scholarly journals A Participant Observation of the Delivery of Home Care Services to Frail Socially Isolated Older People Receiving Two Different Models of Care Delivery

2017 ◽  
Vol 06 (01) ◽  
Author(s):  
Stephen Gethin Jones
2019 ◽  
pp. 140349481989080 ◽  
Author(s):  
Mari S. Aaltonen ◽  
Lina H. Van Aerschot

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.


2017 ◽  
Vol 18 (3) ◽  
pp. 212-220 ◽  
Author(s):  
Laetitia Teixeira ◽  
Maria João Azevedo ◽  
Sara Alves ◽  
Cátia L. Pires ◽  
Constança Paúl

Purpose In Portugal, the three main kinds of care services available for older people are nursing homes, day centers and home care services. The use of these care services is mostly based on complex socioeconomic and functional criteria; however it is not clear if this placement corresponds to a higher/lower risk of adverse outcomes. The purposes of this paper are: to characterize clients of each type of service; to estimate the proportion of individuals at perceived risk of each adverse outcome according to type of service; to assess the ability of the Risk Instrument for Screening in the Community (RISC) to identify the risk profiles according to type of service. Design/methodology/approach The sample comprised individuals aged 65+ (n=224), receiving care at home, in day centers or in nursing homes. The identification of individuals at risk for three adverse outcomes (institutionalization, hospitalization and death) was performed using a short pre-screen instrument (RISC). Findings The RISC identified mental state issues as the unique factor that differentiated clients according the type of care services (χ2 (6, N=224)=20.96, p=0.002), with day center presenting the lowest percentage of mental health concerns and nursing home presenting the highest percentage (44.44 and 71.91 percent, respectively). Additionally, a gradient was found between perceived risk of adverse outcomes (institutionalization and hospitalization) and care of levels required. Originality/value The RISC can be used to discriminate people in different settings of care and can be helpful in the selection of groups at risk that will benefit more from available services.


2020 ◽  
Vol 29 ◽  
Author(s):  
Angélica Mônica Andrade ◽  
Patrícia Pinto Braga ◽  
Maria Ribeiro Lacerda ◽  
Elysangela Dittz Duarte ◽  
Laerte Honorato Borges Junior ◽  
...  

ABSTRACT Objective: to analyze the knowledge standards that found nursing practices in the home care setting. Method: qualitative study using a single case study strategy, supported by the dialectical methodological framework. Thirteen nurses who work in home care services from two municipalities in Minas Gerais, Brazil, participated. The data were obtained in 266.5 hours of participant observation and 8 hours and 58 minutes of interview and submitted to Critical Discourse Analysis. Results: empirical knowledge was revealed to be fundamental for clinical, managerial and educational care at home. The adaptations specific to this environment require aesthetic knowledge. The relational and educational actions, the decisions responsible for benefiting the individual and his family, the doubt and willingness to learn when dealing with unpredictable cases and the assessment of the socioeconomic conditions of the family, represent, respectively, personal, ethical, lack of knowledge and sociopolitical aspects present in the practice of nurses in home care. Conclusion: the particularities of home care trigger different patterns of knowledge to ensure creative, sensitive, human and responsible care. Innovation and availability to learn are part of nurses' performance in home care. The need for differentiated training is reinforced in order to respond to the increasing complexity in this field.


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.


2004 ◽  
Vol 5 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Norma Raynes ◽  
Lydia Coulthard ◽  
Charlotte Glenister ◽  
Bogusia Temple

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.


Sign in / Sign up

Export Citation Format

Share Document