Journal
AGING & MENTAL HEALTH
Volume 25, Issue 9, Pages 1701-1708Publisher
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/13607863.2020.1758914
Keywords
Dementia; Alzheimer's disease; home care services; risk assessment; activities of daily living
Categories
Funding
- FORTE [2014-4674, 201607089]
- Doctoral School in Health Care Sciences at Karolinska Institutet
- Strategic Research Area Health Care Science (SFO-V) at Karolinska Institutet
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The study found that home care staff face various dilemmas in their daily work, including strategies for tracking risks, deciding when to act, and dilemmas when acting on risks. The research shows that staff have to balance respecting the autonomy of persons with dementia with ensuring their safety.
Objectives: Many persons with dementia live at home with support from home care services. Despite this, research is scarce concerning how risks in daily life among persons with dementia are perceived and handled by home care staff. This study aimed to explore how home care staff identify risks in the everyday lives of persons with dementia, and to inquire into how they reasoned about their own actions related to those risks. Method: A qualitative approach was applied for the study. Both individual interviews and focus groups were conducted with home care staff (n = 23). Data was analysed using a constant comparative method. Results: Identifying, reasoning and acting upon risks in the everyday lives of persons with dementia were related to several dilemmas for the home care staff. These dilemmas are described and elaborated on in three categories: 1) Strategies for tracking risks, 2) Dilemmas concerning where to draw the line and deciding when to act, and 3) Dilemmas when acting on risks. Conclusion: The study provides new knowledge about the dilemmas that staff in home care services may face and how they reason about managing risks in the homes of persons with dementia. The study shows that the staff had to weigh risk and safety against the autonomy of persons with dementia. Based on these findings, we want to highlight the importance of competence among home care staff and the organizational conditions that must exist in order to manage the challenges of risky situations.
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