The study contributes to identifying areas of improvement in documentation by nurses in home health care.

No abstract

The study highlights management paradoxes: possible unintended consequences of prioritizing needs for continuity of care should be objects of reflection in care management.

Purpose: To present an emerging innovative care model that supports participation and thriving by older adults in residential care, by introduction to new technology and mobilizing volunteer services. Design: Qualitative, exploratory study, introducing tablet computers to 15 older adults in two municipalities. Methods: The intervention encompassed weekly workshops over the course of 1 year with volunteer adolescents as personal tutors. Observations of workshops, interviews with nurses, and repeated semistructured interviews with older adult participants eliciting their perspective on use, experiences, perceived usefulness, and overall evaluation of the intervention. Findings: A model of four components is suggested to support participation and thriving by older adults in residential care: (a) simplified tools: iPadtechnology relatively easy to use; (b) person-centered process: one-to-one tutoring following each individual's own pace; (c) young volunteers to teach technology, establishing an intergenerational arena; and (d) being mindful of driving forces that encourage use and learning. We found that all kinds of use and all levels of mastery generated a sense of pride that supported thriving and enjoyment. Conclusions: These findings support the use of new technology and use of volunteer services for sustaining thriving in older adults. The person-centered approach stimulates use of the tablet, and participants showed enjoyment, more social participation, and reported subjective experiences of thriving. Clinical Relevance: Innovative models of care that prevent (or postpone) functional decline and support thriving in older adults are highly sought after in health care. A model that systematically involves volunteer services comes with potentials to alleviate nurses' workload, and then the intervention is seen as a manageable and low-cost initiative in residential care.

High-frequency home health care was characterized by interpersonal discontinuity, but with potential for improvement. Objective measures of interpersonal continuity, when the benchmark is adapted to the context, are useful tools for planning and surveying continuity of care.

The municipalities delegated the responsibility of implanting national policies to the first-line leaders. Missing were key quality success criteria such as macro- and meso-perspectives for the municipality as a whole and co-operation with other leaders in the organization and fostering of relevant learning. Quality work was fragmented rather than comprehensive and systematic.

Research on the digital divide has moved beyond connectivity to skills and usage disparities. Yet for many older people lack of connectivity remains a challenge, and for those who do have access skills and usage remains an issue. We report findings of an in-depth qualitative study of older people's perceptions of online communications and also their actual experiences. Findings indicate that older people who are already socially well connected benefit from online communication more than those who are not.

The study explored how 125 older patients and 92 next of kin experienced and assessed continuity in long-term home health care. Data were collected by means of structured interviews. A majority of the patients indicated that having a high number of health care personnel involved in their care was not problematic. For patients, informed and skilled health personnel along with knowing the visiting personnel may compensate for a high number of personnel. For next of kin, accepting a high number of personnel was related to the carers being informed about the patient's situation. This study indicates that, in terms of patient satisfaction, the overall quality of care is more important than the number of people providing the care.Keywords home health care, long-term care, continuity of care, older people, next of kin, logistic regression, weighted kappa, structured interview at University of Exeter on June 5, 2016 hhc.sagepub.com Downloaded from