Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-25T09:26:51.213Z Has data issue: false hasContentIssue false
  • English
  • Français

A systematic review evaluating the impact of paid home carer training, supervision, and other interventions on the health and well-being of older home care clients

Published online by Cambridge University Press:  16 January 2017

Claudia Cooper ,
Blerta Cenko ,
Briony Dow  and
Penny Rapaport
Claudia Cooper*
Affiliation:
Division of Psychiatry, University College London, London, UK
Blerta Cenko
Affiliation:
Camden and Islington NHS Foundation Trust, London, UK
Briony Dow
Affiliation:
School of Population and Global Health; University of Melbourne, Melbourne, Australia
Penny Rapaport
Affiliation:
Division of Psychiatry, University College London, London, UK
*
Correspondence should be addressed to: Dr Claudia Cooper, Clinical Reader, Division of Psychiatry, University College London, Floor 6 Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK. Phone: 020 7679 9248. Email: c.cooper@ucl.ac.uk.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Interventions to support and skill paid home carers and managers could potentially improve health and well-being of older home care clients. This is the first systematic review of interventions to improve how home carers and home care agencies deliver care to older people, with regard to clients’ health and well-being and paid carers’ well-being, job satisfaction, and retention.

Methods:

We reviewed 10/731 papers found in the electronic search (to January 2016) fitting predetermined criteria, assessed quality using a checklist, and synthesized data using quantitative and qualitative techniques.

Results:

Ten papers described eight interventions. The six quantitative evaluations used diverse outcomes that precluded meta-analysis. In the only quantitative study (a cluster Randomized Controlled Trial), rated higher quality, setting meaningful goals, carer training, and supervision improved client health-related quality of life. The interventions that improved client outcomes comprised training with additional implementation, such as regular supervision and promoted care focused around clients’ needs and goals. In our qualitative synthesis of four studies, intervention elements carers valued were greater flexibility to work to a needs-based rather than a task-based model, learning more about clients, and improved communication with management and other workers.

Conclusions:

There is a dearth of evidence regarding effective strategies to improve how home care is delivered to older clients, particularly those with dementia. More research in this sector including feasibility testing of the first home care intervention trials to include health and life quality outcomes for clients with more severe dementia is now needed.

Keywords

dementiahome care provisionpsychological interventions
Type
Review Article
Information
International Psychogeriatrics , Volume 29 , Issue 4 , April 2017 , pp. 595 - 604
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Boyle, M. H. (1998). Guidelines for evaluating prevalence studies. Evidence-Based Mental Health, 1, 37–39.Google Scholar
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.CrossRefGoogle Scholar
Carter, D. (2016). Fix Dementia Care: Homecare Report. London: Alzheimer's Society.Google Scholar
Chou, Y. C., Fu, L. Y., Kroger, T. and Ru-Yan, C. (2011). Job satisfaction and quality of life among home care workers: a comparison of home care workers who are and who are not informal carers. International Psychogeriatric, 23, 814–825.Google Scholar
Coogle, C. L., Parham, I. A., Jablonski, R. and Rachel, J. A. (2007). Enhanced care assistant training to address the workforce crisis in home care: changes related to job satisfaction and career commitment. Care Management Journal, 8, 71–81.CrossRefGoogle ScholarPubMed
Cooper, C., Barber, J., Griffin, M., Rapaport, P. and Livingston, G. (2015). Effectiveness of START psychological intervention in reducing abuse by dementia family carers: randomized controlled trial. International Psychogeriatrics, 28, 881–887.CrossRefGoogle ScholarPubMed
Cooper, C., Katona, C., Finne-Soveri, H., Topinkova, E., Carpenter, G. I. and Livingston, G. (2006). Indicators of elder abuse: a crossnational comparison of psychiatric morbidity and other determinants in the Ad-HOC study. American Journal of Geriatric Psychiatry, 14, 489–497.CrossRefGoogle ScholarPubMed
Elliott, K. J., Stirling, C. M., Martin, A. J., Robinson, A. L. and Scott, J. L. (2015). We are not all coping: a cross-sectional investigation of resilience in the dementia care workforce. Health Expect, 19, 1251–1264.Google Scholar
Fenley, R. C., Bober, S. J., Powell, M. E., Berman, J. and Altman, B. N. (2008). Effect of Alzheimer's training on multicultural personal care aides. Care Management Journal, 9, 4–10.Google Scholar
Fleming, G. and Taylor, B. J. (2007). Battle on the home care front: perceptions of home care workers of factors influencing staff retention in Northern Ireland. Health Soc Care Community, 15, 67–76.Google Scholar
Government, U. (2013). The Cavendish Review: an independent review into healthcare assistants and support workers in the NHS and social care settings. Department of Health, England. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/236212/Cavendish_Review.pdf.Google Scholar
Jones, A. L., Harris-Kojetin, L. D. and Valverde, R. (2012). Characteristics and use of home health care by men and women aged 65 and over National Health Statistics Reports no. 52. https://www.cdc.gov/nchs/data/nhsr/nhsr052.pdf.Google Scholar
King, A. I., Parsons, M. and Robinson, E. (2012a). A restorative home care intervention in New Zealand: perceptions of paid caregivers. Health & Social Care in the Community, 20, 70–79.Google Scholar
King, A. I., Parsons, M., Robinson, E. and Jorgensen, D. (2012b). Assessing the impact of a restorative home care service in New Zealand: a cluster randomised controlled trial. Health & Social Care in the Community, 20, 365–374.Google Scholar
Lawrence, V., Fossey, J., Ballard, C., Ferreira, N. and Murray, J. (2016). Helping staff to implement psychosocial interventions in care homes: augmenting existing practices and meeting needs for support. International Journal of Geriatric Psychiatry, 31, 284–293.CrossRefGoogle ScholarPubMed
Lee, C. Y. et al. (2015). Evaluation of a support worker role, within a nurse delegation and supervision model, for provision of medicines support for older people living at home: the Workforce Innovation for Safe and Effective (WISE) Medicines Care study. BMC Health Services Research, 15, 460.Google Scholar
Low, L. F. et al. (2015). The lifestyle engagement activity program (LEAP): implementing social and recreational activity into case-managed home care. Journal of the American Medical Directors Association, 16, 1069–1076.Google Scholar
Mastel-Smith, B., Binder, B., Malecha, A., Hersch, G., Symes, L. and McFarlane, J. (2006). Testing therapeutic life review offered by home care workers to decrease depression among home-dwelling older women. Issues in Mental Health Nursing, 27, 1037–1049.Google Scholar
Mukadam, N., Cooper, C. and Livingston, G. (2011). A systematic review of ethnicity and pathways to care in dementia. International Journal of Geriatric Psychiatry, 26, 12–20.Google Scholar
Muntaner, C., Li, Y., Xue, X., Thompson, T., Chung, H. and O'Campo, P. (2006). County and organizational predictors of depression symptoms among low-income nursing assistants in the USA. Social Science & Medicine, 63, 1454–1465.Google Scholar
Nikmat, A. W., Al-Mashoor, S. H. and Hashim, N. A. (2015). Quality of life in people with cognitive impairment: nursing homes versus home care. International Psychogeriatric, 27, 815–824.CrossRefGoogle ScholarPubMed
Rapaport, P., Livingston, G., Cooper, C. (submitted paper). A systematic review of the effective components of psychosocial interventions delivered by care home staff to people with dementia.Google Scholar
Rockwood, K., Howlett, S., Stadnyk, K., Carver, D., Powell, C. and Stolee, P. (2003). Responsiveness of goal attainment scaling in a randomized controlled trial of comprehensive geriatric assessment. Journal of Clinical Epidemiology, 56, 736–743.Google Scholar
Rothera, I. et al. (2008). An evaluation of a specialist multiagency home support service for older people with dementia using qualitative methods. International Journal of Geriatric Psychiatry, 23, 65–72.CrossRefGoogle ScholarPubMed
Small, D. J. and Martinson, I. M. (1987). In-service training of home health aides for arthritis care. Journl of Community Health Nursing, 4, 243–251.Google Scholar
Sykes, W. and Groom, C. (2011). Older people's experiences of home care in England, research report 79. Equality and Human rights commission, England. https://www.equalityhumanrights.com/en/publication-download/research-report-79-older-peoples-experiences-home-care-england.Google Scholar
Symes, L., Mastel-Smith, B., Hersch, G., Binder, B., Malecha, A. and McFarlane, J. (2007). The feasibility of home care workers delivering an intervention to decrease depression among home-dwelling, older women: a qualitative analysis. Issues in Mental Health Nursing, 28, 799–810.Google Scholar
UKHCA (2016). An overview of the domiciliary care market in the UK. UKHCA https://www.ukhca.co.uk/pdfs/Overviewofthedomiciliarycaresector.pdf.Google Scholar
Wang, J., Kearney, J., Jia, H. and Shang, J. (2016). Mental health disorders in elderly people receiving home care: prevalence and correlates in the national U.S. population. Nursing Research, 65, 107–116.Google Scholar