A Qualitative Study of Older Adults' Experiences of Embedding Physical Activity Within Their Home Care Services in Ireland

Elissa Burton; N Frances Horgan; Vanda Cummins; Austin Warters; Lauren Swan; Maria O'Sullivan; Dawn A Skelton; Bex Townley; Frank Doyle; Samira B Jabakhanji; Jan Sorensen; Debbie Rooney; Lisa Murphy; Rose Galvin

doi:10.2147/JMDH.S351714

A Qualitative Study of Older Adults' Experiences of Embedding Physical Activity Within Their Home Care Services in Ireland

J Multidiscip Healthc. 2022 May 19:15:1163-1173. doi: 10.2147/JMDH.S351714. eCollection 2022.

Authors

Elissa Burton^{1

2}, N Frances Horgan³, Vanda Cummins^{3

4}, Austin Warters⁵, Lauren Swan^{6

7}, Maria O'Sullivan⁷, Dawn A Skelton^{8

9}, Bex Townley⁹, Frank Doyle¹⁰, Samira B Jabakhanji¹¹, Jan Sorensen¹¹, Debbie Rooney⁶, Lisa Murphy⁶, Rose Galvin¹²

Affiliations

¹ Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.
² enAble Institute, Curtin University, Perth, Western Australia, Australia.
³ School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
⁴ Primary Care Physiotherapy Services CHO9, Health Service Executive (HSE), Dublin, Ireland.
⁵ Older Person Services CHO9, Health Service Executive (HSE), Dublin, Ireland.
⁶ North Dublin Home Care (NDHC), Dublin, Ireland.
⁷ Department of Clinical Medicine, Trinity College Dublin (TCD), Dublin, Ireland.
⁸ School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland.
⁹ Later Life Training Ltd, Killin, Scotland.
¹⁰ Department of Health Psychology, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
¹¹ Healthcare Outcomes Research Centre (HORC), RCSI University of Medicine and Health Sciences, Dublin, Ireland.
¹² School of Allied Health, Ageing Research Centre, Health Research Institute, University of Limerick (UL), Limerick, Ireland.

Abstract

Purpose: Physical activity has been shown to improve older adults' functional capacity, independence, and quality of life. In a feasibility study, we embedded a movement approach within older adults existing home care services through "Care to Move" (CTM). The aim of this qualitative study is to explore older adults' experiences of CTM within their home care support services and to identify the strengths and barriers of engaging in CTM from the perspective of the older recipient.

Materials and methods: We conducted semi-structured telephone interviews with 13 older adults and one informal carer. Topics covered included participants' overall experiences of CTM, changes to their overall activity and participation, aspects of CTM that they found valuable and issues that were challenging. Interview transcripts were coded and analyzed thematically to capture barriers and facilitators to the approach delivery.

Results: Four themes were developed: i) "I have good days and bad days", ii) "safety and security is the name of the game", iii) "we're a team as it stands', iv) "it's [COVID-19] depressing for everybody at the moment". Older adults identified benefits of CTM engagement including improvements in physical and psychological wellbeing. However, subjective frailty and self-reported multimorbidity influenced overall engagement. Participants expressed concerns around the logistics of delivering CTM and competing care staff interests. The broader role of care staff in supporting CTM was highlighted, as well as the emotional support that staff provided to older adults. Care staff continuity was identified as a barrier to ongoing engagement. The impact of COVID-19 on older adults physical and mental health negatively impacted the delivery of the approach.

Conclusion: Our findings suggest that embedding CTM within home care services is feasible and that older adults enjoyed engaging in CTM. Addressing care staff continuity and adopting individual approaches to CTM delivery may enhance the implementation of services.

Keywords: barriers; community care; home support; motivation; movement; older people.