Staff's perspectives on the organization of homecare services to people with dementia-A qualitative study.
Kari-Anne Hoel, Anne Marie Mork Rokstad, Ingvild Hjorth Feiring and 3 others
PMID 33626244WHAT IT FOUND
Homecare staff reported that time pressure and fragmented visits prevent them from building the trust people with dementia need to accept care.
They described spending extra time early in the relationship as essential for identifying unspoken needs.
Key findings
01Staff identified sufficient time in the home and continuity of care as critical for building trust, which enables patients to accept necessary help.
02Participants reported that prioritizing daily task lists and practical tasks often supplants person-centred care and limits the ability to tailor services.
03Extra time was described as necessary to observe patients and identify needs when communication abilities are reduced.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The first author's prior experience as a nurse in homecare services may have influenced data interpretation. Participants were recruited by local homecare leaders, which may have introduced selection bias towards staff who aligned with management perspectives. The participants did not validate the analysis or results. The study was conducted in Norway, so findings may not transfer to health systems with different homecare structures or funding models.
Declared interests
No conflicts of interest were reported. The study was funded by Sykehuset Innlandet HF.
The easy way to misread this
Do not interpret these staff perspectives as evidence that specific organizational changes improve patient outcomes. The study reports what staff experienced and believed, not what was measured in patients. It does not prove that increasing visit time reduces hospital admissions or improves quality of life.