Accuracy of Caregiver Proxy Reports of Home Care Service Use

2016 ◽  
Vol 38 (3) ◽  
pp. 434-442
Author(s):  
Neena L. Chappell ◽  
Helena Kadlec

Although much of the research on service use by older adults with dementia relies on proxy reports by informal caregivers, little research assesses the accuracy of these reports, and that which does exist, does not focus on home care services. This brief report compares proxy reports by family caregivers to those with dementia with provincial Ministry of Health records collected for payment and monitoring. The four home care services examined include home nursing care, adult day care, home support, and respite care. Data come from a province-wide study of caregivers in British Columbia, Canada. Caregiver reports are largely consistent with Ministry records, ranging from 81.0% agreement for home support to 96.6% for respite care. Spouses living with the care recipient (the vast majority of the sample) are the most accurate. Others, whether living with the care recipient or not, have only a 50-50 chance of being correct.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Snoen Glomsås ◽  
Ingrid Ruud Knutsen ◽  
Mariann Fossum ◽  
Kristin Halvorsen

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari-Anne Hoel ◽  
Anne Marie Mork Rokstad ◽  
Ingvild Hjorth Feiring ◽  
Bjørn Lichtwarck ◽  
Geir Selbæk ◽  
...  

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.


2021 ◽  
pp. 108482232199477
Author(s):  
Tracy Chippendale ◽  
Patricia Gentile

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.


2019 ◽  
Vol 5 ◽  
pp. 237796081984436
Author(s):  
Rita Sørly ◽  
Martin Sollund Krane ◽  
Geir Bye ◽  
May-Britt Ellingsen

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.


Author(s):  
Tzu-Pei Yeh ◽  
Hsing-Chia Chen ◽  
Wei-Fen Ma

Few studies have focused on developing a better understanding of the needs of patients with moderate-stage dementia. This study aimed to explore the needs of people living with moderate dementia and receiving home-care services from a local mental hospital. The study adopted a descriptive qualitative approach with purposive sampling to recruit patients with moderate dementia and receiving home-care services. Data were collected by face-to-face interviews and content analysis was used to interpret the experiences in the dialogue data. The results showed that the needs of people living with moderate dementia receiving home-care services contained four themes: the demand for company and care, the wish to recall familiar images, the need of reaffirming life purpose and value through reflection and reminiscence, and the desire for making autonomous end-of-life decisions. In addition to daily care, people living with moderate dementia crave companionship, expect meaningful exchanges of experiences to share their life, and have demands to have a voice in going through the final stage of life. The participants tended to focus more on issues related to the connections between living and dying. The results provide caregivers and home-care service providers with some insights into offering better care for people living with moderate dementia.


2020 ◽  
Vol 11 (2) ◽  
pp. 216
Author(s):  
Razak Abdullah ◽  
Rosyidah Arafat ◽  
Syahrul Syahrul

Latar Belakang : Proses menua merupakan proses alami yang diikuti dengan terjadinya peurunan kondisi fisik, psikologis dan sosial yang saling berkaitan satu sama lain .Kondisi penurunan tersebut mempengaruhi kemampuan lanjut usia dalam melakukan aktifitas sehari – hari/ Activity daily livings yang memerlukan perhatian dan bantuan keluarga sehingga mengakibatkan permintaan untuk perawatan di rumah meningkat dengan cepat. Perawatan Home care menjadi arena perawtaan professional dan informal. Review ini bertujuan untuk mengetahui bagaimana pelayanan home care pada lanjut usia.Metode : Dalam mengumpulkan artikel menggunakan beberapa database Pubmed, Science Direct, Wiley, dan Google Scholar dengan strategi pencarian menggunakan metode PICO (population, intervention, comparison and outcome dengan batasan publikasi artikel dari tahun 2009-2019.Hasil : Hasil temuan diperoleh beberapa point yaitu perlunya perawat melakukan Analisis kehidupan lansia sebelum memberikan pelayanan home care, pelayanan tepat waktu, Ukuran pengalaman aspek interpersonal perawatan karena itu dapat menjadi indikator yang berguna dari hasil kualitas hidup, pentingnya partisipasi lanjut usia, berbagi sejarah dengan perawat dan lansia, terjaminnya privasi lansia, pemenuhan standar kebutuhan lansia, selanjutnya ada factor komunikasi, pembangunan hubungan perawat dan lanjut usia, kepercayaan, keamanan, perawat harus pandai dalam menilai kekahawatiran rasa depresi yang disembunyikan oleh lansia, dan siap dalam menerima perbadaan pandangan dalam hal perawatan home care dengan lansia. Kata kunci :  Home care, Lanjut Usia Abstract Background: The aging process is a natural process that is followed by a decline in physical, psychological and social conditions that are interrelated with each other. The condition of the decline affects the ability of the elderly in carrying out daily activities / Activity daily livings that require attention and assistance from family so resulting in a rapidly increasing demand for home care. Care Home care is an arena for professional and informal care. This review aims to determine the experience of nurses in providing home care services for the elderly.Method: Data was obtained from google scholar website database, Since direct and Proquest, and obtained 5 articles. The five articles were then carried out by the journal research critics using the appropriate CASP tools namely 5 articles with the Critical Appraisal of Qualitative Study.Results: The findings obtained by several points, namely Analysis of the lives of the elderly before giving home care services, timely services, measures of experience of interpersonal aspects of care because it can be a useful indicator of quality of life outcomes, the importance of elderly participation, sharing history with nurses and the elderly, ensuring privacy, fulfilling the standards of elderly needs, then there are factors of communication, building relationships between nurses and the elderly, trustworthiness, security, nurses must be clever in assessing the concerns of depression that are hidden by the elderly, and ready to accept improvements in terms of nursing home care with the elderly . Keywords: Experience, Nurse, Home care, Elderly


2020 ◽  
Author(s):  
Letícia Lousada ◽  
Francisco Clécio Dutra ◽  
Beatriz Silva ◽  
Natália Oliveira ◽  
Ismael Bastos ◽  
...  

Abstract Background: Safety culture in primary care and home care services is still poorly studied, although this levels of care are the gateways to health services. This study aims to evaluate the culture of patient safety in Primary and Home Care Services. Methods: This is an observational cross-sectional study carried out with 147 professionals from nine district linked to the Home Care Program and six primary health care units. For the evaluation of culture, the Safety Attitudes Questionnaire (SAQ) was used, which considers a positive patient safety culture with scores ≥ 75. Results: Men who work in home care with time of professional experience of three to four years scored better for the Safety Climate, Job Satisfaction, Teamwork Climate and Total SAQ. Perception of management and Working Conditions received lower scores from professionals with long time of experience.Conclusions: It is concluded that the safety culture evaluation was better in the home care service when compared to the primary health care service.


Author(s):  
Berit Irene Helgheim ◽  
Birgithe Sandbaek

(1) Background: This paper investigates the distribution of work hours by activity, for the main staff categories in home care services in three rural Norwegian municipalities. In Norway these categories are registered nurses, assistant nurses and assistant health workers. (2) Methods: The three categories of home care staff recorded 20,964 eligible observations over 8 weeks. We identified 19 activities, which were recorded. The majority of staff used a smartphone application for the time measuring, while some staff used a manual form for reporting purposes. (3) Results: The registered nurses (RNs) spent 32% of their time on direct patient work, while driving accounted for 18%. Direct patient work and driving accounted for the majority of activities performed by assistant nurses (48% and 29%, respectively) and assistant health workers (70% and 17%, respectively). (4) Conclusions: The demand for home care services is increasing in terms of both size and complexity. Simultaneously, there is a growing shortage of skilled staff. RNs is the group with the least face-to-face time with patients. To meet the patients’ needs, it is necessary to discuss and modify existing home care service systems in order to use resources appropriately and effectively.


2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 101-101
Author(s):  
Nicole Mittmann ◽  
Ning Liu ◽  
Marnie MacKinnon ◽  
Soo Jin Seung ◽  
Nicole Look Hong ◽  
...  

101 Background: This research evaluates whether active identification of patients who may benefit from a palliative approach to care changes the use of palliative care and home care services. Methods: Between 2014 and 2017, Cancer Care Ontario implemented the INTEGRATE project at 4 cancer centres and 4 primary care teams. Physicians in participating sites were encouraged to systematically identify patients who were likely to die within 1 year and would benefit from a palliative approach to care. Patients in the INTEGRATE intervention group were 1:1 matched to non-intervention controls selected from provincial healthcare administrative data based on a publicly funded health system using the propensity score-matching. Palliative care and home care services utilization was evaluated within 1 year after the date of identification (index date), censoring on death, or March 31, 2017, the study end date. Cumulative incidence function was used to estimate the probability of having used care services, with death as a competing event. Rate of service use per 360 patient-days was calculated. Analyses were done separately for palliative care and home care. Results: Of the 1,187 patients in the INTEGRATE project, 1,185 were matched to a control. The intervention and the control groups were well-balanced on demographics, diagnosis, comorbidities, and death status. The probability of using palliative services in the intervention group was 80.3%, which was significantly higher than that in the control group (62.4%) with more palliative care visits in the intervention group [29.7 (95%CI: 29.4 to 30.1] per 360 patient-days) than in the control group [19.6 (95%CI: 19.3 to 19.9) per 360 patient-days]. The intervention group had a greater probability of receiving home care (81.4%) than the control group (55.2%) with more homecare visits per 360 patient-days [64.7 (95%CI: 64.2 to 65.3) vs. 35.3 (95%CI: 34.9 to 35.7)] The intervention group also had higher physician home visits as compared to the control group (36.5% vs. 23.7%). Conclusions: Physicians actively identifying patients that would benefit from palliative care resulted in increased use of palliative care and home care services.


2018 ◽  
Vol 47 (2) ◽  
pp. 229-239 ◽  
Author(s):  
Elzana Odzakovic ◽  
Lars-Christer Hydén ◽  
Karin Festin ◽  
Agneta Kullberg

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.


Sign in / Sign up

Export Citation Format

Share Document