Older People ’ s Individual Resources and Reality in Home Care Riitta Turjamaa Older People ’ s Individual Resources and Reality in Home Care

Most older people want to live meaningful lives in their own homes despite decreased abilities and, if needed, the aim of home care services is to enable them to live at home for as long as possible. That requires home care professionals to recognize clients’ individual resources and take these into account while delivering daily care. However, little has been studied from the perspectives of older people and home care professionals regarding how care and services can be provided when being supported by professionals in daily care. In addition, there is a lack of research based on evaluating practice in older clients’ daily care. Therefore, research based on supporting clients’ resources in practice is needed. The aim of this study was to describe and evaluate the recognition and realization of older people’s resources in daily home care services from clients’ and home care professionals’ perspectives. This study consisted of four phases. The systematic literature review concerned international articles (n=17). The second phase included focus group interviews of home care professionals (n=32), and the third phase consisted of the analysis of older home care clients’ (aged 75 years or over) care and service plans (n=437). The fourth phase included conducting video-based stimulated recall interviews of older home care clients (aged 75 years or over) (n=23) and practical nurses (n=14). The data of the systematic literature review and interviews were analysed by inductive content analysis and care and service plans by the method of document analysis. According to results, older people were well-aware of their resources, as were home care professionals, and these were described multidimensionally by both. Resources consisted of the social relationships and elements of meaningful daily living, including ability to manage everyday activities, ability to function, available home care services as well as safety and functionality of the environment. However, the gap between awareness and practice in daily care was obvious. The experience of clients was that their resources had not been taken into account and were not supported, and professionals identified narrowly documented resources in care and service plans, insufficiently recognized and realized in daily care. According to older clients and professionals, the development of home care in future requires the recognition of individual resources, meaningful everyday lives, confidential and long-lasting relationships between clients and professionals and a safe environment at home. In conclusion, current home care services are based on daily routine care and emphasize only clients’ physical needs and ability to function. In order to be able to promote older home clients’ living at home, the provided home care services need to be individually designed and must take into account clients’ resources and their perspectives of meaningful and inspirational activities. National Library of Medicine Classification: WY 115 Medical Subject Headings (MeSH): Home Care Services; Home Nursing; Aged; Family Relations; Interpersonal Relations; Activities of Daily Living; Professional-Patient Relations; Qualitative Research