How do clients and (In)formal caregivers experience quality of home care? A qualitative approach.
Roy Haex, Theresa Thoma-Lürken, Anna J H M Beurskens and 1 others
PMID 31612489WHAT IT FOUND
Older home care clients and caregivers valued a small, regular team, trust, and routines that fit the client's former life.
Some clients preferred professional care over personal connection. Staff shortages and time pressure were described as affecting care quality.
Key findings
01Knowing which familiar caregiver would come helped clients and informal caregivers set realistic expectations, and most valued a small number of formal caregivers.
02Care routines that fit the client's former way of living, such as make-up, conversation topics, or adjusted planning, were valued by clients and caregivers.
03Formal caregivers sometimes saw a client's need as outside their professional role, while some clients preferred a professional care relationship rather than a personal connection.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants described experiences at one point in time, so recall bias could have changed how they reported expectations, past interactions, and outcomes. One district nurse took part in three triads, which could over-represent her perspective, although the researchers combined and mitigated caregiver results. Interviewers did not know participants beforehand, which may have made some people less open. The INDEXQUAL framework guided both the interview topics and the coding, so the analysis may have favoured expected themes, despite photo elicitation and invitations to add topics. Findings come from 16 participants in six Dutch home care triads, so they describe experiences in that setting and do not test whether any care approach works.
The easy way to misread this
Do not treat these themes as evidence that a specific home care model improves quality. The study asked 16 participants in Dutch home care triads to describe their experiences, and it did not test an intervention or measure outcomes.