Aim: The overall aim of this thesis is to deepen the understanding of caring relationships in homecare for older adults by exploring the lived experiences of older adults and homecare nurses. 

Approach and method: The first study was a meta-ethnography aimed at identifying and synthesising qualitative studies focusing on older adults’ and homecare nurses’ interpretations of competence in homecare. Drawing on this study, the remaining three studies describe experiences and dimensions of caring relationships in homecare for older adults using a reflective lifeworld research approach. Study II describes the essential meaning of caring relationships based on the lived experiences of homecare nurses in Denmark, including 10 lifeworld interviews analysed using a phenomenological life-world analysis. Study III describes the essential meaning of caring relationships from the perspectives of older adults in Denmark, based on 10 lifeworld interviews; these are analysed using phenomenological lifeworld analysis. Building on the findings from Study III and Jarling et al., 2018, Study IV seeks to describe the existential dimensions of caring relationships in homecare for older adults in Denmark and Sweden. This resulted in the development of a general structure, which was further enriched through a philosophical examination. 

Main results: Collectively, the different experiences and dimensions of the phenomenon of the caring relationship in homecare are shaped by the physical caregiving meetings and the existential and embodied space that is ‘the home’. This intertwinement highlights the profound ethical and existential aspects that so closely link the notion of the home to the caring relationships that occur within it, by linking the relational aspects of being cared for in one’s own home with the experience of relationships that originate from what is culturally and traditionally experienced within the home. Across the studies (I–IV), the findings uncover the essential meanings of caring relationship in homecare, revealing the deeply embedded nature of caring as a question of existential value; namely of freedom and at-homeness.

Purpose

The aim of this study is to describe the essential meaning of the phenomenon of caring relationships in home care for older adults in Denmark, based on their lived experiences of caring relationships with home care nurses.

Methods

Ten older adults receiving home care from registered nurses were interviewed, and a phenomenological analysis was conducted according to the methodological principles of the reflective lifeworld research approach.

Results

The essential meaning of the phenomenon is described as “being in an in-between state in which one's existential freedom is enabled or restricted”. This involves being forced to relate and adapt to home care nurses as freedom givers or freedom takers. This is explored further in the three constituents; Space for authenticity and vulnerability, creating conditions for existential freedom, and being in an in-between space between knowing and not knowing.

Conclusions

The phenomenon of caring relationships adds an important aspect to understanding well-being in home care for older adults. To live well in old age, existential concerns must be placed at the core of caring and older adults must be given the possibility to act freely and authentically in order not to feel like an object of care.

Aim

The aim of this meta-ethnography was to identify and synthesize qualitative studies focusing on older people’s and registered nurses’ interpretations of competence in home care. 

Methods

The meta-ethnography followed the six phases developed by Noblit and Hare (1988). 

Results

In Phase 6, the translation process of the included studies, three themes were identified: i) temporality—the feeling of being of value; ii) dignity—a person, not just a patient; and iii) mutuality of being—togetherness. A synthesis was developed, and the phrase “a becoming in the meeting” emerged. 

Conclusion

The sense of becoming includes progress, which means becoming something other than before in relation with others and refers to what constitutes the meeting between the older person and the registered nurse working in home care. Competence originates from becoming in the meeting, and registered nurses should therefore value what they do and hold on to this aspect of caring competence that centres on a caring relationship. It is important for registered nurses working in home care to be able to cultivate a caring relationship.

Background: This paper describes registered nurses' lived experiences of caring relationships in the context of homecare provision for older adults living in Denmark. With the growing ageing population throughout Europe, more older adults will require complex care solutions within already overburdened care systems. This development places demands on the competencies and organisation of homecare nurses, as they become key players in healthcare systems. Fostering caring relationships in homecare is a rewarding and valuable process that enhances the holistic and humanising aspects of caring for older adults. For a caring relationship to be truly caring, we must understand not only the subjective experience of such a relationship but also how it is experienced in relation to and shared with others. Aim: This study aimed to describe the essential meaning of the phenomenon of caring relationships in homecare for older adults based on the lived experiences of homecare nurses. Approach and Methods: Registered nurses working in homecare for older adults were interviewed, and a phenomenological analysis was conducted according to the methodological principles of the reflective lifeworld research approach. Findings: The essential meaning of the phenomenon is described as creating an existential and embodied space in which each patient's world is the foundation of caring. The constituents are as follows: caring for the whole person, a sense of ‘at-homeness’ through trusting ‘the other’, experiencing continuity as caring and prioritising the time to care. Conclusion: Caring competence in homecare for older adults relies on a nurse's ability to intertwine physical and existential care needs and articulate them in their daily work. A focus on the phenomenon of caring relationships brings value to and adds an extra layer to the discussion on caring competence.