Working with colleagues and other professionals when caring for people with dementia at the end of life: home care workers’ experiences

Manthorpe, Jill; Vandrevala, Tushna; Abrams, Ruth; Samsi, Kritika

doi:10.1332/239788219x15651814499954

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…Thirdly, professionals within the wider health and social care field need to better understand the potential value and skills of the homecare workforce, and how this workforce could be utilised more effectively to improve dementia care with their support (Manthorpe et al ., 2019). Valuing and supporting this workforce are key if they are to better balance risk management with client autonomy, provide optimal support to people with dementia and safeguard themselves.…”

Section: Discussionmentioning

confidence: 99%

Caring for people with dementia in their own homes: homecare workers' experiences of tolerating and mitigating risk

Ruston

Backhouse

2022

Ageing and Society

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Little is known about risk management in homecare for people with dementia. We aimed to gain an understanding of the ways in which homecare workers assess and manage risk whilst caring for people with dementia in their own homes. We conducted a qualitative interview study with 17 homecare workers assisting people with dementia with their personal care. Interviews were face-to-face, semi-structured, recorded and transcribed verbatim. Analysis was inductive and thematic. A key theme of risk was identified, with three main sources: the client as a source of risk to the homecare worker, the clients' home and behaviours as a risk to the client, and the wider health and social care system as a risk to both clients and homecare workers. Three interrelated aspects of risk were found to influence homecare workers' decision making and actions: homecare workers' perception of the level of risk, their perceived ability to control the risk and their tolerability of risk. The higher the perceived risk, the stronger the action taken by the worker or agency to mitigate it and the greater the impact on the client. To support effective development of this workforce there is a need to devise training that incorporates the use of tacit knowledge and experiential learning. Risk management policies for homecare should acknowledge and utilise the expertise, experiences and values of homecare workers.

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Section: Discussionmentioning

confidence: 99%

Caring for people with dementia in their own homes: homecare workers' experiences of tolerating and mitigating risk

Ruston

Backhouse

2022

Ageing and Society

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“…Home‐care organisations should work to support HCWs to manage structural conditions in their daily work practices. Other professions could have a role in supporting HCWS (Manthorpe et al., 2019), particularly with clinical decisions.…”

Section: Discussionmentioning

confidence: 99%

“…More dementia training for HCWs needs to be developed and evaluated (Polacsek et al, 2020; Goh et al., 2018), along with more support from other professional occupations (Manthorpe et al., 2019). Particularly since staff can experience dementia‐related work stress, adding to the emotional labour required from their day‐to‐day work (D’Astous et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Home‐care workers' experiences of assisting people with dementia with their personal care: A qualitative interview study

Backhouse

Ruston

2021

Health Social Care Comm

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Home-care workers are increasingly caring for clients living with dementia. Workers usually have limited dementia training and are low paid and often lone working.Little is known about how home-care workers assist people with dementia with their personal care. We aimed to explore the experiences of home-care workers and the knowledge and skills they rely on when providing personal care to people with dementia. In 2020, we conducted 17 semi-structured, face-to-face interviews with home-care workers in the East of England. Analysis was inductive and thematic. Two key themes were present in the data: 'structural conditions' and 'clients' dementia-related characteristics'. For each of these, we examined the challenges faced by home-care workers and the strategies they used to manage these challenges. Challenges included time allocation for visits, completing care plan tasks, lone working, communication and understanding, refusals of care, and client behaviours.To mitigate these challenges, home-care workers utilised system support, time management, training and experience and enacted a caring relationship, thought about their approach, and used distraction and communication skills. Workers relied on skills such as, relationship building, team working, observation, communication, decision making and interpersonal sensitivity. They drew on knowledge about the person, the person's needs, their own abilities, company policies and procedures and their role and responsibilities as a home-care worker. Home-care workers had more scope to mitigate client-based challenges by adapting care within client interactions, than to manage structural challenges where there was a limit to what workers could do. Despite a commissioning focus on time-and task-based care, when caring for people with dementia, home-care workers used interaction as a way to bring the person along and complete care activities. Home-care services should acknowledge the importance of interactions with people with dementia within home care and support their workers to develop interpersonal sensitivity.

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“…In this context, case management implies a 'negotiation on sharing care tasks' (Kemper-Koebrugge et al 2019: 974), as well as efforts to properly activate a multidisciplinary service infrastructure and to liaise with relevant actors (including funders, care inspectorates, etc. ), each obeying their own regulatory and policy framework (Manthorpe et al 2019;van Bovenkamp et al 2020). Thus, case managers are often faced with the challenge of 'implementing, coordinating and communicating a person-centred model of care across the many health-and social-care structures' of a given LTC system (McDonald et al 2019: 503).…”

Section: Offering Independence To Dependent People?mentioning

confidence: 99%

The Fate of Social Modernity

Bode

2024

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Working with colleagues and other professionals when caring for people with dementia at the end of life: home care workers’ experiences

Cited by 6 publications

References 23 publications

Caring for people with dementia in their own homes: homecare workers' experiences of tolerating and mitigating risk

Caring for people with dementia in their own homes: homecare workers' experiences of tolerating and mitigating risk

Home‐care workers' experiences of assisting people with dementia with their personal care: A qualitative interview study

The Fate of Social Modernity

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