Supporting Older People to Live Safely at Home – Findings from Thirteen Case Studies on Integrated Care Across Europe

Abstract

Introduction: While many different factors can undermine older people's ability to live safely at home, safety as an explicit aspect of integrated care for older people living at home is an underexplored topic in research. In the context of a European project on integrated care, this study aims to improve our understanding of how safety is addressed in integrated care practices across Europe. Methods: This multiple case study included thirteen integrated care sites from seven European countries. The Framework Method guided content analyses of the case study reports. Activities were clustered into activities aimed at identifying and managing risks, or activities addressing specific risks related to older people's functioning, behaviour, social environment, physical environment and health and social care receipt. Results: Case studies included a broad range of activities addressing older people's safety. Although care providers felt they sufficiently addressed safety issues, older people were often concerned and insecure about their safety. Attention to the practical and social aspects of safety was often insufficient. Conclusions and discussion: Integrated care services across Europe address older people's safety in many ways. Further integration of health and social care solutions is necessary to enhance older people's perceptions of safety.

Typology of Family Support in Home Care for Iranian Older People: A Qualitative Study

“…Falls are a highly prevalent problem among older people due to slipping, poor lighting [ 45 ], and age-inappropriate home design [ 46 ]. Therefore, measures should be taken to ensure safety in older people’s homes [ 47 ].…”

Factors associated with perceptions of dignity and well‐being among older people living in residential care facilities in Sweden. A national cross‐sectional study

“…With regard to well‐being, our results show that residents who did not thrive in the environment had higher odds of feeling unsafe at the RCF. Regarding safety, previous research has noted that staff mainly focus on preventing risks in the care environment (Abbott et al., 2016; Chaudhury et al., 2016; Lette et al., 2020; Ross et al., 2015; Saarnio et al., 2019; van der Cingel et al., 2016). This raises the following question: If staff focus on preventing risks in the care environment, how can it be that residents feel unsafe?…”

Games of uncertainty: the participation of older patients with multimorbidity in care planning meetings – a qualitative study

“…A review of how integrated services for older people living at home address patients’ safety shows that safety is protected by preventing (unnecessary) health decline, polypharmacy, and uncoordinated service delivery [ 45 ]. However, although health and social care providers in thirteen case studies of European care programs thought they had sufficiently addressed safety issues, older people often still felt insecure [ 46 ].…”