2018 ◽

Vol 47 (2) ◽

pp. 229-239 ◽

Cited By ~ 8

Author(s):

Elzana Odzakovic ◽

Lars-Christer Hydén ◽

Karin Festin ◽

Agneta Kullberg

Keyword(s):

Home Care ◽

Older People ◽

Care Service ◽

Home Care Services ◽

Cross Sectional Study ◽

Home Care Service ◽

Sectional Study ◽

Dementia Diagnosis ◽

Cross Sectional ◽

Care Services

Aims: This study aims to examine what types of home care services and housing are granted to people with a dementia diagnosis and how these types are associated with socio-demographic factors (sex, age, marital status, native or foreign born, and regional area). Methods: A cross-sectional study of all people diagnosed with dementia in three Swedish counties was conducted from the medical records in 2012. Logistic regression analysis was carried out to investigate associations between home care services and housing and socio-demographic variables. Results: In total, 17,405 people had a dementia diagnosis, and the majority were women, aged 80+ years, and unmarried. Some 72% were living in ordinary housing and 28% lived in special housing. Of those who lived in ordinary housing, 50% did not receive any home care service. Not receiving any type of home care services was less common for older people and was also associated with being married and living in rural municipalities. The most common home care services granted were home help and personal care. Special housing was more common for older people, unmarried persons, and those living in rural municipalities. Conclusions: Most people with a dementia diagnosis were living in ordinary housing, and, surprisingly, half of those did not receive any type of home care service. This knowledge is essential for making the living conditions and needs of people living with dementia more visible and to provide good home care services for people with dementia and their families.

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Age does not come alone: Identifying and implementing older people's views of quality in home care services

Quality in Ageing and Older Adults ◽

10.1108/14717794200400004 ◽

2004 ◽

Vol 5 (1) ◽

pp. 24-31 ◽

Cited By ~ 4

Author(s):

Norma Raynes ◽

Lydia Coulthard ◽

Charlotte Glenister ◽

Bogusia Temple

Keyword(s):

Home Care ◽

Older People ◽

Service Providers ◽

Care Service ◽

Round Table ◽

Home Care Services ◽

Home Care Service ◽

Round Table Discussion ◽

Quality Service ◽

Care Services

This paper describes a study that explored older people's views and priorities on what made for quality in home care services, ways of accessing these and enabling them to become part of mainstream service monitoring. It took place in a city in the north of England, in 2000. The research was funded by the Joseph Rowntree Foundation. Older people's definitions of a quality home care service go outside the service boundaries that are set by social service departments who define the quality specifications for home care services and commission them. Older people had a joined‐up perspective of what contributes to quality in a home care service including, for example, in their definitions of a quality service: access to transport to get out of the house, aids, adaptations and health care. They emphasised the importance of domestic help, which has been reported in other studies. To obtain information on their definitions of a quality service older people were offered the choice of a home‐based interview or participation in a focus group. Following the collection of the data on quality a round table discussion was arranged. The purpose of this was to explore how older people's views on the quality of home care services could become part of routine monitoring, to shape further development and assist in commissioning. Older people who had participated in the first part of the study were invited to attend this, as were local commissioners, service providers and elected members with executive responsibility for older people's services. The recommendations of this round table are discussed.

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Development and Evaluation of a Smart Contract–Enabled Blockchain System for Home Care Service Innovation: Mixed Methods Study

JMIR Medical Informatics ◽

10.2196/15472 ◽

2020 ◽

Vol 8 (7) ◽

pp. e15472

Author(s):

Shuchih Ernest Chang ◽

YiChian Chen ◽

MingFang Lu ◽

Hueimin Louis Luo

Keyword(s):

Home Care ◽

Questionnaire Survey ◽

Care Service ◽

Home Care Services ◽

Home Care Service ◽

Smart Contracts ◽

Process Automation ◽

Traceability System ◽

Care Services ◽

Smart Contract

Background In the home care industry, the assignment and tracking of care services are controlled by care centers that are centralized in nature and prone to inefficient information transmission. A lack of trust among the involved parties, information opaqueness, and large manual manipulation result in lower process efficiency. Objective This study aimed to explore and demonstrate the application of blockchain and smart contract technologies to innovate/renovate home care services for harvesting the desired blockchain benefits of process transparency, traceability, and interoperability. Methods An object-oriented analysis/design combined with a unified modeling language tool was used to construct the architecture of the proposed home care service system. System feasibility was evaluated via an implementation test, and a questionnaire survey was performed to collect opinions from home care service respondents knowledgeable about blockchain and smart contracts. Results According to the comparative analysis results, the proposed design outperformed the existing system in terms of traceability, system efficiency, and process automation. Moreover, for the questionnaire survey, the quantitative analysis results showed that the proposed blockchain-based system had significantly (P<.001) higher mean scores (when compared with the existing system) in terms of important factors, including timeliness, workflow efficiency, automatic notifications, insurance functionality, and auditable traceability. In summary, blockchain-based home care service participants will be able to enjoy improved efficiency, better transparency, and higher levels of process automation. Conclusions Blockchain and smart contracts can provide valuable benefits to the home care service industry via distributed data management and process automation. The proposed system enhances user experiences by mitigating human intervention and improving service interoperability, transparency/traceability, and real-time response to home care service events. Efforts in exploring and integrating blockchain-based home care services with emerging technologies, such as the internet of things and artificial intelligence, are expected to provide further benefits and therefore are subject to future research.

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Does context matter? Voluntary work in long-term care

Nordic Journal of Social Research ◽

10.7577/njsr.3698 ◽

2021 ◽

Vol 12 (1) ◽

pp. 155-180

Author(s):

Laila Tingvold ◽

Oddvar Førland

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

Long Term Care ◽

Home Care Services ◽

Voluntary Work ◽

Term Care ◽

Home Setting ◽

Care Services

Introduction: Increased voluntary work in long-term care (LTC) is encouraged in white papers in Norway as well as in many other western states. This is due to the growth in the number of service recipients and a subsequent economic burden for the state. Voluntary work in nursing homes and home care services take place in different spatial contexts, but little attention has been paid to how the different contexts may potentially influence the possibilities for voluntary work. The aim of this study is to obtain new knowledge of the significance of context in recruitment of volunteers in LTC. Method: A cross-sectional study was conducted among leaders in nursing homes and home services in 50 municipalities across all regions of Norway. Descriptive analysis was used. Results: According to the leaders, home care services had less voluntary work than nursing homes. Respondents from home care scored “poor flow of information” and “low interest in the municipality” as major hinderances, more so than respondents from nursing homes did. Discussion: Nursing homes typically have many residents under one roof following a similar schedule. Thus, volunteer-run activities are held more easily at set times and incorporated into the daily life of the institutions. On the other hand, home dwellers in home care stay in a more individualised setting with more autonomy and can opt out of activities that nursing home residents would normally join. Skill acquisition, networking and socializing are common motivations for volunteering, and a nursing home setting may be an easier context to obtain this. The governmental endeavour for increased voluntary work in LTC can be seen as an effort to meet expected rises in public expenditure. However, the realism can be debated due to substantial challenges on the future potential of volunteerism in LTC, especially in the home care context.

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Investigating factors influencing quality-of-life effects of home care services in Austria, England and Finland: A comparative analysis

Journal of European Social Policy ◽

10.1177/0958928720974189 ◽

2021 ◽

pp. 095892872097418

Author(s):

Birgit Trukeschitz ◽

Assma Hajji ◽

Judith Kieninger ◽

Juliette Malley ◽

Ismo Linnosmaa ◽

...

Keyword(s):

Quality Of Life ◽

Home Care ◽

Service Provision ◽

Care Service ◽

Home Care Services ◽

Home Care Service ◽

Term Care ◽

Care Services

European countries have developed a range of long-term care (LTC) policy responses to support the increasing share of older people. However, little is known about the effectiveness of LTC services and benefits, particularly their impact on older peoples’ quality of life (QoL). This paper investigates the role of personal, care service and environmental characteristics on the effects of home care services on QoL across England, Finland and Austria. We used data from surveys conducted in England, Finland and Austria. In total, 811 older adults were included in the analysis. OLS regression including main effects and country-specific interactions was used to explore variation in gains in long-term care service-related quality-of-life (LTC-QoL). Explanatory variables were derived from the production of welfare framework and comprised home care service user socio-demographics, needs indicators, social support and environmental variables and characteristics of home care service provision. In all three countries, LTC-QoL gains increased with needs, indicating that home care services perform well, with additional gains declining the higher the needs. Also, better process quality contributed to LTC-QoL improvements in all three countries. In addition, the availability of informal care, social contact, financial household situation and living alone, were associated with changes in LTC-QoL only in one or two of the countries. Home care services increased service users’ QoL in all three European countries. The increase in QoL, however, varied across the countries. The results also provide insights into the benefits and limits of home care service provision and areas for future improvements. JEL: I31, I38, J14

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Development and Evaluation of a Smart Contract–Enabled Blockchain System for Home Care Service Innovation: Mixed Methods Study (Preprint)

10.2196/preprints.15472 ◽

2019 ◽

Author(s):

Shuchih Ernest Chang ◽

YiChian Chen ◽

MingFang Lu ◽

Hueimin Louis Luo

Keyword(s):

Home Care ◽

Questionnaire Survey ◽

Care Service ◽

Home Care Services ◽

Home Care Service ◽

Smart Contracts ◽

Process Automation ◽

Traceability System ◽

Care Services ◽

Smart Contract

BACKGROUND In the home care industry, the assignment and tracking of care services are controlled by care centers that are centralized in nature and prone to inefficient information transmission. A lack of trust among the involved parties, information opaqueness, and large manual manipulation result in lower process efficiency. OBJECTIVE This study aimed to explore and demonstrate the application of blockchain and smart contract technologies to innovate/renovate home care services for harvesting the desired blockchain benefits of process transparency, traceability, and interoperability. METHODS An object-oriented analysis/design combined with a unified modeling language tool was used to construct the architecture of the proposed home care service system. System feasibility was evaluated via an implementation test, and a questionnaire survey was performed to collect opinions from home care service respondents knowledgeable about blockchain and smart contracts. RESULTS According to the comparative analysis results, the proposed design outperformed the existing system in terms of traceability, system efficiency, and process automation. Moreover, for the questionnaire survey, the quantitative analysis results showed that the proposed blockchain-based system had significantly (<i>P</i><.001) higher mean scores (when compared with the existing system) in terms of important factors, including timeliness, workflow efficiency, automatic notifications, insurance functionality, and auditable traceability. In summary, blockchain-based home care service participants will be able to enjoy improved efficiency, better transparency, and higher levels of process automation. CONCLUSIONS Blockchain and smart contracts can provide valuable benefits to the home care service industry via distributed data management and process automation. The proposed system enhances user experiences by mitigating human intervention and improving service interoperability, transparency/traceability, and real-time response to home care service events. Efforts in exploring and integrating blockchain-based home care services with emerging technologies, such as the internet of things and artificial intelligence, are expected to provide further benefits and therefore are subject to future research.

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A Home-Care Service for Frail Older Adults: Findings from a Quasi-Experiment in Milan

Ageing International ◽

10.1007/s12126-021-09462-6 ◽

2021 ◽

Author(s):

Simone Sarti ◽

Francesco Molteni ◽

Federica Cretazzo ◽

Gianluca Giardini ◽

Stefania Pozzati ◽

...

Keyword(s):

Home Care ◽

Population Aging ◽

Care Service ◽

Home Care Services ◽

Home Care Service ◽

Control Group ◽

Negative Effects ◽

Care Services ◽

Nursing Visit ◽

Patient Health

AbstractPopulation aging is particularly pronounced in Italy. Recently, home-care services emerged as one of the desirable strategy when dealing with such situations of fragility. In this framework, we present the evaluation of a home-care service which was experimentally implemented by Fondazione Sacra Famiglia and Casa di Cura Ambrosiana in the 2017–2018 biennium. The service consisted of a twice-weekly nursing visit intended to monitor patient health conditions and to gather data constantly supervised by a geriatrician. The eligible population consisted of the users of San Carlo Hospital Emergency Department (91 individuals). Twenty of these individuals had access to the experimental home-care service. The results show the smaller probability of mortality for the treatment group compared to the control group, but similar probabilities in admissions to ER and in hospitalizations. These findings suggest that health home-care policies could reduce mortality by lessening the negative effects of relational isolation.

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Healthcare leaders’ use of innovative solutions to ensure resilience in healthcare during the Covid-19 pandemic: a qualitative study in Norwegian nursing homes and home care services

BMC Health Services Research ◽

10.1186/s12913-021-06923-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hilda Bø Lyng ◽

Eline Ree ◽

Torunn Wibe ◽

Siri Wiig

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Home Care ◽

Home Care Services ◽

Care Practice ◽

Second Phase ◽

Research Attention ◽

Care Services ◽

Systems Research ◽

Innovative Solutions

Abstract Background The Covid-19 pandemic introduced a global crisis for the healthcare systems. Research has paid particular attention to hospitals and intensive care units. However, nursing homes and home care services in charge of a highly vulnerable group of patients have also been forced to adapt and transform to ensure the safety of patients and staff; yet they have not received enough research attention. This paper aims to explore how leaders in nursing homes and home care services used innovative solutions to handle the Covid-19 pandemic to ensure resilient performance during times of disruption and major challenges. Methods A qualitative exploratory case study was used to understand the research question. The selected case was a large city municipality in Norway. This specific municipality was heavily affected by the Covid-19 pandemic; therefore, information from this municipality allowed us to gather rich information. Data were collected from documents, semi-structured interviews, and a survey. At the first interview phase, informants included 13 leaders, Head of nursing home (1 participant), Head of Sec. (4 participants), Quality manager (4 participants), Head of nursing home ward (3 participants), and a Professional development nurse (1 participant), at 13 different nursing homes and home care services. At the second phase, an online survey was distributed at 16 different nursing homes and home care services to expand our understanding of the phenomenon from other leaders within the case municipality. Twenty-two leaders responded to the survey. The full dataset was analysed in accordance with inductive thematic analysis methodology. Results The empirical results from the analysis provide a new understanding of how nursing homes and home care leaders used innovative solutions to maintain appropriate care for infected and non-infected patients at their sites. The results showed that innovative solutions could be separated into technology for communication and remote care, practice innovations, service innovations, and physical innovations. Conclusion This study offers a new understanding of the influence of crisis-driven innovation for resilience in healthcare during the Covid-19 pandemic. Nursing home and home care leaders implemented several innovative solutions to ensure resilient performance during the first 6–9 months of the pandemic. In terms of resilience, different innovative solutions can be divided based on their influence into situational, structural, and systemic resilience. A framework for bridging innovative solutions and their influence on resilience in healthcare is outlined in the paper.

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