Enhancing existing formal home care to improve and maintain functional status in older adults: Protocol for a feasibility study on the implementation of the Care to Move (CTM) programme in an Irish healthcare setting

Horgan, N Frances; Cummins, Vanda; Doyle, Frank; O’Sullivan, Maria; Galvin, Rose; Burton, Elissa; Sørensen, Jan; Skelton, Dawn A.; Townley, Bex; Rooney, Debbie; Jackson, Gill; Swan, Lauren; Warters, Austin

doi:10.22540/jfsf-05-010

Cited by 3 publications

(12 citation statements)

References 34 publications

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“…The primary feasibility study and the CTM approach are described in detail elsewhere. 26 , 27 In brief, the physical activity initiative was embedded into existing formal home support services and delivered by HCAs. Prior to delivering the initiative, HCAs completed a 2-day CTM training course delivered by a Senior Physiotherapist and qualified CTM trainer.…”

Section: Methodsmentioning

confidence: 99%

“…This work forms part of the feasibility study of embedding the Care to Move (CTM) program into a care at home setting. 26 , 27 While Care To Move is referred to as a program throughout, it is not a structured exercise plan. 26 , 27 Care to Move is a whole workforce-based approach that aims to bring consistent language to the promotion of “movement” within formal care services.…”

Section: Introductionmentioning

confidence: 99%

“… 26 , 27 While Care To Move is referred to as a program throughout, it is not a structured exercise plan. 26 , 27 Care to Move is a whole workforce-based approach that aims to bring consistent language to the promotion of “movement” within formal care services. 26 This approach emphasizes “movement prompts” that encourage older adults to “sit less and move more”.…”

Section: Introductionmentioning

confidence: 99%

“… 26 , 27 Care to Move is a whole workforce-based approach that aims to bring consistent language to the promotion of “movement” within formal care services. 26 This approach emphasizes “movement prompts” that encourage older adults to “sit less and move more”. The experience and acceptability of delivering the program, including “movement prompts” by HCAs to their home support clients, however, is not known.…”

Section: Introductionmentioning

confidence: 99%

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Embedding Physical Activity Within Community Home Support Services for Older Adults in Ireland – A Qualitative Study of Barriers and Enablers

Swan

Horgan²,

Cummins

et al. 2022

CIA

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Introduction In Ireland, over 55,000 older adults are supported in their community by formal home support, amounting to an estimated 23 million care hours annually. There is a growing need to move beyond care, to more proactive approaches to maintain physical function. In a feasibility study, we delivered the “Care to Move” (CTM) program through existing home support services. This qualitative study aimed to explore the experience and perceptions of Health Care Assistants (HCAs), who were trained in and delivered the CTM program. Methods We conducted semi-structured telephone interviews with 22 HCAs [mean age 49.0 ± 10.7 years and female 21/22] involved in the delivery of the program with older adults [n = 35, mean age 82.8 (7.8) years]. Interview transcripts were coded and analyzed thematically to capture barriers and enablers to program delivery. Results Barriers and enablers were identified under three themes i) the CTM approach ii) the home support setting, iii) older adults and physical activity, with iv) delivering care in a crisis and v) future directions further identified. Overall, there was a positive perception of the program’s focus on “movement prompts and motivators”, the “fit” within home support services, and the training provided. Practical challenges of limited time and the task-orientated nature of home support were reported as recurring barriers for CTM. Many HCAs commented on the value and perceived positive benefits of the program for their clients. Though negative perceptions of older adults’ motivation or ability to engage with physical activity were noted. Risk, such as injury or pain, was identified but was not a dominant theme. Conclusion Our findings suggest that embedding physical activity initiatives within home support services could be feasible. Restructuring of services, engaging HCAs, and moving beyond traditional “task-oriented” care models to more personalised proactive approaches may facilitate this initiative and support aging in place.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Embedding Physical Activity Within Community Home Support Services for Older Adults in Ireland – A Qualitative Study of Barriers and Enablers

Swan

Horgan²,

Cummins

et al. 2022

CIA

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“…CTM is designed to encourage the older adult to “move more” with activities associated with self-care and to incorporate mobility within their day using “movement prompts”, rather than being set a structured program and advised, for example, to complete 10 exercises, three times a day, every day. 15 Another benefit of CTM is that it is aimed at being a whole workforce approach, where the language and messaging around delivering CTM remains the same regardless of who is speaking with the person receiving the support services. 15 Due to the strengths of CTM it may be a beneficial approach to utilize with older adults receiving home support services, however to date no formal research evaluation has been undertaken.…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study of Older Adults’ Experiences of Embedding Physical Activity Within Their Home Care Services in Ireland

Burton¹,

Horgan²,

Cummins³

et al. 2022

JMDH

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Purpose Physical activity has been shown to improve older adults’ functional capacity, independence, and quality of life. In a feasibility study, we embedded a movement approach within older adults existing home care services through “Care to Move” (CTM). The aim of this qualitative study is to explore older adults’ experiences of CTM within their home care support services and to identify the strengths and barriers of engaging in CTM from the perspective of the older recipient. Materials and Methods We conducted semi-structured telephone interviews with 13 older adults and one informal carer. Topics covered included participants’ overall experiences of CTM, changes to their overall activity and participation, aspects of CTM that they found valuable and issues that were challenging. Interview transcripts were coded and analyzed thematically to capture barriers and facilitators to the approach delivery. Results Four themes were developed: i) “I have good days and bad days”, ii) “safety and security is the name of the game”, iii) “we’re a team as it stands’, iv) “it’s [COVID-19] depressing for everybody at the moment”. Older adults identified benefits of CTM engagement including improvements in physical and psychological wellbeing. However, subjective frailty and self-reported multimorbidity influenced overall engagement. Participants expressed concerns around the logistics of delivering CTM and competing care staff interests. The broader role of care staff in supporting CTM was highlighted, as well as the emotional support that staff provided to older adults. Care staff continuity was identified as a barrier to ongoing engagement. The impact of COVID-19 on older adults physical and mental health negatively impacted the delivery of the approach. Conclusion Our findings suggest that embedding CTM within home care services is feasible and that older adults enjoyed engaging in CTM. Addressing care staff continuity and adopting individual approaches to CTM delivery may enhance the implementation of services.

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Enhancing Existing Formal Home Care to Improve and Maintain Functional Status in Older Adults: Results of a Feasibility Study on the Implementation of Care to Move (CTM) in an Irish Healthcare Setting

Horgan

Cummins

Skelton

et al. 2022

IJERPH

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Background: Care to Move (CTM) provides a series of consistent ‘movement prompts’ to embed into existing movements of daily living. We explored the feasibility of incorporating CTM approaches in home care settings. Methods: Feasibility study of the CTM approach in older adults receiving home care. Recruitment, retention and attrition (three time points), adherence, costs to deliver and data loss analyzed and differentiated pre and post the COVID-19 pandemic. Secondary outcomes, including functional status, physical activity, balance confidence, quality of life, cost to implement CTM. Results: Fifty-five home care clients (69.6% of eligible sample) participated. Twenty were unable to start due to COVID-19 disruptions and health issues, leaving 35 clients recruited, mostly women (85.7%), mean age 82.8 years. COVID-19 disruption impacted on the study, there was 60% retention to T2 assessments (8-weeks) and 13 of 35 (37.1%) completed T3 assessments (6-months). There were improvements with small to medium effect sizes in quality of life, physical function, balance confidence and self-efficacy. Managers were supportive of the roll-out of CTM. The implementation cost was estimated at EUR 280 per carer and annual running costs at EUR 75 per carer. Conclusion: Embedding CTM within home support services is acceptable and feasible. Data gathered can power a definitive trial.

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Enhancing existing formal home care to improve and maintain functional status in older adults: Protocol for a feasibility study on the implementation of the Care to Move (CTM) programme in an Irish healthcare setting

Cited by 3 publications

References 34 publications

Embedding Physical Activity Within Community Home Support Services for Older Adults in Ireland – A Qualitative Study of Barriers and Enablers

Embedding Physical Activity Within Community Home Support Services for Older Adults in Ireland – A Qualitative Study of Barriers and Enablers

A Qualitative Study of Older Adults’ Experiences of Embedding Physical Activity Within Their Home Care Services in Ireland

Enhancing Existing Formal Home Care to Improve and Maintain Functional Status in Older Adults: Results of a Feasibility Study on the Implementation of Care to Move (CTM) in an Irish Healthcare Setting

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