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Developing a support program for care networks of home-dwelling older persons

Authors:

Wendy Kemper-Koebrugge ,

Han University of Applied Science, Faculty of Health and Social Studies, NL
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Marian Adriaansen,

Han University of Applied Science, Faculty of Health and Social Studies, NL
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Miranda Laurant,

Han University of Applied Science, Faculty of Health and Social Studies; Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, NL
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Michel Wensing

Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare; University Hospital Heidelberg, Dept. of general practice and health services research, NL
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Abstract

Introduction: Informal caregivers and formal care providers support home-dwelling older people in a care network, in order to stabilize the health situation and optimize quality of life of the older person. Many studies have focused on the network constellation and less on functioning of the network. Our study focuses on the functioning of the care network, in particular on network mechanisms as navigation to resources, negotiation in the care network and contagion of behaviours and practices. In a first study, we evaluated how participants in care networks acted in regard of these network mechanisms. This study  revealed areas in which the functioning of the care network and delivered support could be improved. Care networks showed themselves as closed system in which participants navigated towards existing contacts. Formal care providers did not use the two-step-reach in order to make the full potential of the network of organisations admissible for their clients. Both informal caregivers and formal care providers found navigating to non-organized informal care in the neighbourhood difficult and connecting to new (potential) informal caregivers time-consuming and full of pitfalls. Thus enlarging the support network was hindered. Furthermore, participants did not have network meetings in which the older person, informal care and informal care participated, also they did not anticipate future care. Reciprocity was underused, both the older person as the other participants did not know how to shape reciprocity when the older person was not physically able. Dilemmas were not discussed between the older person, informal care and formal care. Contagion factors from outside the network, for example seeing the older person as not being able to change, were not recognized, thus not open for intervention.

Methods: The research questions are: which interventions aimed at network mechanisms in care networks of home-dwelling older persons contribute to using the network in order to 1) generate (potential) support,  and 2) improve perceived health and quality of life of the home-dwelling older person?

To develop a support program for care networks, this study follows the first steps of the systematic process of intervention mapping: logic model of the problem, logic model of change and program design. In multidisciplinary focus groups with older persons, informal caregivers and formal care providers the areas for the support program will be discussed.  On every area a logic model of the problem is prepared in the research team, with an older person as co-researcher. Subsequently, we organize 3 focus group interviews, the results of the focus groups are input for two meetings with an expert group with knowledge of elderly care and education of professionals.

Results: The focus group and expert meetings are planned in October-December 2018, results are available in April 2019.

Future research: The developed support program will be tested with 20 professionals in the context of education, in which they will try to improve the functioning of the care network of one of their older clients. And contribute to better support.

How to Cite: Kemper-Koebrugge W, Adriaansen M, Laurant M, Wensing M. Developing a support program for care networks of home-dwelling older persons. International Journal of Integrated Care. 2019;19(4):425. DOI: http://doi.org/10.5334/ijic.s3425
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Published on 08 Aug 2019.

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