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Relationships first: Formal and informal home care of older adults in Sweden
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
Jönkoping Univ, Sch Hlth & Welf, Dept Nat Sci & Biomed, Jönkoping, Sweden.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
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2022 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524Article in journal (Refereed) Epub ahead of print
Abstract [en]

To a great extent, older people in Sweden, often with extensive care needs, are cared for in their own home. Support is often needed from both family and professional caregivers. This study aimed to describe and analyse different aspects of health, functioning and social networks, and how they relate to formal and informal care in the home among older adults. Analyses were performed utilising data from the OCTO-2 study, with a sample of 317 people living in Jonkoping County, aged 75, 80, 85 or 90 years, living in their own homes. Data were collected with in-person-testing. Based on receipt of care, the participants were divided into three groups: no care, informal care only, and formal care with or without informal care. Descriptive statistics and multinomial regression analysis were performed to explore the associations between received care and different aspects of health (such as multimorbidity, polypharmacy), social networks (such as loneliness, number of confidants) and functioning (such as managing daily life). The findings demonstrate that the majority of the participants received no care at home (61%). Multimorbidity and polypharmacy were more common among those receiving some kind of care in comparison to those who received no care; moreover, those receiving some kind of care also had difficulties managing daily life and less satisfaction with their social networks. The multinomial logistic regression analyses demonstrated that age, functioning in daily life, perceived general health and satisfaction with the number of confidants were related to receipt of care, but the associations among these factors differed depending on the type of care that was received. The results show the importance of a holistic perspective that includes the older person's experiences when planning home care. The results also highlight the importance of considering social perspectives and relationships in home care rather than focusing only on health factors.

Place, publisher, year, edition, pages
2022.
Keywords [en]
community, family caregiving, health and social care, health care, home care, informal care, older people, PEOPLE, HEALTH, LIFE
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-27717DOI: 10.1111/hsc.13765ISI: 000772823500001Scopus ID: 2-s2.0-85127257006OAI: oai:DiVA.org:hb-27717DiVA, id: diva2:1649644
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden, 13282Available from: 2022-04-04 Created: 2022-04-04 Last updated: 2022-04-12Bibliographically approved
In thesis
1. Delad utsatthet: Vård i hemmet ur äldre människors, anhörigas och professionella vårdares perspektiv
Open this publication in new window or tab >>Delad utsatthet: Vård i hemmet ur äldre människors, anhörigas och professionella vårdares perspektiv
2020 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of the thesis was to deepen the knowledge about home care from the perspective of older people, family caregivers, and professional caregivers.

Approach and method: A lifeworld approach was used to describe different experiences of home care. Lifeworld interviews were performed in three studies, and analyses were conducted according to different methodological principles. Study I describes the meaning of home care from the perspective of older people who live alone, including interviews with 12 participants analyzed with qualitative content analysis. Study II describes the life situation in which responsibility for an older person is imposed upon family caregivers. Ten interviews were conducted and analyzed using a phenomenological method. Study III, using phenomenography, describes perceptions of caring responsibility based on interviews with 14 professional caregivers. Study IV explores health and social network factors related to receiving care in the home among older adults (n = 317). Descriptive statistics and regression analyses were conducted. Finally, a synthesis was carried out and interpreted with a philosophical analysis in order to support the understanding of home care from different perspectives as a whole.

Main results: Becoming older with increased caring needs disrupts one’s life when the private home becomes a public arena. The older person needs to adapt to a caring culture, but they are often unable to influence their care and must deal with forced relations. Family caregivers assume a great responsibility that changes and interferes with their whole life situation and impacts their health and relationships. Professional caregivers are also affected to a great extent, as the burden is high. Responsibility is perceived as limitless, constrained by time, moral, overseeing, meaningful and lonesome. To be cared for in one’s own home is complex from both a medical and psychosocial perspective. The results also give an indication of the importance of relationships and increasing awareness of the social perspectives of home care.

Conclusion: This thesis contributes to the existing knowledge of how home care can be experienced from the perspectives of older people, family caregivers and professional caregivers in order to provide good and safe home care based on individual needs. Home care as a phenomenon is complex—it entails a vulnerable situation for the older person, the family caregivers, and professional caregivers. The results show the importance of a holistic perspective that includes individual experiences. They also highlight the importance of considering social perspectives and relationships in home care rather than merely focusing on medical and/or functional factors.

Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2020
Series
Skrifter från Högskolan i Borås, ISSN 0280-381X ; 113
Keywords
home care, older people, family caregivers, informal care, formal care, professional caregivers, health, lifeworld.
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-23848 (URN)978-91-88838-95-7 (ISBN)978-91-88838-96-4 (ISBN)
Public defence
2020-12-04, M404, Sandgärdet, Borås, 09:30 (Swedish)
Opponent
Supervisors
Note

Disputationen sänds via videolänk, förinformation se kalendariet på hb.se/forskning.

Available from: 2020-11-13 Created: 2020-09-24 Last updated: 2022-04-12Bibliographically approved

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Jarling, AleksandraRydström, IngelaNyström, MariaDalheim Englund, Ann-Charlotte

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