An exploration of older people’s perspectives of future homecare in the United Kingdom and principles for its design: A participatory approach.

Abstract

Background: The United Kingdom, like many countries, has an increasing population of older people living with chronic conditions, which leads to an increased need for homecare. A systematic review was done to explore emergent models of homecare, focusing on the lived experiences of older people and perceptions of service providers on emergent homecare models. The systematic review showed that despite person-centred care being the emergent homecare model, older people criticized the lack of involvement in their homecare decision- making. Growing evidence shows that participatory research may help understand and address some homecare issues among older people. Aim: To explore older people’s perspectives of the future homecare they want and collaborate with them to co-produce concepts and principles that should underpin homecare. Design: The research was a qualitative design with a participatory research approach. Participants: There were 14 participants aged 63 to 89 from one community organisation in England. Method: Individual semi-structured interviews explored participants’ perceptions of future homecare. The participatory groups discussed themes that emerged from anonymised individual semi-structured interview findings. Participants contributed to the co-production of homecare concepts and principles that should underpin future homecare. Recruitment was done using emails. Interviews and participatory group discussions were done using virtual Zoom. Data analysis: The thematic analysis of Braun and Clarke, now called reflexive thematic analysis, was used in this research analysis focusing on an inductive approach because the inductive technique is unbounded by theoretical commitments and based exclusively on data. This was to enable older people to participate in the analysis phase when they wanted. The lifeworld-led well-being and suffering theory of Galvin and Todres was used to discuss findings because it could capture the suffering and the potential well-being that older people expressed. Findings: The co-produced future homecare concepts emphasised proactive planning of homecare, to have homecare that addressed the wants and needs of an older person and homecare services from a one-stop shop. Older people wanted homecare that enabled participation, and trustworthy relationships in community. Contribution to knowledge and implication to practice was that older people contributed to co-producing principles that should underpin homecare. These principles would inform policymakers and care providers in decision-making.