More good days at home: Advancing health promoting practices in municipal healthcare services for older recipients of home care

An increasing number of older people need professional care. This adds pressure on the municipals? healthcare service resources. It is therefore vital to organize services that can provide adequate help for older persons and are sustainable for the society. One way is to promote measures that enable older persons to stay longer at home and enabling family caregivers to maintain care. This appears to be a shared goal between the majority of older people and the health authorities. The overall aim of the project is to strengthen health-promoting practices to enable recipients of homecare to have more good days at home, and to support their families in helping them to do so. The project will apply qualitative interviews and IPLOS register data to develop knowledge of what characterise recipients of home care, and what older people themselves and their family consider important to have more good days at home. This includes factors influencing their health, well-being, and interactions with the care services, and how the home setting is perceived as health-promoting. Frailty and sensory loss are factors that affect older people?s quality of life and opportunity to remain living at home and will have a special focus. It is a goal to increase health literacy among older persons, relatives and health professionals. Adequate health literacy will strengthen the capacity to make responsible, appropriate health decisions and support remaining at home. The project will explore interprofessional simulation training to improve health literacy and teach health care professionals to perform systematic assessments of health (frailty and sensory loss) and implement measures to postpone further functional decline. Further, the project will investigate the feasibility of the simulation training approach to provide robust, integrated, and sustainable municipal home health care services to enable more good days at home.

The population of older people is rapidly increasing worldwide as well as in Norway. A growing number of older persons are in need of professional health care, which put a massive strain on municipal finance and workforce. A present and future challenge is to provide adequate health and care services to older persons. It is imperative to organize the services in a manner that is both adequate for the older persons in need of help and sustainable for society. A way to ensure this is to facilitate and promote measures allowing the older persons to have more good days at home. This is in accordance with the wishes of the older persons themselves, and it is a health political goal. A guiding principle in this area, and for this project, is health promotion. Accordingly, enabling the older person, their family caregivers and the healthcare professionals in obtaining health literacy and to actively engage with health determinants and their influence over quality of life is of great importance. It is a need for improved knowledge on what determines the transition process from home to residential care, as well as what can be done to postpone this transition. Studies suggest a need for strengthening interprofessional collaboration and systematic frameworks. One area of importance is a call for improving workforce competencies in assessing and acting upon indications of functional decline such as cognitive and sensory impairments and frailty. It is also a call for better collaboration and support for family caregivers, cooperation, and interplay among the health care personnel. The project addresses the knowledge gaps outlined by applying both qualitative and quantitative approaches. As there is a pressing need to transfer the insights from the study, the study will test and assess an interprofessional simulation intervention to train the health care personnel with a goal to improve adequate measurements and enhance communication skills to improve health literacy.