No Place Like Home: A Systematic Review of Home Care for Older Adults in Canada

Johnson, Shanthi; Bacsu, Juanita; Abeykoon, Hasanthi; McIntosh, Tom; Jeffery, Bonnie; Novik, Nuelle

doi:10.1017/s0714980818000375

Cited by 67 publications

(43 citation statements)

References 59 publications

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“…In other words, as Golant (2015, p.356) advocated, we need to adopt an “it takes a village” perspective. Nevertheless, consistent with previous studies ( Johnson et al, 2018 ; Kadowaki, Wister, & Chappell, 2015 ), publicly supported long-term home care – especially for maintenance and prevention purposes, such as home support services and physiotherapy – was still unavailable for many of our participants. Our study adds further contextual evidence to Canada's need for the publicly supported long-term home care system many have advocated over the past decade ( Canadian Home Care Association, 2016 ; Gilmour, 2018 ; Kadowaki et al, 2015 ; Special Senate Committee on Aging, 2009 ; Turcotte, 2014 ).…”

Section: Discussionsupporting

confidence: 86%

“…As more and more older adults age in place, their homes and communities increasingly become locations for health and social care services (hereafter “home care”). Since long-term home care is not universally insured under the Canada Health Act, older adults who don't qualify need to resort to community agencies that often require a co-payment or privately hire help ( Armstrong, Zhu, Hirdes, & Stolee, 2015 ; Gilmour, 2018 ; Government of Ontario, 2019 ; Johnson et al, 2018 ; Lee, Barken, & Gonzales, 2018 ). According to the 2015/2016 Canadian Community Health Survey, over one-third (35.4%) of people with home care needs did not have their needs met, especially among those with home support services for maintenance of daily living ( Gilmour, 2018 ).…”

Section: Literature Reviewmentioning

confidence: 99%

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“Fiercely independent”: Experiences of aging in the right place of older women living alone with physical limitations

Narushima

Kawabata

2020

Journal of Aging Studies

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This study explores the experience of aging among older Canadian women with physical limitations who live by themselves. While aging in place has been a policy priority in rapidly greying Canada, a lack of complementary public supports poses challenges for many older adults and their family members. Employing a qualitative methodology, and drawing from the notion of aging in the right place , we collected personal narratives of 12 women (aged 65 to 92) in two geographic areas in Ontario, including residents of regular houses, apartments, condominiums, assisted living and community housing for seniors. Through thematic analysis, we identified four overarching themes: 1) striving to continue on “at home”, 2) living as a “strong independent woman”, 3) the help needed to support their “independence”, and 4) social activities to maintain self. Our findings illustrate how, despite their mobility limitations, older women can change their residential environment and their behavior by deploying the coping strategies and resources they have developed over time. However, we also found that older women are largely silent about their needs, and that experiences varied depending on life histories, health conditions, and the availability of supports in their wider environment (home care, alternative housing options, accessible transportation, opportunities for social and physical activities). We hope these findings will incite further studies and discussion to help make aging in the right place a real choice for anyone who wishes to do so.

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Section: Discussionsupporting

confidence: 86%

Section: Literature Reviewmentioning

confidence: 99%

“Fiercely independent”: Experiences of aging in the right place of older women living alone with physical limitations

Narushima

Kawabata

2020

Journal of Aging Studies

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“…on Open access care providers [4][5][6] and experience of informal home care providers under non-emergency health situations. 7 8 During the COVID-19 pandemic, in an attempt to reduce the surge of patients requiring hospital care, many countries have implemented epidemic control measures 9 to limit activities outside the home such as closure of nonessential services.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and well-being of urban informal home care providers during COVID-19 pandemic: a population-based study

et al. 2020

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ObjectivesGlobally, the COVID-19 pandemic has overwhelmed many healthcare systems, which has hampered access to routine clinical care during lockdowns. Informal home care, care provided by non-healthcare professionals, increases the community’s healthcare capacity during pandemics. There is, however, limited research about the characteristics of informal home care providers and the challenges they face during such public health emergencies.DesignA random, cross-sectional, population-based, RDD, telephone survey study was conducted to examine patterns of home care, characteristics of informal home care providers and the challenges experienced by these care providers during this pandemic.SettingData were collected from 22 March to 1 April 2020 in Hong Kong, China.ParticipantsA population representative study sample of Chinese-speaking adults (n=765) was interviewed.Primary and secondary outcome measuresThe study examined the characteristics of informal home care providers and self-reported health requirements of those who needed care. The study also examined providers’ self-perceived knowledge to provide routine home care as well as COVID-19 risk reduction care. Respondents were asked of their mental health status related to COVID-19.ResultsOf the respondents, 25.1% of 765 provided informal home care during the studied COVID-19 pandemic period. Among the informal home care providers, 18.4% of respondents took leave from school/work during the epidemic to provide care for the sick, fragile elderly and small children. Care providers tended to be younger aged, female and housewives. Approximately half of care providers reported additional mental strain and 37.2% reported of challenges in daily living during epidemic. Although most informal home care providers felt competent to provide routine care, 49.5% felt inadequately prepared to cope with the additional health risks of COVID-19.ConclusionDuring public health emergencies, heavy reliance on informal home healthcare providers necessitates better understanding of their specific needs and increased government services to support informal home care.

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“…Several studies have shown that institutionalization may be associated with adverse outcomes such as depression, lower quality of life, an increase in the use of medication and a rise in mortality [3][4][5][6][7][8]. Policy makers are therefore keen to foster community care and long-term care policies are shifting to allow older persons to remain in their homes for as long as possible, avoiding early nursing home admission [9][10][11][12][13][14]. According to a WHO-report (2009), an appropriate balance between care settings for older persons' care is necessary, including supported self-care and home-based services.…”

Section: Introductionmentioning

confidence: 99%

Comparing the case-mix of frail older people at home and of those being admitted into residential care: a longitudinal study

Mello¹,

Cès

Vanneste³

et al. 2020

BMC Geriatr

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Background: In order to optimize interventions and services in the community, it is important to identify the profile of persons who are able to stay at home and of those who are being admitted into residential care. Understanding their needs and their use of resources is essential. The main objective of the study is to identify persons who are likely to enter residential care based upon their needs and resource utilization, so that care providers can plan interventions effectively and optimize services and resources to meet the persons' needs. Methods: This is a longitudinal quasi-experimental study. The data consists of primary data from the community setting collected every six months during the period of 2010-2016. Interventions had the goal of keeping older people longer at home. Participants were at least 65 years old and were living in the community. The interRAI Resource Utilization Group system (RUG-III) was used to calculate the case-mix indexes (CMI) of all participants. Comparisons were made between the case-mix of those who were still living at home and those who were admitted into residential care at follow-up. Results: A total of 10,289 older persons participated in the study (81.2 ± 7.1 yrs., 69.1% female). From this population, 853 participants (8.3%) were admitted into residential care. The CMI of the persons receiving night care at home were the highest (1.6 at baseline and 1.7 at the entry point of residential care), followed by persons receiving occupational therapy (1.5 at baseline and 1.6 at the entry point of residential care) and persons enrolled in case management interventions with rehabilitation (1.4 at baseline and 1.6 at the entry point of residential care). The CMIs at follow-up were significantly higher than at baseline and the linear regression model showed that admission to residential care was a significant factor in the model.

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No Place Like Home: A Systematic Review of Home Care for Older Adults in Canada

Cited by 67 publications

References 59 publications

“Fiercely independent”: Experiences of aging in the right place of older women living alone with physical limitations

“Fiercely independent”: Experiences of aging in the right place of older women living alone with physical limitations

Characteristics and well-being of urban informal home care providers during COVID-19 pandemic: a population-based study

Comparing the case-mix of frail older people at home and of those being admitted into residential care: a longitudinal study

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