Home Care Safety Perspectives from Clients, Family Members, Caregivers and Paid Providers

Abstract

Designing Safer Systems T he demand for home care services is growing in Canada (Canada Institute for Health Information 2003). There has been a 51% increase in the number of home care clients since 1997, with over 900,000 receiving services in 2007 (Canadian Home Care Association 2008). Yet, overwhelmingly, research on patient safety has focused on institutional settings. Moreover, there has been an augmentation in the medicalization of private homes, resulting not only from the escalating threshold for admission to hospital but also from the increasing acuity of patients at the time of their discharge. This shift in care setting has been facilitated by the explosion of "hospital at home" services and the ever-growing availability of mobile technology (e.g., hemo-and peritoneal dialysis, long-term intravenous catheters and oxygen/inhalation therapy) (Williams 2002). The physical environment, socioeconomic status, family dynamics and cognitive and physical abilities of the client and caregivers are essential factors to be considered when delivering services. Family members or friends who are unpaid caregivers are often untrained, elderly and contending with their own health challenges. They frequently lack sleep as they provide around

Examining the relationship between therapeutic self-care and adverse events for home care clients in Ontario, Canada: a retrospective cohort study

“…In the literature adverse events are usually in reference to a breakdown in the process of care by the health care system. However, Lang et al proposed that the safety of the home care client, informal caregiver, and health care providers are closely linked [20]. This recognition is consistent with the context of home care, where much of care is provided by clients and informal caregivers.…”

Safety Strategies for Care in the Home

“…People are cared for in their homes and within the context of their family and the daily lives of all concerned. The quality and safety of care is infl uenced by the nature of formal service provision and the characteristics of the client receiving care, the physical environment and the availability of family and other carers (Hirdes et al 2004 ;Lang et al 2008b ). We outline some of the main factors that will need to be assessed and understood when designing safe home care services.…”

Workers’ Experiences of Crises in the Delivery of Home Support Services to Older Clients

“…Although there has been little if any work done specifically using the language of crisis episodes in home care services, there has been recent attention to adverse events (AEs) in home care (Johnson, 2006;Lang et al, 2009;Madigan & Tullai-McGuinness, 2004;Masotti, Green, & McColl, 2009;Masotti, Green, Shortt, Hunter, & Szala-Meneok, 2007;Masotti, McColl, & Green, 2010). Adverse events are defined differently depending on the health care setting.…”