Home care clients: a research protocol for studying their pathways.

Area of Science:

• Gerontology
• Health Services Research
• Sociology of Health

Background:

• Enhancing non-clinical home care is a priority for aging populations in developed countries.
• Home care policies, programs, and practices shape care delivery and client experiences.
• Jurisdictional differences in care approaches lead to varied pathways through home care systems.

Purpose of the Study:

• To understand how different approaches to care shape the pathways of older adult home care clients with chronic and long-term conditions.
• To compare these pathways across two Canadian health jurisdictions.
• To identify how jurisdictional differences in care are experienced by clients and their families.

Main Methods:

• A longitudinal mixed-methods study using a socio-ecological framework.
• Retrospective analysis of home care assessment data (Resident Assessment Instrument- Home Care).
• Prospective qualitative comparative case study of clients, caregivers, and professionals over 18 months, alongside policy review and key informant interviews.
• Integrated knowledge translation (iKT) approach engaging knowledge users throughout the research process.

Main Results:

• Client pathways through home care systems vary based on jurisdictional approaches to care.
• Differences in care approaches are experienced by older adult clients and their families.
• Policy context significantly influences the implementation and experience of home care.

Conclusions:

• A mixed-method design effectively elucidates variations in older adult home care pathways across jurisdictions.
• Findings highlight the client and family experience of differing care approaches and policies.
• The study provides evidence for strategic planning, decision-making, and practice changes in home care to better support older adults.