Collaboration between home care staff, leaders and care partners of older people with mental health problems: a focus on personhood

Abstract

Background Collaboration with care partners is a political aim in recent white papers in Norway and internationally. Home care services regularly work closely with care partners, but there are many indications that the collaboration does not work satisfactorily. Aim To explore home care staff and leaders’ experiences of collaborating with care partners of older people with mental health problems through a personhood perspective. Methods The study had a qualitative design and comprised eight health professionals in two focus groups and in‐depth interviews with three leaders in one home care district. The data were analysed using a thematic framework analysis building on previous research on personhood. criteria for reporting qualitative reporting guidelines were used to ensure comprehensive reporting. Results Four themes were identified in the analysis: ‘non‐negotiated relationships’, ‘contradictory agendas’, ‘weak paternalism’ and ‘moral compromise’. Conclusion There seems to be a lack of facilitation of collaborative relationships through all levels of the home care organisation. The interactions between care partners and home care staff sometimes appear to produce low or negative levels of emotional energy, and situations where the personhood of neither of them is respected occurs. Paying attention to the four modes of being as a framework for understanding personhood creates the foundation for a person‐centred approach that enhances the potential of creating stronger partnership in care relationships.

Professionals' understanding of their responsibilities in the collaboration with family caregivers of older persons with mental health problems in Norway

“…They found it particularly challenging to balance the care recipients' right to privacy and confidentiality, and the family caregivers' right to information. National and international research underpins our findings regarding the description of professionals' experiences of conflicting standards in task performance (Anker-Hansen et al, 2019;Eassom et al, 2014;Hengelaar et al, 2018;Landeweer et al, 2017;Weimand et al, 2013).…”

Personhood in aloneness and in affinity: Satisfactory social participation among home care recipients

“…[43]. In these findings, the meaning of 'personhood' resonates with the individuals' perceptions of their identities, as reflexively understood in relation to their personal narratives [44], and as acquired or actualized through relationships with others [35]. This can, for example, be seen in the participants' wishes for attending activities with people of the same age or interacting with people 'on the same wavelength', or that interaction even with close family members was enhanced if they shared interests or personality traits.…”

“…To experience 'sameness' can be seen as resonating and strengthening their sense of personhood. Personhood has been argued to be the core of person-centeredness, and as such, is central to relevant and respectful care services [35]. The term 'occupational identitiy' is another way of understanding identities, as operationalized through desired or executed occupations.…”

“…Home care staff usually have assistant nurse training (or lack formal training), and their work situation has been described as demanding [33], and that the work situation for staff in eldercare can be stressful and low in control: factors that may affect their health and also the quality of their care output [34]. Home care should apply a person-centred approach, although research suggests that person-centred values are not strongly endorsed by the organizational cultures of home care [35]. In addition to home care services, a home healthcare team consisting of occupational therapists, physiotherapists and registered nurses supports health and participation among community-dwelling frail older adults.…”

Developing New Methods for Person-Centred Approaches to Adjudicate Context–Mechanism–Outcome Configurations in Realist Evaluation

“…McCormack and McCance [ 3 ] claim that health professionals need to have their own personhood acknowledged as equal to that of patients, in effect to experience person-centredness. Person-centredness can therefore be viewed as the ‘operationalisation of personhood’ [ 5 ]. Applied to patients, it can be considered ‘person-centred care’; and when it is applied to patients and others, it is termed person-centred practice.…”