Differences in Home-Care Services in Finland for Older Adults between 2012 and 2019 - A Developmental Evaluation Study.

This study aimed to evaluate differences in client-centered approaches to home-care services for older adults from the perspectives of nurses and service managers in Finland. The research method used developmental evaluation. Developmental activities for client-centered services were implemented in three home-care organizations between 2012 and 2019. Home care nurses and service managers were interviewed individually and in groups at the beginning and end of the development process. Then, four categories of differences enabling operating models in client-centered care were identified: modernized client-centered service patterns, comprehensive service coordination, digital service environments technology utilization, and changing human resources. This study found a positive trend in adopting a client-centered approach and technology in home care services. In the implementation of home care practices, innovations for client-centered implementation of homecare should consider the renewal of service models, development of case management, and development and utilization of technology in homecare operating environments.

A client-centered approach in home care for older persons - an integrative review.

OBJECTIVE: To describe and synthesize client-centered care and service in home care for older persons. METHODS: The study was an integrative review using the guidelines for literature reviews by the Joanna Briggs Institute. The research process followed the Whittemore and Knafl framework and PRISMA toolkit in the selection of eligible articles. The CINAHL, Medline, Scopus, Web of Science and Social Sciences abstracts were searched for articles published between January 2007 and May 2020 according to previously designed search strategies. In total, 24 articles were deemed relevant for an analysis using a thematic analysis. RESULTS: The analysis resulted in four themes with sub-themes which revealed that client-centered care and service in home care consist of: 1) Clients' involvement in their own care; self-care, decision-making, satisfactory daily life, 2) Family members' and care partners' participation in care; family members' and care partners' commitment to care, family members' and care partners' competence in care, 3) Communication and co-operation; communication models, empowerment, partnership, and 4) Evidence-based service competence; delivery and organization of services, implementation of services, versatile clinical skills, quality outcomes and personnel wellbeing. CONCLUSIONS: According to the results, achieving client-centered care and service in home care requires the realization of all of the above aspects. The practice of nursing must better identify all dimensions of client-centered care and take these into account in the delivery of home care services. KEY POINTS Client-centeredness is a fundamental value and the basis of nursing and care in home care provided for older persons This paper: deepens and structures the concept of client-centered care in the context of home care. assists professionals to understand the factors behind client-centered care within the home care environment. provides deeper understanding of the roles of the older person, family members, and the service system in developing client-centered services in home care for older persons.

Home care services for older persons. The views of older persons and family members: A realistic evaluation.

AIMS AND OBJECTIVES: The aim of the present study was to evaluate client-centred care in older persons' home care services from the perspective of older persons and family members. The following research questions were addressed: How do home care older persons and family members perceive client-centered care in their home care services? What kind of social mechanisms are realized when home care services are implemented? BACKGROUND: Several older persons are dependent on home care services for their continued living at home. The fundamental value and best practice of home care is the client-centred care in services. METHOD: The research method was realistic evaluation. Six families with six older person clients of home care and seven family members were interviewed. In the present study, the interview contained three themes (1) content and services of the home care, (2) activities and practices of the home care and (3) development of client centredness in home care. Research data were analysed with deductive content analysis. RESULTS: Home care service should be based on analysis of older person's individual life situation. Social mechanisms such as interaction, participation, trust and adaptation are realised in implementation of home care services. The most significant outcomes of client-centred service were timely availability of services, safe care relationship and continuity of care, ability to influence on own services and appropriate price of services. Significant factors in quality of service were unhurriedness, kindness and competence of professionals. IMPLICATION FOR PRACTICE: Social mechanisms, such as participation, trust, adaptation and interaction, should be taken in account in care relationship in home care. Client centredness and methods for evaluating it should be defined in practical work. Client-centeredness competence should also be included in all stages of professional education of home care.