Care Networks of Home-dwelling Older Persons in the Netherlands: Proof of Concept of a Network Typology

Abstract

Background Studies on care networks of home-dwelling older persons often focus on network constellation. However, looking at network interaction can be helpful to improve the support generated by the care network. A European study on diabetes patients found network types based on the interaction within a network, which can be beneficial (generative, proxy) or detrimental (struggling, avoidant) to support. This study explored whether these network types are present in care networks of home-dwelling older persons in the Netherlands and how these network types manifest in constellation or ways of interaction (negotiation, navigation and contagion). Methods The present study is a secondary analysis of a cross‐sectional qualitative study of 16 care networks with home‐dwelling older persons, informal caregivers and formal care providers conducted between March and September 2016. First, navigation, negotiation and contagion were analysed for each network; then the network type was determined for each network. ResultsWe found nine proxy networks, four generative networks, two avoidant networks and one struggling network. In the proxy networks, all negotiation and navigation were centralised by the proxy. In generative networks, negotiation was possible if the older person could be reciprocal and the network supported this. In avoidant networks, informal and formal caregivers had to deal with an older person who refused support. In the struggling network, the underlying problem could not be addressed. Furthermore, two networks seemed to show a transition process from generative to proxy network.ConclusionWe concluded that the network typology on interaction offered extra information about the functioning of the care network. It seems that the network type can change over time, but more research is needed to confirm this. This study suggests that interventions in avoidant or struggling networks are difficult. Also actions were aimed at developing proxy networks. Interventions maintaining or developing generative networks seem underused.