Who Is Doing What in Home Care Services?

(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.

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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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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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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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A Qualitative Exploration of the Needs of Community-Dwelling Patients Living with Moderate Dementia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18178901 ◽

2021 ◽

Vol 18 (17) ◽

pp. 8901

Author(s):

Tzu-Pei Yeh ◽

Hsing-Chia Chen ◽

Wei-Fen Ma

Keyword(s):

Home Care ◽

Service Providers ◽

Care Service ◽

Home Care Services ◽

Community Dwelling ◽

End Of Life Decisions ◽

Face To Face ◽

Care Services ◽

Moderate Dementia ◽

Qualitative Exploration

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.

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Patient Safety Culture in Primary and Home Care Services

10.21203/rs.3.rs-23098/v2 ◽

2020 ◽

Author(s):

Letícia Lousada ◽

Francisco Clécio Dutra ◽

Beatriz Silva ◽

Natália Oliveira ◽

Ismael Bastos ◽

...

Keyword(s):

Health Care ◽

Patient Safety ◽

Primary Health Care ◽

Home Care ◽

Safety Culture ◽

Care Service ◽

Patient Safety Culture ◽

Home Care Services ◽

Care Services ◽

Primary Health

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.

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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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Effectiveness of the Labour Inspection Authority’s regulatory tools for work environment and employee health: study protocol for a cluster-randomised controlled trial among Norwegian home-care workers

BMJ Open ◽

10.1136/bmjopen-2019-031226 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031226

Author(s):

Anne-Marthe R Indregard ◽

Stein Knardahl ◽

Jan Shahid Emberland ◽

Øivind Skare ◽

Håkon A Johannessen

Keyword(s):

Home Care ◽

Work Environment ◽

Care Service ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Home Care Services ◽

Employee Health ◽

Mechanical Work ◽

Care Services ◽

Randomised Controlled

IntroductionThere is a need to evaluate whether, and to what degree, labour inspections or other regulatory tools have the desired effects on psychosocial, organisational and mechanical work environment, and employee health. The Norwegian Labour Inspection Authority (NLIA) uses different tools and strategies to enforce compliance with occupational safety and health (OSH) legislation. The aim of the present study is to evaluate the effects of labour inspections and other regulatory tools employed by the NLIA. The home-care service is one of the fastest growing occupations and a prioritised area for the NLIA, hence the present study will investigate regulatory tools in this sector.Methods and analysisThe research project has been designed as a longitudinal, cluster-randomised, controlled trial and will be conducted among Norwegian home-care workers. The objective of the research project is to evaluate the effects of the NLIA’s regulatory tools (inspection and guidance) on: (1) compliance with OSH legislation and regulation; (2) psychosocial, organisational and mechanical work environment; (3) employee health in terms of musculoskeletal and mental health complaints; and (4) sickness absence. Public home-care services have been randomised to three intervention groups and one control group. Home-care services in the intervention groups will receive one of three intervention activities from the NLIA: (1) inspection from the Labour Inspection Authority; (2) guidance through an online interactive risk-assessment tool; and (3) guidance on psychosocial, organisational and mechanical work environment through workshops. The interventions will be performed at the organisational level (home-care service), and the effects of the interventions on the working environment and health complaints will be measured at the individual level (home-care employees).Ethics and disseminationThis project has been approved by the Regional Committees for Medical and Health Research Ethics (REC) in Norway (REC South East) (2018/2003/REK sør-øst C), the Norwegian Center for Research Data (566128), and will be conducted in accordance with the World Medical Association Declaration of Helsinki. The results will be reported in international peer-reviewed journals.Trial registration numberNCT03855163.

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The role of health services in encouraging disclosure of violence against women

Slovenian Journal of Public Health ◽

10.1515/sjph-2017-0030 ◽

2017 ◽

Vol 56 (4) ◽

pp. 220-226

Author(s):

Vesna Leskošek ◽

Miha Lučovnik ◽

Lucija Pavše ◽

Tanja Premru Sršen ◽

Megie Krajnc ◽

...

Keyword(s):

Health Care ◽

Health Services ◽

Health Care Services ◽

Health Workers ◽

Care Service ◽

Health Care Service ◽

Care Staff ◽

Health Care Staff ◽

Care Services

Abstract Introduction The aim of the survey was to assess the differences in disclosure by the type of violence to better plan the role of health services in identifying and disclosing violence. Methods A validated, anonymous screening questionnaire (NorAQ) for the identification of female victims of violence was offered to all postpartum women at a single maternity unit over a three-month period in 2014. Response rate was 80% (1018 respondents). Chi square test was used for statistical analysis (p<0.05 significant). Results There are differences in disclosure by type of violence. Nearly half (41.5%) of violence by health care services was not reported, compared to 33.7% physical, 23.4% psychological, and 32.5% sexual that was reported. The percentage of violence in intimate partnership reported to health care staff is low (9.3% to 20.8%), but almost half of the violence experienced by heath care services (44%) is reported. Intimate partnership violence is more often reported to the physician than to the psychologist or social worker. Violence in health care service is reported also to nurses. Conclusions Disclosure enables various institutions to start with the procedures aimed at protecting victims against violence. Health workers should continuously encourage women to speak about violence rather than asking about it only once. It is also important that such inquiries are made on different levels of health care system and by different health care professions, since there are differences to whom women are willing to disclose violence.

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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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