Collaborative relationship in preventive home visits to older people

To describe what characterizes preventive home visits with collaborative relationships among non-disabled home-dwelling older people in Japan.

Preventive home visits have the potential to result in improved health outcomes among older people. Collaboration, mutual understanding and trust between visitor and the visited person seem to work as a vehicle, but little is known about which part of the encounters contributes to a collaborative relationship.

We performed a retrospective qualitative analysis of visiting records written by preventive home visitors immediately after the visits were made. A collaborative relationship was predefined as a favourable change in behaviour seen in the visited person during the study period. Visitor characteristics were analysed from 248 records where 37 cases of collaborative relationships were documented.

The three most important elements associated with a collaborative relationship were (i) visitor communication skills i.e. mastering 'enhancing motivation' and 'having patience and coping with frustrations' in difficult and problematic situations, (ii) professionalism, which includes 'professional instruction and guidance' based on documented knowledge in health and social domains combined with an overall 'caring approach' and (iii) practical actions which imply an 'immediate concrete response to identified needs or problems' and 'individually tailored advice' to suit the older person's daily life.

Preventive home visitor communication skills and professionalism, and practical actions after the visits characterized cases, where favourable changes in behaviour were obtained in non-disabled home-dwelling older people in Japan.

Education should be emphasized, because preventive home visitor competence may be the most important element of proactive assessment schemes to obtain beneficial outcomes.