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Supporting independence at home for people living with dementia: a qualitative ethnographic study of homecare.

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Title: Supporting independence at home for people living with dementia: a qualitative ethnographic study of homecare.
Authors: Leverton, Monica (AUTHOR), Burton, Alexandra (AUTHOR), Beresford-Dent, Jules (AUTHOR), Rapaport, Penny (AUTHOR), Manthorpe, Jill (AUTHOR), Azocar, Ignacia (AUTHOR), Giebel, Clarissa (AUTHOR), Lord, Kathryn (AUTHOR), Cooper, Claudia (AUTHOR)
Source: Social Psychiatry & Psychiatric Epidemiology. Dec2021, Vol. 56 Issue 12, p2323-2336. 14p.
Subjects: Dementia, Medical personnel, Qualitative research, Information technology, Home environment
Abstract: Purpose: The aim of this ethnographic study was to investigate how homecare workers support or inhibit independence in people living with dementia. Methods: We undertook 100 h of participant observations with homecare workers (n = 16) supporting people living with dementia (n = 17); and 82 qualitative interviews with people living with dementia (n = 11), family carers (n = 22), homecare managers and support staff (n = 11), homecare workers (n = 19) and health and social care professionals (n = 19). We triangulated data and analysed findings thematically. Results: We developed three themes: (1) independence and the home environment, highlighting ongoing negotiations between familiarity, suitability and safety for care; (2) independence and identity, exploring how homecare workers' understanding of their clients' identity can enable active participation in tasks and meaningful choices; and (3) independence and empowerment, considering the important position of homecare workers to advocate for clients living with dementia while navigating authoritative power amongst proxy decision-makers. Conclusion: We consider that person-centred care should also be home-centred, respecting the client's home as an extension of self. Homecare workers can use their understanding of clients' identities, alongside skills in providing choice and developing relationships of interdependence to engage clients in everyday tasks. Homecare workers are well placed to advocate for their client's voice within the care network, although their ability to do so is limited by their position within power structures. [ABSTRACT FROM AUTHOR]
Copyright of Social Psychiatry & Psychiatric Epidemiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Supporting independence at home for people living with dementia: a qualitative ethnographic study of homecare.
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  Data: <searchLink fieldCode="JN" term="%22Social+Psychiatry+%26+Psychiatric+Epidemiology%22">Social Psychiatry & Psychiatric Epidemiology</searchLink>. Dec2021, Vol. 56 Issue 12, p2323-2336. 14p.
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  Data: <searchLink fieldCode="DE" term="%22Dementia%22">Dementia</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+personnel%22">Medical personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br /><searchLink fieldCode="DE" term="%22Information+technology%22">Information technology</searchLink><br /><searchLink fieldCode="DE" term="%22Home+environment%22">Home environment</searchLink>
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  Data: Purpose: The aim of this ethnographic study was to investigate how homecare workers support or inhibit independence in people living with dementia. Methods: We undertook 100 h of participant observations with homecare workers (n = 16) supporting people living with dementia (n = 17); and 82 qualitative interviews with people living with dementia (n = 11), family carers (n = 22), homecare managers and support staff (n = 11), homecare workers (n = 19) and health and social care professionals (n = 19). We triangulated data and analysed findings thematically. Results: We developed three themes: (1) independence and the home environment, highlighting ongoing negotiations between familiarity, suitability and safety for care; (2) independence and identity, exploring how homecare workers' understanding of their clients' identity can enable active participation in tasks and meaningful choices; and (3) independence and empowerment, considering the important position of homecare workers to advocate for clients living with dementia while navigating authoritative power amongst proxy decision-makers. Conclusion: We consider that person-centred care should also be home-centred, respecting the client's home as an extension of self. Homecare workers can use their understanding of clients' identities, alongside skills in providing choice and developing relationships of interdependence to engage clients in everyday tasks. Homecare workers are well placed to advocate for their client's voice within the care network, although their ability to do so is limited by their position within power structures. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Social Psychiatry & Psychiatric Epidemiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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