Changes in home care clients’ characteristics and home care in five European countries from 2001 to 2014: comparison based on InterRAI - Home Care data

Abstract

Background Policymakers advocate extended residence in private homes as people age, rather than relocation to long-term care facilities. Consequently, it is expected that older people living in their own homes will be frailer and have more complex health problems over time. Therefore, community care for aging people is becoming increasingly important to facilitate prevention of decline in physical and cognitive abilities and unnecessary hospital admission and transfer to a nursing home. The aim of this study was to examine changes in the characteristic of home care clients and home care provided in five European countries between 2001 and 2014 and to explore whether home care clients who are most in need of care receive the care required. Methods This descriptive study used data from two European research projects, Aged in Home Care (AdHOC; 2001–2002) and Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care (IBenC; 2014–2016). In both projects, the InterRAI-Home Care assessment tool was used to assess a random sample of home care clients 65 years and older in five European countries. These data facilitate a comparison of physical and cognitive health and the provided home care between countries and study periods. Results In most participating countries, both cognitive (measured on the Cognitive Performance Scale) and functional ability (measured on the Activities of Daily Living Hierarchy scale) of home care clients deteriorated over a 10-year period. Home care provided increased between the studies. Home care clients who scored high on the physical and cognitive scales also received home care for a significantly higher duration than those who scored low. Conclusion Older people in several European countries remain living in their own homes despite deteriorating physical and cognitive skills. Home care services to this group have increased. This indicates that the government policy of long-term residence at own home among older people, even in increased frailty, has been realised.

Ethical sensitivity and compassion in home care: Leaders’ views

“…While the need for home care is increasing globally, research shows that several countries cannot fully meet patients' care needs. 1 Internationally, healthcare is governed by human rights, healthcare legislation, and ethical guidelines. 2,3 According to The National Advisory Board on Social Welfare and Health Care Ethics ETENE, older people should have the right to good qualitative care that respects the individual's integrity, needs, and right to self-determination.…”

Research priorities for homecare for older people: A UK multi‐stakeholder consultation

“…‘Homecare’ is broadly understood to refer to services that allow older people (predominantly) to continue to live in their own homes. Many countries have seen year‐on‐year increases in the number of older people using homecare, driven both by demographic changes and the implementation of ‘ageing in place’ policies (Kristinsdottir et al, 2021; OECD, 2020). However, there is considerable variation between countries in how this is organised and funded, and what tasks and activities are regarded as constituting homecare (Contandriopoulos et al, 2021; Incisive Health, 2018).…”

Recognising older people's individual resources and home‐care‐specific tasks in home care in Finland: A document analysis of care and service plans

“…The clients of home care are becoming older and weaker as regards their functional ability than in the past decades [1][2][3]. Multiple comorbidities and medical conditions affect their well-being and quality of life [3,4].…”

“…Memory disorders [5,6] and polypharmacy [7,8] are common and affect an increasing number of older people in home care. Even though older people often have various care needs [1,3] tailored home care services enable more dependent older people to live longer in their own homes [2,3]. Older people also have individual resources that support and help them achieve their daily living despite possible disabilities [9][10][11].…”