Our Future is Aging: Advancing Knowledge Series
EVIDENCE TO ENHANCE POLICY AND PRACTICE
IN CONTINUING CARE
The Issue – Access to supports that maintain and enhance quality of life…
Timely and effective home and community-based care plays an important role in helping older adults live well at home for as long as they are able. The availability of quality care in a residential care setting for people whose care needs cannot be met at home is equally important. In the current environment of societal and system change, evidence is needed to support innovation and decision making, and ensure older adults and their families have access to supports that maintain and enhance quality of life regardless of care setting.
NSCA Contribution to Understanding the Issue…
The NSCA actively works with older adults and their families, as well as researchers, service providers, workers, and decision makers to generate and share evidence with the potential to enhance the continuing care system. Select recent high-impact initiatives with a focus on continuing care include:
NEXUS Home Care in Canada This project examined the role of home support workers in the continuum of care to elderly persons living in the community with a focus on work conditions to better understand recruitment and retention of workers. NSCA implemented the project activities in Nova Scotia which included personal interviews with 40 home support workers. This project was part of a larger initiative on home care in Canada led by Dr. Anne Martin Matthews, University of British Columbia.
Home to Nursing Home: Understanding Factors That Impact the Path Seniors Take The project sought to understand the situations of individuals who were approved for admission to a nursing home but waiting placement. It aimed to identify gaps in services in home and community care that contributed to individuals’ decision to apply for, and move into, long term care facilities. The study involved surveys with a random sample of 125 clients approved for admission to a nursing home in Nova Scotia and 85 caregivers of clients approved for nursing home admission.
Care and Construction A multi-method study that assessed the impact of policy changes on resident quality of life in nursing homes in Nova Scotia. Different physical designs (household, traditional) and staffing approach (full scope, traditional) were examined from the perspectives and experiences of the people who live in nursing homes and their families, and staff. Surveys were completed with 319 nursing homes, 397 family members, and 862 staff members. Focus groups, personal interviews and case studies were also conducted. The project’s integrated knowledge translation approach enabled sector representatives to be actively engaged in all stages of the research.
Supporting Access to Knowledge and Training on Caregiver Assessment Various initiatives that support the accessibility and use of knowledge on caregiver assessment and the C.A.R.E. Tool, a comprehensive needs assessment tool, include: a policy brief that synthesizes evidence-based knowledge on caregiver assessment; online training and educational workshops for healthcare professionals interested in better understanding the experiences and realities of family/friend caregivers and how to support them; contributions to a demonstration project that evaluated and examined the implementation of caregiver assessment and respite in Alberta.
What We’ve Learned…
· Almost all Nova Scotia home support workers reported satisfaction with their jobs, yet many also identified challenges with their job including client needs beyond what was in their care plans, unpredictable events on the job, and issues related to scheduling and compensation.
Important considerations for individuals deciding to apply for nursing home admission included scope of services available, issues with workers (continuity, scheduling) and caregiver burnout. Further, clients on the wait list were being “counselled” by health professionals to apply for nursing home care even though a significant proportion of study participants indicated they would not accept a bed if offered. As a result, the study found that the wait list was being inflated unnecessarily presenting challenges for program and service planning.
Model of care (differences in physical design/staff approach) did not emerge as being a significant predictor of resident quality of life for residents, family or staff. However, variables that measured “home-likeness” and “relationships” did when examined independently with the “household” design and expanded care staff roles uniquely supporting relationships and home likeness. This suggests that resident quality of life can be enhanced regardless of model of care.
Caregiver assessment provides positive benefits to health practitioners by increasing their awareness of caregiver contexts and needs, so that they can provide timely and appropriate care plans and help caregivers access supports when they need them. This has implications for the health system, by potentially reducing the likelihood of costly and avoidable interventions.
In addition to reports, brochures and other materials related to this topic you can find available at www.msvu.ca/nsca, we offer the following resources you may want to check out!
Caregiver assessment: An essential component of continuing care policy (Policy Brief) http://www.msvu.ca/site/media/msvu/Documents/PolicyBrief19.pdf
Nursing Home Quality of Life Knowledge Sharing Series
www.careandconstruction.ca Results and Dissemination – Brochures
Panagiotoglou, D., Keefe, J., Fancey, P., & Martin-Matthews, A. (2017). Job satisfaction and the context of care work by home support workers: Insights from three Canadian jurisdictions. Canadian Journal on Aging. (36)1, 1-14. Retrieved here
Aging, Community and Health Research Unit – Leading program of research on community based care involving seven inter-related studies being conducted in Ontario and Alberta. http://achru.mcmaster.ca