Toward developing care outcome quality indicators for home care for older people: A prospective cohort study in Japan

Abstract

Introduction Care quality in Japan's long‐term care (LTC) agencies, including home care, is the responsibility primarily of individual agencies, and the evaluation of service processes and outcomes is minimal. Objectives To describe the development of quality indicators for LTC (QIs‐LTC) in Japan. Methods QIs‐LTC were developed through literature review and expert panel discussions and then were piloted and used in a 2‐year longitudinal survey. The survey (launched in September 2019) targeted older people receiving home care (n = 1450), their family members (n = 880), their professional home care providers (n = 577), and managers of home care agencies (n = 122). Results Across eight domains (maintaining dignity, minimizing symptoms and disease deterioration, maintaining nutritional status, maintaining bladder/bowel control, encouraging physical activities, experiencing sound sleep, maintaining serenity and contentedness, and maintaining family's well‐being), 24 care quality objectives were set with 24 outcome QIs‐LTC and 144 process QIs‐LTC. In the survey, 84.8% of clients were using home care nursing, 26.3% were living alone, and 39.5% had dementia. In the month preceding the data collection, 13.9% of clients had a new disease or worsening of an existing disease, 8.8% were hospitalized at least once, and 47.9% did not participate in activities of interest. About 20% of clients' families were unable to spend time peacefully, and 52.8% were exhausted from the client's care. Conclusions The QIs‐LTC developed in the current study are generic and client‐ and family‐centered. They encompass objective and subjective information and would facilitate standardized monitoring if adopted and comparison between LTC settings, including home care. In addition, future research directives are outlined. Geriatr Gerontol Int 2023; 23: 383–394.

Exploring a career pathway for home support workers in Ireland: a systematic scoping review of the international evidence

“…Ethnic background can affect experiences of attaining paid help, highlighting the need for enhanced support and targeted interventions for ethnically diverse communities ( 282 ). The development of family-centered quality indicators for long-term care, could help to improve the experiences family members and caregivers have of home support services ( 283 ).…”