Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Research Centre for Community Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands.
Health Soc Care Community. 2020 Jan;28(1):291-299. doi: 10.1111/hsc.12863. Epub 2019 Oct 6.
To face the challenges of an ageing population, many Western countries nowadays stimulate an ageing in place policy to empower older adults to grow old in their own homes with the highest degree of self-reliance. However, many community-living older adults experience limitations in (instrumental) activities of daily living ((I)ADLs), which may result in a need for home-care services. Unfortunately, home-care workers often provide support by taking over tasks, as they are used to doing things for older adults rather than with them, which undermines their possibilities to maintain their self-care capabilities. In contrast, reablement focuses on capabilities and opportunities of older adults, rather than on disease and dependency. Consequently, older adults are stimulated to be as active as possible during daily and physical activities. The 'Stay Active at Home' programme was designed to train home-care workers to apply reablement in practice. To explore the experiences of home-care workers with this programme an exploratory study was conducting in the Netherlands, between April and July, 2017. In total, 20 participants were interviewed: nine nurses (including a district nurse), 10 domestic support workers and the manager of the domestic support workers. The semi-structured interviews focused on the experienced improvements with regard to knowledge, skills, self-efficacy and social support. Furthermore, the most and least appreciated programme components were identified. The study has shown that home-care workers perceived the programme as useful to apply reablement. However, they also need more support with mastering particular skills and dealing with challenging situations. Future implementation of the 'Stay Active at Home' programme can potentially benefit from small adaptions. Furthermore, future research is needed to examine whether the programme leads to more (cost-) effective home care.
为了应对人口老龄化带来的挑战,当今许多西方国家都在推行“原地老龄化”政策,以使老年人能够最大限度地自理,在自己的家中安度晚年。然而,许多社区居住的老年人在(工具性)日常生活活动(IADLs)方面存在局限性,这可能导致他们需要家庭护理服务。不幸的是,家庭护理人员通常通过接管任务来提供支持,因为他们习惯于为老年人做事,而不是与他们一起做事,这削弱了他们维持自我护理能力的可能性。相比之下,康复着重于老年人的能力和机会,而不是疾病和依赖。因此,鼓励老年人在日常生活和体育活动中尽可能活跃。“居家活跃”计划旨在培训家庭护理人员在实践中应用康复。为了探索家庭护理人员对该计划的体验,2017 年 4 月至 7 月在荷兰进行了一项探索性研究。共有 20 名参与者接受了采访:9 名护士(包括一名地区护士)、10 名家政支持人员和家政支持人员的经理。半结构化访谈集中在知识、技能、自我效能和社会支持方面的经验改善。此外,还确定了最受赞赏和最不受赞赏的方案组件。研究表明,家庭护理人员认为该计划有助于实施康复。然而,他们在掌握特定技能和处理具有挑战性的情况方面也需要更多的支持。未来实施“居家活跃”计划可能会受益于一些小的调整。此外,还需要进一步研究该计划是否会带来更(成本)有效的家庭护理。