What constitutes ‘good’ home care for people with dementia? An investigation of the views of home care service recipients and providers

Goh, Anita M Y; Polacsek, Meg; Malta, Sue; Doyle, Colleen; Hallam, Brendan; Gahan, Luke; Low, Lee Fay; Cooper, Claudia; Livingston, Gill; Panayiotou, Anita; Loi, Samantha M; Omori, Maho; Savvas, Steven; Burton, Jason; Ames, David; Scherer, Samuel; Chau, Nadia; Roberts, Steven; Winbolt, Margaret; Batchelor, Frances; Dow, Briony

doi:10.1186/s12877-021-02727-4

Cited by 13 publications

(11 citation statements)

References 27 publications

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“…Continuous education for all staff is also called for, where ethical issues also need to be discussed (SOU, 2021: 52). Goh et al (2022) found that, beyond education, good communication between the employer and the employee is needed regarding, for example, the information that the staff receives about the person they are going to help. If staff receive too little information, they do not know what is expected of them except for specific tasks to be completed.…”

Section: Discussionmentioning

confidence: 99%

Working in a gray area—Healthcare staff experiences of receiving consent when caring for persons with dementia

2022

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Background Every person has the right to autonomy, and to be involved in decisions about their care. When persons with dementia have difficulties in expressing what they want, their autonomy is challenged. Staff should strive to involve the person in care decisions, to obtain consent and to avoid the use of coercion and restraints. However, care without consent exists and coercion and restraints are being used. In order to improve care, further knowledge is warranted. Aims The purpose of this study was to explore staff’s experiences of obtaining consent when caring for persons with dementia. Methods In total 14 focus group interviews were conducted with staff with experience of dementia care who work in either home care or residential care in Sweden. An inductive qualitative content analysis was used to analyze the collected data. Results Three categories were generated describing staff experiences of consent in dementia care: the person as the decision-maker, the staff as the decision-makers, and the viability of the consent. Overall, staff found it difficult to know if they really had consent from the individual. Even if the person verbally gave consent, it was challenging to know if the person really understood what they had consented to. Common to all three categories was the significance of the relationship between the person with dementia and staff: getting to know the person, recognizing the person’s response in terms of their facial expressions and body language as well as being able to explain and justify specific actions to the person. Conclusion Staff need better conditions in dementia care, including training and time to reflect on how to obtain consent. A person-centered approach can be one way to develop care and ensure that persons with dementia are allowed autonomy and to share in making decisions.

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Section: Discussionmentioning

confidence: 99%

Working in a gray area—Healthcare staff experiences of receiving consent when caring for persons with dementia

2022

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“…Good training is essential for homecare, not only to drive‐up quality but also to promote the welfare and social status of its workers. It is internationally recognised that training requirements in homecare lack rigour (Goh et al, 2022 ; Leverton et al, 2021 ). Some evidence links poor training as a characteristic trait of ‘dirty work’ occupations (Hansen, 2016 ) with the prospect that improved standards of learning may improve recruitment and retention and provide a more positive occupational identity (Clarke & Ravenswood, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Developing effective workforce training to support the long‐term care of older adults: A review of reviews

Newbould

Samsi

Wilberforce

2022

Health Social Care Comm

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This review of reviews aimed to identify and synthesise evidence to support the design of learning interventions for non-registered practitioners supporting older people in long-term care (people's own homes, hospices or residential/nursing care). Our objectives were to inform the analysis part of the Analysis, Design, Development Implementation and Evaluation framework by finding evidence on the following five components of learning: content, format (teaching strategies and resources/media), structure, contextual factors (barriers and enablers) and measures used when monitoring the effectives of learning. Databases searched included Pro-quest (ASSIA), Scopus, Ovid (PsycINFO, Medline, Embase and Social Policy and Practice), SCIE Online and Cochrane Reviews and reference searching, with the last search being conducted in April 2021. Fifteen papers were identified as eligible for inclusion. Most of the interventions aimed to improve dementia care (n = 10), with others exploring LGBT+ competency (n = 2), or other forms of professional development (n = 3). Common features of effective learning included a multifaceted approach, with in-practice learning being blended with additional implementation strategies (e.g. supervision) and didactic learning/worksheets. An important contextual factor was working within an organisational culture which supported shared learning and reflection. This may also help encourage engagement with training, where staff are unwilling to attend if it may compromise care delivery. Future research should focus on the characteristics of trainers and the structure of learning, with more research being needed in in mental and physical morbidities outside the remit of dementia to improve the overall quality of the social care workforce.

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Section: Introductionmentioning

confidence: 99%

“…In contrast, studies have identified elements considered to be important for "good" home care for people living with dementia [11,[15][16][17]. These elements include the availability of formal home care services and support, in addition to the perceived knowledge, security and dignity needed to care for a person with dementia [11,15]. While few frameworks for quality dementia home care exist for use in general health settings [18], Forbes and colleagues (2008) previously identified the availability and acceptability of formal services as central to positive home and community care experiences.…”

Section: Introductionmentioning

confidence: 99%

Towards defining quality in home care for persons living with dementia

et al. 2022

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Introduction Accelerating rates of dementia worldwide coupled with older adults living longer in the community calls for greater focus on quality home care support services. Few frameworks for quality dementia home care exist though prior findings have found elements considered to be important for “good” home care for people living with dementia. This study aimed to identify core components of a quality home care experience for people with dementia and their caregivers. Methods As part of a larger research study, in-depth interviews were conducted with persons living with dementia and caregivers (n = 25) to explore hospital-to-home care transitions. The design used for this study was a qualitative description. We used deductive-inductive thematic analysis, which was informed by previous work in this area. Open codes were mapped to pre-determined themes, and for codes not accommodated by an a piori framework, new themes were developed. Findings Our findings resulted in 4 overarching themes. Two themes were identified deductively (Availability and Acceptability of Home Care Services) and two inductively (Adaptability and Affordability of Home Care Services). Findings highlight the roles of family—care provider partnerships and responsive support in receiving quality home care, and the cost associated with unmet needs. Interpretation With an aging population, an increase in home care client acuity, and post-COVID-19 concerns over long-term care, more attention is needed to improve the quality of home care. The demand for these services will continue to increase particularly for those living with dementia and their families. The findings of availability, acceptability, adaptability, and affordability as core to quality care can help lay the groundwork for a home care framework for persons living with dementia and their caregivers. Future research could benefit from comparative analyses to evaluate the applicability of the findings to non-dementia home care service users and caregivers.

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What constitutes ‘good’ home care for people with dementia? An investigation of the views of home care service recipients and providers

Cited by 13 publications

References 27 publications

Working in a gray area—Healthcare staff experiences of receiving consent when caring for persons with dementia

Working in a gray area—Healthcare staff experiences of receiving consent when caring for persons with dementia

Developing effective workforce training to support the long‐term care of older adults: A review of reviews

Towards defining quality in home care for persons living with dementia

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