Understanding Older Persons' Experiences of Care Encounters in the Home Environment: A Hermeneutic Study

理解老年人在家庭环境中接受照护的体验:一项诠释学研究

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Abstract

AIM: To explore and gain a deeper understanding of older persons' experiences of care encounters when their home becomes a workplace. BACKGROUND: Worldwide healthcare services are increasingly being provided in older persons' homes by registered nurses. This presents new challenges as the home environment of older persons now doubles as a workplace for healthcare professionals. However, there is limited research available on how older persons experience care encounters when their homes serve as workplaces and how this influences their overall well-being and quality of life. DESIGN: A qualitative hermeneutic study. METHODS: In-depth face-to-face interviews were conducted in Sweden from October 2023 to January 2024 with 10 purposefully selected older persons (aged 65+). Each participant received regular visits from a home care nurse in their home to address specific care needs, such as wound care, medication administration, blood sampling and general supervision. The interviews were audiotaped, transcribed verbatim and analysed using a hermeneutic interpretation. FINDINGS: The hermeneutic analysis emerged with one main theme: 'Experiencing care encounters at home as a lottery', with two underlying themes: 'Adapting to loss of control in the private sphere' and 'Striving for independence while navigating daily living'. CONCLUSIONS: Older persons try to control their lives despite the challenges associated with ageing and receiving care at home. They strive to maintain their independence and autonomy, which reflects their desire for self-determination. Supporting these efforts in an interdependent relationship can enhance their well-being and quality of life. REPORTING METHOD: Findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines. PATIENT OR PUBLIC CONTRIBUTION: Data were collected by patient interviews. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: This study emphasises the importance of supporting older persons in maintaining control over their lives while being cared for in their homes. In the care encounters with home care nurses, their well-being and quality of life can be improved by respecting their autonomy, involving them in decision-making and offering tailored support.

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