Invisible cornerstones. A hermeneutic study of the experience of care partners of older people with mental health problems in home care services

Abstract

Objectives To explore the lived experiences and support needs of the care partners of older people with mental health problems living at home with assistance from home care services. Care partners face significant challenges in their care role and they often feel unsupported. An understanding of their experiences may help improve home care to support their needs. Method An exploratory qualitative approach was used. The study is based on the SRQR and COREQ reporting guidelines. In‐depth interviews were conducted with six Norwegian care partners from two municipalities. Data were collected during 2012–2013 and 2016. The data were analysed using Gadamer's hermeneutics. Results Three themes were identified: “invisible cornerstones,” “dimensions of collaboration” and “unwanted roles.” Conclusion Few or no routines for collaboration exist between care partners and home care, and the care partners seem to have little knowledge of legal rights. They request more information, spare time and the opportunity to remain in their original family role. However, their main focus is for the patient to receive the necessary help from home care. Home care have restricted resources for meeting these needs and share a sense of powerlessness and lack of influence over their own everyday life with the care partners. There is a need for a systematic, person‐centred approach to collaboration. A correlation is necessary between what is communicated at the system level and the means of realising this in practice for home care to meet care partners' needs.

Informal caregivers and assistive technology in Norwegian nursing homes

“…A metasynthesis by Tranvåg et al [ 36 ] describes that formal caregivers need to ensure that each person’s essential needs are met and their dignity is protected. In the fulfilment of this, informal caregivers are crucial collaborators [ 20 , 37 ].…”

“…Further, some informal caregivers discovered new AT installations that they had not been notified of in advance, that were supposed to create security but instead created more insecurity. This is in stark contrast to person-centred ideals, where a core value is that the person must come first [ 38 ]–a principle that embraces the patient, the informal caregiver and the staff [ 18 ].…”

“…The inclusion of informal caregivers can be an essential component in order to facilitate the introduction of AT for a person with dementia [ 17 ]. Enabling informal caregivers’ involvement in AT, however, requires an organisation and care culture that is underpinned by person-centred values, where the informal caregivers are empowered to contribute according to individual wishes, and are seen as partners and not just a mean to achieve goals [ 18 , 19 ]. In many cases, the informal caregivers can provide important information about the patient’s wishes, hopes and preferences, especially in cases where the patient is unable to express these on their own, both in general [ 20 ] and more specifically concerning the use of AT.…”

But is It Hermeneutic Enough?: Reading for Methodological Salience in a Scoping Review of Hermeneutics and Implementation Science

“…For example, the authors of one study of experiences of family carers (Anker-Hansen et al, 2019) stated their "inquiry was framed by Gadamer's philosophical perspective on hermeneutics" (p. 4) and gave a brief outline of Gadamer's ideas. However, in their findings section, they organized interview data into themes, sub-themes, and finally "meaningful units" (p. 4) which simply served as ways of labelling similar points expressed across the interviews.…”

Collaboration between home care staff, leaders and care partners of older people with mental health problems: a focus on personhood

“…It has been stated that municipalities should offer individually tailored support, relief, training and guidance to care partners , but research suggests that both older people with mental health problems and their care partners receive poor attention from the municipal healthcare system . Research also shows that home cares services do not involve care partners sufficiently: there is a lack of communication, and few or no routines for collaboration exist between home care and care partners of older people with mental health problems .…”