Adequacy of care provision in long‐term home nursing arrangements: A triangulation of three perspectives

Abstract

Background A growing proportion of older people in Germany receive long‐term care from informal and professional caregivers at home. Their personal assessment of the individual care situation is scarcely considered. Aim This study aimed to explore the subjective views of care recipients, informal and professional caregivers on the adequacy of care provision in long‐term home care arrangements. Design and Methods Qualitative semi‐structured face‐to‐face interviews were conducted with ten care recipients, ten professional caregivers and eight informal caregivers to capture their perspectives on the adequacy of the care received and delivered. Qualitative content analysis was applied using MAXQDA software. Results All groups highlighted that they perceive an underprovision of care, even though their explanations differed. The underprovision was mainly described regarding the quality rather than quantity of services. It occurs especially in interpersonal relationships and social inclusion, where the gap between the self‐perceived current situation and the desires of those affected is most prominent. The ambivalent impact of home care on social participation becomes apparent. Perceptions of an overprovision of care range from the view that it appears mainly with respect to informal care to the statement that it is currently non‐existent or generally impossible. Misprovision of care is experienced as serious whenever the interviewees face the challenge of preserving existing abilities or regaining certain skills.

Discrepancies between self‐ and proxy‐rated quality of life in people living with dementia

“…On the other hand, caregivers may underestimate the PlwD abilities because their care focuses less on supporting the independence of the PlwD and is rather based on completing care tasks as efficiently as possible 18 . In a qualitative study about the adequacy of long‐term care provision, care recipients reported a feeling of overprotection and overprovision by their informal caregivers, assuming they do not fully understand what PlwD can do on their own 39 . The different response behavior may also be caused by differences in the interpretation of the EQ‐5D‐5L's dimensions.…”

“… 18 In a qualitative study about the adequacy of long‐term care provision, care recipients reported a feeling of overprotection and overprovision by their informal caregivers, assuming they do not fully understand what PlwD can do on their own. 39 The different response behavior may also be caused by differences in the interpretation of the EQ‐5D‐5L's dimensions. Lay et al.…”

Nurse assistants' experiences and knowledge of how they create a meaningful daily life for older persons receiving municipal home healthcare

“…In this study, NAs not knowing the older person became an obstacle to a meaningful daily life. An additional obstacle was the NAs lacking time to talk or create a relationship, which is found in the other studies within the project [11, 21, 22, 24–26] as well as in others, where lack of time entails insufficient care [41]. However, discussing lack of time can often create a defence or continue a tradition and culture about lack of time.…”

Informing existing Technology Acceptance Models: A qualitative Study with older Persons and Caregivers

“…As the world population is growing older, the number of older persons in need of care is ever increasing, expecting to cross the threshold of 16% of the world population by 2050 (United Nations Department of Economic and Social Affairs, 2022). At the same time, professionals who are willing to do caregiving work are becoming increasingly scarce (Santos & Miguel, 2020;Seidlein et al, 2020) and informal caregivers become overburdened and distressed (Syse et al, 2022). To remedy the growing imbalance between older persons in need of care and available care, research is turning towards new technologies.…”