Understanding Change in Home Care Pathways Over Time Through Longitudinal Qualitative Inquiry

Area of Science:

• Social Gerontology
• Qualitative Health Research

Background:

• Older adults' wellbeing is complex and influenced by home care service continuity.
• Understanding service trajectories is crucial for effective elder care.
• The COVID-19 pandemic significantly disrupted home care services.

Purpose of the Study:

• To explore the wellbeing and home care service experiences of older adults.
• To analyze how service changes impact clients and their families over time.
• To investigate the role of social, emotional, and relational factors in care needs.

Main Methods:

• Longitudinal qualitative temporal case study design.
• Analysis of 136 interviews with 12 older home care clients and 53 network actors.
• Data collected over three time points in Manitoba and Nova Scotia.

Main Results:

• Clients and families frequently experienced daily service adjustments, despite official stability.
• The pandemic exacerbated disruptions to clients' lives, wellbeing, and relationships.
• Changes in wellbeing and care needs were often subtle and not always recognized by case coordinators.

Conclusions:

• Theorizing change for older adults in home care requires considering multifaceted wellbeing and integration.
• Policy and practice should be informed by equity considerations to address complex client needs.
• Longitudinal qualitative research offers deep insights into home care trajectories.