Person-Centered Home Care: Exploring Worker-Client Relationships Using an Intersectional and Critical Disability...

Area of Science:

• Gerontology and Health Services Research
• Qualitative Health Research
• Disability Studies and Social Determinants of Health

Background:

• Person-centered care (PCC) is crucial for older adults with chronic conditions receiving home care (HC).
• Understanding the nuances of PCC within HC worker-client relationships requires further investigation.
• Existing HC policies may inadvertently create barriers to flexible and relationship-centered care.

Purpose of the Study:

• To explore how person-centered care (PCC) is enacted in home care (HC) worker-client relationships.
• To identify the benefits and challenges associated with PCC from both worker and client perspectives.
• To examine the influence of critical disability and intersectionality frameworks on understanding PCC in HC.

Main Methods:

• Qualitative study employing data collection at three time points.
• Involved twelve home care (HC) workers and other stakeholders in two Canadian health jurisdictions.
• Utilized critical disability and intersectionality frameworks for data analysis.

Main Results:

• Person-centered care (PCC) was found to provide social and instrumental benefits for both HC workers and clients.
• Home care (HC) policies presented difficulties in achieving flexibility and fostering interpersonal relationships.
• HC workers identified risks and the need to distinguish between reasonable and unreasonable client demands.

Conclusions:

• Enhanced training is recommended for HC workers on navigating flexibility, boundaries, and relational PCC.
• Policy adjustments are necessary to better support PCC and protect the well-being of workers and clients.
• A relational approach to PCC, informed by critical disability and intersectionality, is vital for effective home care.