Home Care Pathways Project

Project funded from April 2018-March 2024


Understanding clients’ journeys through provincial home care systems is critical to providing good quality care. “How approaches to care shape the pathways of older adult home care clients” (or “Home Care Pathways”) is an interdisciplinary research project being conducted in Nova Scotia and Manitoba. The goal is to understand how approaches to care shape client pathways of older adult home care clients with chronic and long term conditions through the home care systems in the two provinces.


iStock_000017050592Large cropThe interdisciplinary team includes researchers from Nova Scotia and Manitoba and sector representatives at the provincial and national level. The project uses a mixed method approach which includes analysis of home care client data, case studies, and policy analysis.

The project is funded through a Project Grant from the Canadian Institutes of Health Research, 2018 through to 2022, extended to 2024.

What’s New:

2 NEW SUMMARIES RELEASED: Two more summaries of published manuscripts are now available: Inter-provincial Variation in Older Home Care Clients and Their Pathways and Receiving Home Support Services Does Not Mean Client Dependence

2 NEW ARTICLES PUBLISHED: The team is pleased so share that two articles are now available that draw on the research involving 12 care constellations. Ageing in place with non-medical home support services need not translate into dependence https://doi.org/10.1017/S0144686X23000478, is now available online Person-centered home care: Exploring worker-client relationships using an intersectional and critical disability framework https://doi.org/10.1177/07334648231201837, is now available online

TEAM PRESENTING STUDY RESULTS: Results from the care constellation stream are being presented at the Canadian Association on Gerontology conference in October by Team Member Laura Funk. Results from the data stream are being presented at the Gerontological Society of America conference in November by Janice Keefe.

STUDY RESULTS PUBLISHED:  “Inter-provincial variation in older home care clients and their pathways: a population-based retrospective cohort study in Canada“, published in BMC Geriatrics.


Study results shared at the Canadian Association for Health Services and Policy Research Conference in Montreal.

*Relational Cultures in Homecare” by Dr. Lauren Spring.






*Diversity among home care client pathways: Applying latent class models in longitudinal data” by Dr. Jeff Poss.






Co-investigator Dr. Grace Warner presents to Nova Scotia Home Care Network, Dartmouth.



Profiles of home care programs in Nova Scotia and Manitoba are available.


Principal Investigator Dr. Keefe was a panelist for Healthcare Excellence Canada’s Spotlight Series, Better home care for older adults and caregivers, on Feb. 9 at 12:00 p.m. (ET) during which she featured learnings from the Home Care Pathways study. Hear panelists discuss the emerging research in home care and how we can support providers, caregivers and clients, including some of the latest tools and resources. To view go to https://healthcareexcellence.ca/en/events-and-opportunities/spotlight-series/

The Disparities in Utilization of Psychiatry Services Among Home Care Clients video is now available. To view click here.


Stream updates

The Data Stream: Analysis of home care client data is underway at both sites. The results will provide insights into home care client characteristics and their interactions with other health resources, such as physicians and hospital emergency departments, over a four-year period.

The Care Constellations Stream: The Care Constellation team is analyzing interviews of members of the 12 care constellations in Nova Scotia and Winnipeg across the three data collection points.

The Policy Stream: The Policy Stream is reviewing emerging findings with a policy lens.

Team activities:

May 2023 – Team member Grace Warner shared findings from the care constellation work with the NS Home Care Network.

May 2023 – Team members Jeff Poss and Lauren Spring sharing study findings at Canadian Association on Health Services and Policy Research Conference, Montreal.

April 2023 – Team member Jasmine Mah presenting at Canadian Geriatrics Society, Vancouver.

October 2022 – Several presentations from members of the research team at Canadian Association on Gerontology Annual Conference in Regina.

Home care pathways meetingJune 2022 – Full team meeting – June 21 and 22, 2022: The full team came together in hybrid format to share findings, discussion opportunities for integration and areas for further analysis.





June 2022 – Presentation by Grace Warner and Lauren Spring at Northwood Research Symposium (online).

May 2022 – Sector Engagement Session with 20+ representatives from government, health authorities, stakeholder organizations, online.

May 2022 – Oral presentation by Postdoctoral Fellow Lauren Spring at the Canadian Association of Health Services and Policy Research Conference (online).

April 2022 – Article published (online) in Social Science & Medicine Qualitative Research in Health, Home care program flexibility as a relational phenomenon.

April 2022 – The full team came together virtually to share findings, particularly insights from Care Constellation group – changes over three points in time.

October 2021 – Presentation by Co-Investigator Dr. Lori Mitchell at the Canadian Association on Gerontology Annual Conference.

November 2021 – The full team came together virtually.

September 2021 – Article published in Frontiers in Psychiatry https://www.frontiersin.org/articles/10.3389/fpsyt.2021.712112/full

May 2021 – The full team met virtually to share findings, particularly insights from Care Constellation T2 interviews.

November 2020 – The full team met virtually to share research findings and opportunities for integration and to discuss impact of COVID-19 on the project’s time line.

June 2020 – Study protocol released https://doi.org/10.1186/s12913-020-05363-7d

June 2020 – The full team came together virtually to share research findings and planned for the final two years of the project.

May 2019 – Oral presentation by Susan Stevens and Janice Keefe at the Canadian Academy of Health Sciences and Policy Research (CAHSPR) Conference in Halifax on the overall project with focus on the role of the Nova Scotia Health Authority.

May 2019 – Oral presentation by Jeff Poss of preliminary findings of the WRHA client data analysis to stakeholders at a meeting hosted by Janice Keefe and Vicki Elliott-Lopez at the Nova Scotia Department of Health and Wellness.

June 2019 – Poster of the overall project displayed at the Nova Scotia Health Authority Annual General Meeting

DSC_1300 Full team meeting September 27 & 28, 2018:

L to R, back row: Susan Stevens, Nick Monaghan, Susan Shanks, Rebecca Visser. L to R, middle row, second from back: Lori Mitchell, Kaitlyn Obedzinski, Glenda Keenan, Greta Davis, Martha MacDonald
L to R, middle row, second from front: Lucy Knight, Kathryn Graves, Marilyn Macdonald, Michelle Lobchuk. Front: Julie Donaldson, Laura Funk, MJ MacDonald, Janice Keefe
Missing from photo: Heather Armstrong, Barb Baker, Beverley Brown-Sweeting, Angus Campbell, Maureen Henson, Scott Lewin, Grace Warner