Dataset Information

Experiences of home-care workers with the 'Stay Active at Home' programme targeting reablement of community-living older adults: An exploratory study.

ABSTRACT: To face the challenges of an ageing population, many Western countries nowadays stimulate an ageing in place policy to empower older adults to grow old in their own homes with the highest degree of self-reliance. However, many community-living older adults experience limitations in (instrumental) activities of daily living ((I)ADLs), which may result in a need for home-care services. Unfortunately, home-care workers often provide support by taking over tasks, as they are used to doing things for older adults rather than with them, which undermines their possibilities to maintain their self-care capabilities. In contrast, reablement focuses on capabilities and opportunities of older adults, rather than on disease and dependency. Consequently, older adults are stimulated to be as active as possible during daily and physical activities. The 'Stay Active at Home' programme was designed to train home-care workers to apply reablement in practice. To explore the experiences of home-care workers with this programme an exploratory study was conducting in the Netherlands, between April and July, 2017. In total, 20 participants were interviewed: nine nurses (including a district nurse), 10 domestic support workers and the manager of the domestic support workers. The semi-structured interviews focused on the experienced improvements with regard to knowledge, skills, self-efficacy and social support. Furthermore, the most and least appreciated programme components were identified. The study has shown that home-care workers perceived the programme as useful to apply reablement. However, they also need more support with mastering particular skills and dealing with challenging situations. Future implementation of the 'Stay Active at Home' programme can potentially benefit from small adaptions. Furthermore, future research is needed to examine whether the programme leads to more (cost-) effective home care.

SUBMITTER: Smeets RGM

PROVIDER: S-EPMC6916334 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Experiences of home-care workers with the 'Stay Active at Home' programme targeting reablement of community-living older adults: An exploratory study.

Smeets Rowan G M RGM Kempen Gertrudis I J M GIJM Zijlstra G A Rixt GAR van Rossum Erik E de Man-van Ginkel Janneke M JM Hanssen Whitney A G WAG Metzelthin Silke F SF

Health & social care in the community 20191006 1

To face the challenges of an ageing population, many Western countries nowadays stimulate an ageing in place policy to empower older adults to grow old in their own homes with the highest degree of self-reliance. However, many community-living older adults experience limitations in (instrumental) activities of daily living ((I)ADLs), which may result in a need for home-care services. Unfortunately, home-care workers often provide support by taking over tasks, as they are used to doing things for ...[more]

PMID: 31588655

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Project description:BACKGROUND:According to the principles of Reablement, home care services are meant to be goal-oriented, holistic and person-centred taking into account the capabilities and opportunities of older adults. However, home care services traditionally focus on doing things for older adults rather than with them. To implement Reablement in practice, the 'Stay Active at Home' programme was developed. It is assumed that the programme leads to a reduction in sedentary behaviour in older adults and consequently more cost-effective outcomes in terms of their health and wellbeing. However, this has yet to be proven. METHODS/ DESIGN:A two-group cluster randomised controlled trial with 12 months follow-up will be conducted. Ten nursing teams will be selected, pre-stratified on working area and randomised into an intervention group ('Stay Active at Home') or control group (no training). All nurses of the participating teams are eligible to participate in the study. Older adults and, if applicable, their domestic support workers (DSWs) will be allocated to the intervention or control group as well, based on the allocation of the nursing team. Older adults are eligible to participate, if they: 1) receive homecare services by the selected teams; and 2) are 65 years or older. Older adults will be excluded if they: 1) are terminally ill or bedbound; 2) have serious cognitive or psychological problems; or 3) are unable to communicate in Dutch. DSWs are eligible to participate if they provide services to clients who fulfil the eligibility criteria for older adults. The study consists of an effect evaluation (primary outcome: sedentary behaviour in older adults), an economic evaluation and a process evaluation. Data for the effect and economic evaluation will be collected at baseline and 6 and/or 12 months after baseline using performance-based and self-reported measures. In addition, data from client records will be extracted. A mixed-methods design will be applied for the process evaluation, collecting data of older adults and professionals throughout the study period. DISCUSSION:This study will result in evidence about the effectiveness, cost-effectiveness and feasibility of the 'Stay Active at Home' programme. TRIAL REGISTRATION:ClinicalTrials.gov: NCT03293303 , registered on 20 September 2017.

Project description:BackgroundPeople living with dementia at home are a group who are at increased risk of malnutrition. Health care professionals and home care workers, are ideally placed to support nutritional care in this vulnerable group. Yet, few, if any studies, have captured the experiences of these workers in respect of treating and managing nutritional issues. This interpretative phenomenological study aimed to explore the experiences and perceptions of the nutritional care of people living with dementia at home from the perspectives of health care professionals and home care workers.MethodsSemi-structured interviews were conducted between December 2017 and March 2018, and supplemented with the use of a vignette outlining a scenario of a husband caring for his wife with dementia. Health care professionals and home care workers were purposively recruited from local care providers in the south west of England, who had experience of working with people with dementia. An Interpretative Phenomenological Analysis (IPA) approach was used throughout.ResultsSeven participants took part including two home care workers, a general practitioner, dietitian, occupational therapist, nurse and social worker. The time in their professions ranged from 3 to 15?years (mean?=?8.9?years). Following analysis, four superordinate themes were identified: 'responsibility to care', 'practice restrained by policy', 'in it together', and 'improving nutritional care'. This group of health care professionals and home care workers recognised the importance of improving nutritional care for people living with dementia at home, and felt a responsibility for it. However they felt that they were restricted by time and/or knowledge. The importance of supporting the family carer and working collaboratively was highlighted.ConclusionsHealth care professionals and home care workers require further training to better equip them to provide nutritional care for people living with dementia at home. Models of care may also need to be adapted to enable a more flexible and tailored approach to incorporate nutritional care. Future work in this area should focus on how health care professionals and home care workers can be better equipped to screen for malnutrition, and support changes to nutritional intake to mitigate malnutrition risk.

Dataset Information

Experiences of home-care workers with the 'Stay Active at Home' programme targeting reablement of community-living older adults: An exploratory study.

Publications

Experiences of home-care workers with the 'Stay Active at Home' programme targeting reablement of community-living older adults: An exploratory study.

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