Adequacy of care provision in long-term home nursing arrangements: A triangulation of three perspectives

Nurs Open. 2020 Jul 2;7(5):1634-1642. doi: 10.1002/nop2.548. eCollection 2020 Sep.

Abstract

Background: A growing proportion of older people in Germany receive long-term care from informal and professional caregivers at home. Their personal assessment of the individual care situation is scarcely considered.

Aim: This study aimed to explore the subjective views of care recipients, informal and professional caregivers on the adequacy of care provision in long-term home care arrangements.

Design and methods: Qualitative semi-structured face-to-face interviews were conducted with ten care recipients, ten professional caregivers and eight informal caregivers to capture their perspectives on the adequacy of the care received and delivered. Qualitative content analysis was applied using MAXQDA software.

Results: All groups highlighted that they perceive an underprovision of care, even though their explanations differed. The underprovision was mainly described regarding the quality rather than quantity of services. It occurs especially in interpersonal relationships and social inclusion, where the gap between the self-perceived current situation and the desires of those affected is most prominent. The ambivalent impact of home care on social participation becomes apparent. Perceptions of an overprovision of care range from the view that it appears mainly with respect to informal care to the statement that it is currently non-existent or generally impossible. Misprovision of care is experienced as serious whenever the interviewees face the challenge of preserving existing abilities or regaining certain skills.

Keywords: caregiving; home nursing; informal care; long‐term home care; qualitative research; social inequality; underprovision.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Caregivers
  • Germany
  • Home Care Services*
  • Home Nursing*
  • Humans
  • Long-Term Care