Why are we doing this research?
To generate evidence that will support better understanding of older adult home care client pathways, and inform enhanced home care policy and practice that meets the needs of older adult clients with chronic and long term conditions. Specifically, the project aims to address a critical knowledge gap about how approaches to care shape older adult clients pathways through the home care system, from individual, provider and system level perspectives.
The integrated knowledge translation model (iKT) will ensure that findings are shared with the right people in the right mediums to support informed decision making at varied levels of care.
What is this research about?
A strategic priority in many provinces is to enhance supports including home care services for older adults to help them live well at home. Yet, there are restrictions on the availability of home care supports and services and client eligibility which can create barriers to access and utilization, and may negatively impact client and caregiver experience. We have little evidence-informed knowledge on approaches to care, which encompass how supports and services are provided and accessed and how they are experienced over time with consequences for client and system outcomes. Provincial and jurisdictional differences in approaches to care meant that client and caregiver pathways through the home care system may differ, depending on where one lives. We will address these issues by examining the home care pathways of older adult client with chronic and long term conditions in Nova Scotia and Manitoba. Cross provincial analysis will provide valuable insights into whether, and to what extent, the organization/policy context of home care systems makes a difference to approaches to care (and in turn for client pathways).
How are we doing this research?
To meet the objectives of the research, a number of activities will take place in the two study sites – Nova Scotia and Manitoba. The project employs a longitudinal multi-methods research design that is informed by aspects of a social ecological theoretical framework.Below is a description of the research methods related to each objective (stream).
Data Stream – Construct Client Pathways: What are the common pathways of older adult home care clients through the home care system?
Analysis of inter-RAI home care client data (Winnipeg Regional Health Authority, Nova Scotia Health Authority) to identify points in time and interactions with the health system that contribute to different pathways.
Lead: Lori Mitchell, Winnipeg Regional Health Authority
Care Constellations Stream – Understand the Experiences of Individuals within a Home Care Constellation: How are pathways shaped and shaped by the experiences of recipients, family/friend caregivers, home support workers and health care professionals?
Interviews with clients and their family/friend caregiver, home support worker, and care coordinator (the care constellation) in each province to explore how the experiences and perceptions of clients, their caregivers and care providers shape pathways.
Lead: Laura Funk, University of Manitoba
Policy Stream – Policy Content: How do policy contexts inform approaches to care and shape client pathways?
Review of home care program policies in each province to understand how the organization of home care shapes client pathways. This component also involves interviews with key informants.
Lead: Janice Keefe, Mount Saint Vincent University