HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester
More good days at home: Advancing health promoting practices in municipal healthcare services for older recipients of home care
Alternative title: Flere gode dager hjemme: Styrke helsefremmende praksis i kommunale helse- og omsorgstjenester til eldre som mottar tjenester i hjemmet
Popular Science Summary: “HEIME”
An increasing number of elderly people need healthcare. This adds pressure on the municipality’s 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 most 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 moregooddays at home, and to support their families in helping them to do so. The project aims 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. Frailty and sensory loss are factors that affect the quality of life of the elderly and their ability to remain in their own homes and will therefore have a particular focus.
The project consists of three partial studies. Sub-studies I and II developed knowledge about what the older persons themselves and relatives experience as important in order to have moregooddays at home. In sub-study III, knowledge was developed about simulation and training with healthcare professionals for systematic interdisciplinary assessment of the health and health needs of elderly people living at home. Furthermore, in sub-study III, the implementation of interdisciplinary health assessments and the initiation of measures in practice in municipal health and care services were examined.
Sub-study I explores the health significance of living in one’s own home, how elderly recipients of home nursing services perceive the importance of the home from a health-promoting perspective, and what elderly recipients of home nursing services themselves consider important for promoting moregooddays at home. Interviews with a narrative approach have been conducted. Preliminary findings suggest that being able to live in one’s own home promotes independence, autonomy, identity and self-confidence. Living in one’s own home is also closely linked to various ways of being active, both physically and mentally. The preliminary findings further indicate that the support the elderly receive, both formally and informally, is crucial to ensure that the home environment promotes health.
Sub-study II explores the experiences of spouses and adult children as caregivers for older persons living at home and receiving home nursing services. The aim is to gain knowledge about factors that promote the health of caregivers in their role. Interviews with a narrative approach have been conducted with spouses and adult children, as well as observations of the interaction between spouses and healthcare professionals in the elderly persons’ home. Preliminary findings from the study with spouses suggest that men and women have different care and coping strategies, which necessitates different approaches and support from healthcare services in their caregiving role.
Sub-study III explores how simulation can be used to train healthcare personnel in performing systematic interdisciplinary assessments of the health of elderly people living at home, in order to implement measures to maintain health. It explores how systematic interdisciplinary health assessments, and the implementation of measures can be carried out in municipal health and care services. Additionally, it investigates the participants’ perspectives on participating in the assessments. Interdisciplinary simulation training has been conducted with healthcare personnel, and the health of elderly people living at home has been assessed by interdisciplinary teams. Perspectives on conducting and participating in the assessments have been collected through interviews. Preliminary findings show that simulation is an appropriate method for interdisciplinary training in assessing the health of elderly people living at home. Systematic interdisciplinary assessments are feasible in practice and help to identify health needs among the elderly living at home.
Watch the project film using the link: https://www.usn.no/eldreforsk/heime/
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 moregooddays 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.