What constitutes feeling safe at home? A qualitative interview study with frail older people receiving home care.
Anastasia Silverglow, Eva Lidèn, Heléne Berglund and 2 others
PMID 33318827WHAT IT FOUND
Frail older people defined safety at home as maintaining independence and control, not just receiving care.
They felt unsafe when staff disrupted routines or lacked continuity. Trust depended on staff competence, language skills, and having enough time to build relationships.
Key findings
01Feeling safe was closely tied to maintaining independence and control over the home environment and daily routines.
02Participants wanted to know who was visiting and when, as lack of information about staff arrival times caused stress and reduced their sense of control.
03Trust in staff was built through competence, language ability, continuity of care, and having sufficient time to interact positively with the older person.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
The study excluded people with cognitive impairment and those who did not speak Swedish, so it misses perspectives of more complex patients. The frailest older people were difficult to recruit because they were too tired, potentially biasing the sample towards those with more energy. Results are based on only 12 interviews in Sweden and may not generalise to other healthcare systems or populations. Data saturation was judged subjectively by the authors, which is a limitation of qualitative design.
Declared interests
The authors declare no conflicts of interest. Funding was provided by Stiftelsen Handlanden Hjalmar Svenssons.
The easy way to misread this
Do not interpret these themes as evidence that specific interventions improve safety outcomes. This is a descriptive study of patient experiences, not a test of whether changing care practices reduces harm or increases safety.