scholarly journals What constitutes ‘good’ home care for people with dementia? An investigation of the views of home care service recipients and providers

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anita M. Y. Goh ◽  
Meg Polacsek ◽  
Sue Malta ◽  
Colleen Doyle ◽  
Brendan Hallam ◽  
...  
Keyword(s):  
Home Care ◽  
Care Service ◽  
Home Care Services ◽  
Dementia Care ◽  
Trial Registration ◽  
Care Providers ◽  
Family Carers ◽  
People With Dementia ◽  
Care Workers ◽  
Home Care Workers

Abstract Background Our objective was to explore what people receiving and providing care consider to be ‘good’ in-home care for people living with dementia. Methods We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke’s six-step approach. Results Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers’ understanding of dementia and its impact; 2) Home care workers’ demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers’ knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. Conclusions It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. Trial registration ACTRN 12619000251123.

scholarly journals Working with colleagues and other professionals when caring for people with dementia at the end of life: home care workers’ experiences

2019 ◽  
Vol 3 (4) ◽  
pp. 567-583
Author(s):  
Jill Manthorpe ◽  
Tushna Vandrevala ◽  
Ruth Abrams ◽  
Kritika Samsi
Keyword(s):  
Home Care ◽  
Home Care Services ◽  
Care Staff ◽  
Structured Interviews ◽  
Care Services ◽  
People With Dementia ◽  
Care Workers ◽  
Informal Practices ◽  
Home Care Workers ◽  
Care Agency

Caring for people with dementia often necessitates inter-professional and inter-agency working but there is limited evidence of how home care staff work as a team and with professionals from different agencies. Through analysis of semi-structured interviews, we explored the experiences of home care workers (n = 30) and managers of home care services (n = 13) in England (2016‐17). Both groups sought to collaboratively establish formal and informal practices of teamwork. Beyond the home care agency, experiences of interacting with the wider health and care workforce differed. More explicit encouragement of support for home care workers is needed by other professionals and their employers.

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

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.

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 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 Using a Reflective Diary Method to Investigate the Experiences of Paid Home Care Workers Caring for People With Dementia

2019 ◽  
Vol 32 (1) ◽  
pp. 10-21 ◽  
Author(s):  
Cheryl Travers ◽  
Justine Schneider ◽  
Lucy Perry-Young ◽  
Samantha Wilkinson ◽  
Kezia Scales ◽  
...  
Keyword(s):  
Home Care ◽  
Occupational Group ◽  
Care Organization ◽  
Diary Method ◽  
People With Dementia ◽  
Hourly Rate ◽  
Care Workers ◽  
Care Practices ◽  
Home Care Workers ◽  
And Training

This article reports on the use of an innovative reflective diary method with paid home care workers caring for people with dementia. It examines the key features of the diary design, recruitment and training of participants, diarists’ approaches and responses to diary-keeping, and evaluates the use of diaries in this context. Following training, 11 volunteers (all female) employed by a U.K.-based home care organization kept diaries of their experiences of caring for those with dementia. Using specially designed diaries, they wrote about their visits to clients for a period of approximately 4 months and were remunerated for up to 16 extra hours at their usual hourly rate of pay. Overall, home care workers engaged well with the process, keeping regular, lengthy, timely, and reflective diary entries. Diary-keeping provided a means for these workers to express their emotions about their work, while enhancing their self-insight and care practices. We demonstrate the feasibility of diaries for research with this occupational group and conclude that the written reflexivity employed in diaries can document, enrich, and improve the work of these caregivers.

scholarly journals What Is Important at the End of Life? Perspectives From Experienced Home Care Workers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 70-70
Author(s):  
Emma Tsui ◽  
Emily Franzosa ◽  
Kathrin Boerner
Keyword(s):  
New York ◽  
Home Care ◽  
End Of Life ◽  
Limited Information ◽  
Care Providers ◽  
Patient Death ◽  
Home Based ◽  
Care Workers ◽  
Home Care Workers ◽  
Eol Care

Abstract Home care workers (HCWs) make up a large and rapidly growing sector of the American health care workforce serving older adults. This study focuses on a common but understudied feature of home care labor: workers’ thoughts around what makes a "good" or "bad" patient death. While researchers have investigated patients’, families’, physicians’, and other care providers’ perspectives on this issue, the perspectives of HCWs, who contribute substantially to home-based care at the end of life, have yet to be explored. We conducted 40 in-depth interviews with HCWs in New York City on their experiences with and reflections on patient death. We used a inductive, iterative approach to analyze data on what HCWs believe is important for dying patients. HCWs described EOL values that align well with the views held in common by patients, families, and other care providers, like the importance of not being alone when dying and being physically comfortable (not in pain and not suffering). In particular, HCWs conceptualized a detailed role for themselves when providing EOL care near the time of death. HCWs’ sustained presence and relationships with patients may uniquely position them to assist in the attainment of patients’ EOL goals, particularly when HCWs understand what these goals are. HCWs’ potential for playing this role, however, is jeopardized by a lack of training in EOL care and by the limited information they receive about a patient’s health status.

scholarly journals Right at home: living with dementia and multi-morbidities

2020 ◽  
pp. 1-25
Author(s):  
Nicola A. Cunningham ◽  
Julie Cowie ◽  
Karen Methven
Keyword(s):  
Home Care ◽  
Policy Development ◽  
Multiple Perspectives ◽  
Health Crisis ◽  
People With Dementia ◽  
Care Workers ◽  
Health And Social Care ◽  
Care Systems ◽  
Home Care Workers ◽  
At Home

Abstract Dementia is recognised as the biggest health crisis of our time in terms of high personal and social costs and wider impact on health and social care systems. Increases in people living with dementia and multi-morbidities presents critical challenges for home care worldwide. Health-care systems struggle to provide adequate home-care services, delivering limited care restricted to a single-condition focus. This study explored the experiences and expectations of home care from the multiple perspectives of people living with dementia and multi-morbidities and home-care workers providing support. Findings draw from qualititative semi-structured interviews with people with dementia (N = 2), their partners (N = 2), other partners or family carers (N = 6) and home-care workers (N = 26). Three themes are identified: (a) the preference for and value of home; (b) inadequate home-care provision and enhanced care burden; and (c) limited training and education. Despite continued calls for home-care investment, the focus on reduction in costs hides key questions and further dialogue is required exploring how people with dementia can be supported to live independently and flourish at home. This study considers these complex experiences and care requirements through the prism of disability and human rights frameworks. This paper concludes with consideration of more recent human social rights debate. We discuss critically what this may mean for people living with dementia and consider the implications for co-requisite policy development to optimise available home-care support.

Fears come true: the experiences of older care recipients and their family members of live-in foreign home care workers

2009 ◽  
Vol 21 (4) ◽  
pp. 779-786 ◽  
Author(s):  
Liat Ayalon
Keyword(s):  
Home Care ◽  
Qualitative Interviews ◽  
Family Members ◽  
Home Care Services ◽  
Care Recipient ◽  
Care Services ◽  
Care Recipients ◽  
Care Workers ◽  
Home Care Workers ◽  
Care Worker

ABSTRACTBackground: Foreign home care services provided to frail older adults by individuals from the developing world are a global phenomenon. This study evaluated the challenges associated with live-in foreign home care from the perspective of older care recipients and their family members.Methods: Qualitative interviews were conducted with 23 family members and seven older care recipients. Interviews were analyzed thematically.Results: Three main themes were identified: (i) the intense fears associated with witnessing the decline of the older care recipient and the subsequent employment of a foreign home care worker; (ii) actual negative experiences within this caregiving setting; and (iii) the ways in which family members and older care recipients coped with these challenging experiences.Conclusions: The key to this caregiving arrangement is the establishment of trust. Yet, many care recipients experienced violations of trust that resulted in abuse and neglect, which served to further intensify fears and concerns about this caregiving arrangement. The same coping methods used to maintain this arrangement, despite fears and concerns, are the ones responsible for maintaining the older care recipient in an abusive situation.

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