A qualitative study of health‐care experiences and challenges faced by ageing homebound adults

Abstract

Background The ageing of the global population is associated with an increasing prevalence of chronic diseases and functional impairments, resulting in a greater proportion of homebound individuals. Objective To examine the health‐care experiences of older homebound adults who have not previously received home‐based primary care (HBPC). To explore their impressions of this method of care. Design Cross‐sectional qualitative study using semi‐structured interviews. Setting and Participants 18 older homebound individuals in Central Virginia. Results Our findings revealed that homebound individuals faced significant health challenges, including pain resulting from various comorbidities. They felt that their mobility was restricted by their physical conditions and transportation challenges. These were major barriers to social outings and health‐care access. Participants left their homes infrequently and typically with assistance. Regarding office‐based care, participants were concerned about long wait times and making timely appointments. Some thought that HBPC would be convenient and could result in better quality care; however, others believed that the structure of the health‐care system and its focus on efficiency would not permit routine HBPC. Discussion and Conclusions Older homebound adults in this study faced high burdens of disease, a lack of mobility and difficulty accessing quality health care. Our observations may help researchers and clinicians better understand the health‐care experiences and personal opinions of older homebound individuals, informing the development of effective and empathetic home‐based care. Participant responses illuminated a need for education about HBPC. We must improve health‐care delivery and develop comprehensive, patient‐centered HBPC to meet the needs of homebound individuals.

Understanding the Daily Experiences and Perceptions of Homebound Older Adults and Their Caregivers: A Qualitative Study

“…Prior research on HBMC has highlighted the challenges faced by caregivers of patients with dementia and emphasized the importance of developing relevant frameworks, quality indicators, and outcome measures to promote the further development of patient-centered research agendas (Van Kempen et al, 2012). Whereas patient or caregiver input has been sought regarding perceptions of HBMC quality (Cheng et al, 2020; Shafir et al, 2016; Van Kempen et al, 2012), no studies, to our knowledge, have investigated both caregiver and patient perspectives on how being homebound, caregiving, and receiving HBMC interplay into the day-to-day lives of American HBMC beneficiaries. To inform future research and policies needed to support improvements in HBMC delivery, it is necessary to gain a more in-depth understanding of the daily life and perspectives of homebound older adults and their caregivers.…”

Telehealth's New Horizon: Providing Smart Hospital-Level Care in the Home

“…Telehealth can help patients who do not wish to visit the hospital or have economic barriers. In a study of attitudes toward home-based Primary Care (HBPC) among homebound adults over 50 with multiple health issues (44% Caucasian, 6% Asian, 50% African-American, and mostly rural), 49 patients reported challenges with transportation to the hospital and other barriers. The authors recommend educating patients about home-based care and developing ''comprehensive, patient-centered HBPC to meet the needs of home-bound individuals.''…”

The Holobiont Blindspot: Relating Host-Microbiome Interactions to Cognitive Biases and the Concept of the “Umwelt”

“…Could this have implications for our relationships and motivations, with downstream effects, for example, on work performance and mental health? After all, in the case of depression, oftentimes people do not know (and so cannot articulate) why they feel depressed ( Cheng et al, 2020 ) – could this also be a Holobiont Blindspot ? If there is a microbial link to depression as suggested by researchers ( Foster and Neufeld, 2013 ), investigating interventions (e.g., through microbial therapeutics) to address this could play an important role in managing mental health in the future ( Long-Smith et al, 2020 ).…”