The experience of dependence on homecare among people ageing at home

Abstract

Being dependent on homecare potentially threatens a person's integrity and autonomy, particularly when people are dependent on help to manage basic bodily functions that involve intimacy and nudity, making the person vulnerable despite being in his or her own home. As the population continues to age and live longer, more people are expected to be dependent on homecare. The aim of this study was to investigate the phenomenon of dependence on homecare among people ageing at home. Individual in-depth interviews were used to explore 15 Danish and Norwegian homecare receivers’ experiences of dependence on homecare. Interview records were transcribed and analysed in a hermeneutical phenomenological process described by van Manen. First and foremost, the experience of dependence on homecare is a question of adaption. The older people in this study struggled to get used to their deteriorating body and at the same time they continuously had to negotiate to get care in accordance with their values. Being dependent on care could be experienced as being reduced to a task or a problem to be solved though the participants had a significant need for undivided mental attention. The presence of homecare staff in the participants’ homes could entail a change where the participants experienced that they lost control over the surroundings. According to the voices of the older people in this study, future homecare should be accommodated in an organisational set-up that gives priority to stability and continuity in the relation between the homecare receiver and the homecare staff. Also it is significant that homecare staff do not have a task-oriented approach to their job and are sensitive to the values of the homecare receivers.

Home care nursing practice for older persons with heart failure living at home

“…As studies from different countries have shown, home care nursing has been constrained by demands for cost-containment leading to task-oriented services (Funk et al, 2022;Martinsen et al, 2022;Strandås et al, 2019;Suhonen et al, 2018). We suggest that home…”

Being well? A meta-ethnography of older patients and their relatives’ descriptions of suffering and well-being in the transition from hospital to home

“…Importantly, the findings show that this can be further understood as an intersubjective bond between the older patients and the relatives, which unfolds itself into different nuances of dependency and interdependency. Usually, dependency and especially dependency on care are experienced on an individual level [33][34][35]. However, this study emphasizes the intertwined experiences and different nuances of dependency in the relationship of the older patients and their relatives.…”

What Makes Dependency on Homecare Bearable? A Phenomenological Study

“…However, our findings also demonstrated that in some caring relationships participants hesitated to express their wishes, which may impede the development of a genuine relationship where good care may be provided (Strandberg et al, 2003). In principle, the dependent person has the possibility to verbalize precisely how he or she would like the care to be provided; however, in reality, dependent peoples’ tendency to state demands to their carers is closely related to their personality, their current situation, and their relationship with the caregiver (Martinsen et al, 2022). From an existential viewpoint, care is provided in a tiny, shared space occupied by the caregiver and the care recipient, and in this space, the caregiver is responsible for using their power to assist and underpin the dependent person’s being.…”

“…The purpose of this study was to explore the existential dimension of being dependent on homecare in general and what makes dependency bearable in particular. This article forms part of a larger study aiming to explore the experience of dependency among people ageing at home (Martinsen et al, 2022).…”

“…Moreover, older people receiving homecare find that they have minimal or no influence on decisions concerning the allocation and overall planning of the care they receive. Important decisions involving their lives are made at an organizational level beyond care receivers’ sphere of influence (Fjordside & Morville, 2016; Martinsen et al, 2022). Dependency on homecare also tends to affect the care relation negatively; the more dependent a person is, the lower his or her level of self-determination is (Møller & Norlyk, 2017).…”