Mid Sweden University

Aim

To explore and describe older persons' unique experiences of care encounters with home care nurses in a real-life context.

Background

The increasing number of older persons in society contributes to increases in age-related impairments compromising their quality of life. Future care consists of “hospitals at home” where care encounters occur in a person's private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted.

Design

Multiple-case study.

Methods

The cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated.

Findings

The cross-analysis emerged in three categories: “Nursing routine rules the care encounters”, “Lack of knowledge and information” and “Dependency on support from others”.

Conclusions

Our research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person-centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time-sensitive care encounters.

Reporting Method

Findings were reported using COREQ guidelines.

Patient or Public Contribution

Patients were interviewed and contributed with data for this study.

Implications for the Profession and Patient Care

This study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality.

ABSTRACT Aim To explore and gain a deeper understanding of older persons' experiences of care encounters when their home becomes a workplace. Background Worldwide healthcare services are increasingly being provided in older persons' homes by registered nurses. This presents new challenges as the home environment of older persons now doubles as a workplace for healthcare professionals. However, there is limited research available on how older persons experience care encounters when their homes serve as workplaces and how this influences their overall well-being and quality of life. Design A qualitative hermeneutic study. Methods In-depth face-to-face interviews were conducted in Sweden from October 2023 to January 2024 with 10 purposefully selected older persons (aged 65+). Each participant received regular visits from a home care nurse in their home to address specific care needs, such as wound care, medication administration, blood sampling and general supervision. The interviews were audiotaped, transcribed verbatim and analysed using a hermeneutic interpretation. Findings The hermeneutic analysis emerged with one main theme: ?Experiencing care encounters at home as a lottery?, with two underlying themes: ?Adapting to loss of control in the private sphere? and ?Striving for independence while navigating daily living?. Conclusions Older persons try to control their lives despite the challenges associated with ageing and receiving care at home. They strive to maintain their independence and autonomy, which reflects their desire for self-determination. Supporting these efforts in an interdependent relationship can enhance their well-being and quality of life. Reporting Method Findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines. Patient or Public Contribution Data were collected by patient interviews. Implications for the Profession and Patient Care This study emphasises the importance of supporting older persons in maintaining control over their lives while being cared for in their homes. In the care encounters with home care nurses, their well-being and quality of life can be improved by respecting their autonomy, involving them in decision-making and offering tailored support.

Many ill people want to be cared for at home, and home care nurses face an infinite number of encounters when providing that service. Despite the rising prominence of home care organizations worldwide, little research has been conducted on the encounters between home care nurses and patients and how encounters influence the nursing care provided. The aim of the present study was to describe home care nurses’ experiences of encounters with patients in their homes. In total, 11 home care nurses were selected through purposive sampling. The data consisted of individual interviews, which were analyzed through qualitative content analysis, and reported using COREQ reporting guidelines. The results were based on two categories describing the importance of adapting to each patient's needs and collaborating with the person being cared for. Implementing the findings could enable nurses to care for the patients without reducing them to recipients of objectified care.

Purpose: nurses working in home care often encounter patients with multiple diagnoses in unpredictable environments. This may cause ethical and emotional challenges and influence nurses’ daily work. The aim of this study was to illuminate the meaning of nurses’ lived experiences of encountering patients in home care. Methods: narrative interviews were conducted with 11 nurses. These interviews were audiotaped and transcribed verbatim and analysed using a phenomenological hermeneutic approach. Findings: the findings are presented under three main themes: (1)”Being receptive to the other” (with subthemes “Caring about the encounter,” and “Establishing trusting relationships”). (2) “Need to handle Handling the unpredictable” (with subthemes “Being alone in the encounter” and “Being experienced and competent”). (3) “Managing frustration” (with subthemes “Feeling insufficient” and “Feeling restricted”. Having overall nursing responsibility challenged the nurse’s self-confidence in providing care trustfully. Conclusions: encountering patients in home care means relating to the other unconditionally, which aim to highlight patients’ needs. Being a nurse in home care is both emotionally demanding and rewarding. Having the courage to face their own and the patients’ vulnerabilities will entail the promotion of natural receptivity and responsiveness to patients’ needs.