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No Place Like Home: A Systematic Review of Home Care for Older Adults in Canada

Published online by Cambridge University Press:  04 September 2018

Shanthi Johnson ,
Juanita Bacsu ,
Hasanthi Abeykoon ,
Tom McIntosh ,
Bonnie Jeffery  and
Nuelle Novik
Shanthi Johnson*
Affiliation:
Saskatchewan Population Health & Evaluation Research Unit, Universities of Regina and Saskatchewan School of Public Health, University of Alberta
Juanita Bacsu
Affiliation:
Saskatchewan Population Health & Evaluation Research Unit, Universities of Regina and Saskatchewan
Hasanthi Abeykoon
Affiliation:
Saskatchewan Population Health & Evaluation Research Unit, Universities of Regina and Saskatchewan Community Health and Epidemiology, University of Saskatchewan
Tom McIntosh
Affiliation:
Saskatchewan Population Health & Evaluation Research Unit, Universities of Regina and Saskatchewan Department of Politics and International Studies, University of Regina
Bonnie Jeffery
Affiliation:
Saskatchewan Population Health & Evaluation Research Unit, Universities of Regina and Saskatchewan Faculty of Social Work, University of Regina
Nuelle Novik
Affiliation:
Saskatchewan Population Health & Evaluation Research Unit, Universities of Regina and Saskatchewan Faculty of Social Work, University of Regina
*
*La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Shanthi Johnson, PhD, RD, FDC, FACSM, FGSA School of Public Health Saskatchewan Population Health and Evaluation Research Unit 3-387 Edmonton Clinic Health Academy University of Alberta 11405 – 87 Ave Edmonton, AB T6G 1C9 <shanthi.johnson@ualberta.ca>
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Abstract

Given Canada’s aging population, the demand for home care is expected to increase significantly. To date, little is known about home care for older adults in Canada such as characteristics of home care recipients, gaps in services, or interventions designed to support home care client needs. Consequently, we conducted a systematic review of seven electronic databases for the years 2000–2016 to examine the current knowledge of home care services for Canada’s older adults. This synthesis examined four main themes in the literature: older adult client-level predictors; unmet care needs; interventions; and issues and challenges in home care. This review found significant knowledge gaps on home care for older adults across the country, as over half of the studies were focused primarily in Ontario. Although promising strategies were evident, more research and evaluation of interventions, and outcomes are required to effectively support Canada’s home care system now and over time.

Résumé

Les prévisions liées au vieillissement de la population canadienne impliquent que la demande en soins à domicile augmentera significativement. À ce jour, peu d’études ont été menées au Canada sur les soins à domicile pour les personnes âgées, notamment sur les caractéristiques des bénéficiaires de soins à domicile, les lacunes dans les services, ou les interventions permettant de répondre aux besoins des clients en matière de soins à domicile. Une revue systématique de sept bases de données électroniques a été réalisée pour les années 2000-2016 afin d’examiner les connaissances actuelles dans le domaine des soins à domicile pour les personnes âgées au Canada. Cette synthèse était centrée sur quatre principaux thèmes retrouvés dans la littérature : les prédicteurs au niveau de la personne âgée, les besoins de soins non comblés, les interventions, les enjeux et les défis dans les soins à domicile. Cette revue a mis en évidence plusieurs lacunes dans les connaissances liées aux soins à domicile pour les personnes âgées au Canada, considérant que plus de la moitié des études étaient centrées sur le contexte ontarien. Bien que des stratégies prometteuses aient été mises en évidence, davantage de recherche et d’évaluation des interventions et des résultats sont requises pour appuyer efficacement le système de soins à domicile au Canada, à court et à long terme.

Keywords

aginghome caresystematic reviewolder adultsvieillissementsoins à domicilevieillissementrevue systématiquepersonnes âgées

Information

Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 37 , Issue 4 , December 2018 , pp. 400 - 419
Copyright
Copyright © Canadian Association on Gerontology 2018 

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References

Armstrong, J. J., Zhu, M., Hirdes, J. P., & Stolee, P. (2012). K-means cluster analysis of rehabilitation service users in the home health care system of Ontario: Examining the heterogeneity of a complex geriatric population. Archives of Physical Medicine and Rehabilitation, 93(12), 2198–2205.CrossRefGoogle ScholarPubMed
Armstrong, J. J., Zhu, M., Hirdes, J. P., & Stolee, P. (2015). Rehabilitation therapies for older clients of the Ontario home care system: Regional variation and client-level predictors of service provision. Disability and Rehabilitation, 37(7), 625–631.CrossRefGoogle ScholarPubMed
Ayalon, L., Fialová, D., Areán, P. A., & Onder, G. (2010). Challenges associated with the recognition and treatment of depression in older recipients of home care services. International Psychogeriatrics, 22(04), 514–522.CrossRefGoogle ScholarPubMed
Bartfay, E., Bartfay, W. J., & Gorey, K. M. (2016). Dementia care in Ontario, Canada: Evidence of more timely diagnosis among persons with dementia receiving care at home compared with residential facilities. Public Health, 130, 6–12.CrossRefGoogle ScholarPubMed
Beatty, B., & Berdahl, L. (2011). Health care and Aboriginal seniors in urban Canada: Helping a neglected class. International Indigenous Policy Journal, 2(10), 1–18.CrossRefGoogle Scholar
Blais, R., Sears, N.A., Doran, D., Baker, G.R., Macdonald, M., Mitchell, L., & Thalès, S. (2013). Assessing adverse events among home care clients in three Canadian provinces using chart review. BMJ Quality & Safety, 22(12), 989–997.CrossRefGoogle ScholarPubMed
Bocock, M. A., Keller, H. H., & Brauer, P. M. (2008). Defining malnutrition risk for older home care clients. Canadian Journal of Dietetic Practice and Research, 69(4), 171–176.CrossRefGoogle ScholarPubMed
Burton, E., Lewin, G., & Boldy, D. (2015). A systematic review of physical activity programs for older people receiving home care services. Journal of Aging and Physical Activity, 23(3), 460–470.CrossRefGoogle ScholarPubMed
Canadian Home Care Association. (2016). Better home care in Canada: A national plan. Available from https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/better-home-care-in-canada_a-national-action-plan-copy.pdf?la=en&hash=D7C8B69F4E0B000F74CE372D6DAFCA9D198ADD39Google Scholar
Canadian Medical Association. (2016). The state of seniors health care in Canada. Available from http://sagelink.ca/the_state_of_seniors_healthcare_in_canadaGoogle Scholar
Carpenter, I., Gambassi, G., Topinkova, E., Schroll, M., Finne-Soveri, H., Henrard, J., … Bernabei, R. (2004). Community care in Europe. The aged in home care project (AdHOC). Aging Clinical and Experimental Research,16(4), 259–269.CrossRefGoogle Scholar
Conference Board of Canada. (2015). Future care for Canadian seniors. Available from http://www.shapeseniorscare.ca/887/documents/2544Google Scholar
Cook, R. J., Berg, K., Lee, K. A., Poss, J. W., Hirdes, J. P., & Stolee, P. (2013). Rehabilitation in home care is associated with functional improvement and preferred discharge. Archives of Physical Medicine and Rehabilitation, 94(6), 1038–1047.CrossRefGoogle ScholarPubMed
Craven, C., Byrne, K., Sims-Gould, J., & Martin Matthews, A. (2012). Types and patterns of safety concerns in home care: Staff perspectives. International Journal for Quality in Health Care, 24(5), 525–531.CrossRefGoogle ScholarPubMed
Dalby, D. M., Hirdes, J. P., Hogan, D. B., Patten, S. B., Beck, C. A., Rabinowitz, T., & Maxwell, C. J. (2008). Potentially inappropriate management of depressive symptoms among Ontario home care clients. International Journal of Geriatric Psychiatry, 23(6), 650–659.CrossRefGoogle ScholarPubMed
Effective Public Health Practice Project. (2009). Quality assessment tool for quantitative studies. Available from http://www.ephpp.ca/tools.htmlGoogle Scholar
Fernandes, S., & Guthrie, D. M. (2015). A comparison between end-of-life home care clients with cancer and heart failure in Ontario. Home Health Care Services Quarterly, 34(1),14–29.CrossRefGoogle ScholarPubMed
First Nations and Inuit Health Branch. (1999). First Nations and Inuit regional health survey: National report 1999. St. Regis, QC: First Nations and Inuit Regional Longitudinal Health Survey National Steering Committee.Google Scholar
Foebel, A. D., Heckman, G. A., Hirdes, J. P., Tyas, S. L., & Tjam, E.Y., McKelvie, R.S., & Maxwell, C. J. (2011). Clinical, demographic and functional characteristics associated with pharmacotherapy for heart failure in older home care clients: A retrospective, population-level, cross-sectional study. Drugs and Aging, 28(7), 561–573.CrossRefGoogle ScholarPubMed
Foebel, A. D., Hirdes, J. P., Heckman, G. A., Tyas, S. L., & Tjam, E. Y. (2011). A profile of older community-dwelling home care clients with heart failure in Ontario. Chronic Diseases in Canada, 31(2), 49–57.Google ScholarPubMed
Funk, L. M., Stajduhar, K. I., & Purkis, M. E. (2011). An exploration of empowerment discourse within home-care nurses’ accounts of practice. Nursing Inquiry, 18(1), 66–76.CrossRefGoogle Scholar
Gallagher, E., Alcock, D., Diem, E., Angus, D., & Medves, J. (2002). Ethical dilemmas in home care case management. Journal of Healthcare Management, 47(2), 85–97.CrossRefGoogle ScholarPubMed
Genet, N., Boerma, W. G., Kringos, D. S., Bouman, A., Francke, A. L., Fagerström, C., … Devillé, W. (2011). Home care in Europe: A systematic literature review. BMC Health Services Research, 11(1), 207.CrossRefGoogle ScholarPubMed
Glendinning, C., & Newbronner, E. (2008). The effectiveness of home care reablement − Developing the evidence base. Journal of Integrated Care, 16(4), 32–39.CrossRefGoogle Scholar
Government of Canada. (2016). Home and community health care. Ottawa, ON: Author. Available from https://www.canada.ca/en/health-canada/services/home-continuing-care/home-community-care.htmlGoogle Scholar
Health Council of Canada/Conseil canadien de la sante (HCC/CCS). (2005). Home care – A background paper to accompany health care renewal in Canada: Accelerating change. Toronto, ON: Author.Google Scholar
Health Council of Canada/Conseil canadien de la sante (HCC/CCS). (2012). Seniors in need, caregivers in distress: What are the home care priorities for seniors in Canada? Toronto, ON: Author.Google Scholar
Hirdes, J. P., Dalby, D. M., Knight Steel, R., Iain Carpenter, G., Bernabei, R., Morris, J. N., & Fries, B. E. (2006). Predictors of influenza immunization among home care clients in Ontario. Canadian Journal of Public Health, 97(4), 335–339.Google ScholarPubMed
Johnson, C.S., Bacsu, J., McIntosh, T., Jeffery, B., & Novik, N. (2017). Addressing social isolation among immigrant and refugee seniors: Environmental scan of programs and services in Canada. Regina, SK: Saskatchewan Population Health and Evaluation Research Unit, University of Regina and University of Saskatchewan. Available from http://www.spheru.ca/publications/files/SI_NIRS%20Programs%20Scan_18June2017final.pdfGoogle Scholar
Johnson, C. S., & Begum, M. N. (2008). Adequacy of nutrient intake among elderly persons receiving home care. Journal of Nutrition for the Elderly, 27(1–2), 65–82.CrossRefGoogle ScholarPubMed
Johnson, C. S. J., Myers, A. M., Scholey, L. M., Cyarto, E. V., & Ecclestone, N. A. (2003). Outcome evaluation of the Canadian Centre for Activity and Aging’s home support exercise program for frail older adults. Journal of Aging and Physical Activity,11(3), 408–424.CrossRefGoogle Scholar
Johnson, C. S., & Noel, M. (2007). Level of empowerment and health knowledge of home support workers providing care for frail elderly. Home Health Care Services Quarterly, 26(3), 61–80.CrossRefGoogle ScholarPubMed
Kadowaki, L., Wister, A. V., & Chappell, N. L. (2015). Influence of home care on life satisfaction, loneliness, and perceived life stress. Canadian Journal on Aging, 34(1), 75–89.CrossRefGoogle ScholarPubMed
Kelly, R., & Godin, L. (2015). The effect of a “surveillance nurse” telephone support intervention in a home care program. Geriatric Nursing, 36(2), 111–119.CrossRefGoogle Scholar
Lehoux, P. (2004). Patients’ perspectives on high-tech home care: A qualitative inquiry into the user-friendliness of four technologies. BMC Health Services Research, 4(28), 1–9.CrossRefGoogle ScholarPubMed
Lewin, G., & Vandermeulen, S. (2010). A non-randomised controlled trial of the Home Independence Program (HIP): An Australian restorative program for older home-care clients. Health and Social Care in the Community, 18(1), 91–99.Google ScholarPubMed
Livadiotakis, G., Gutman, G., & Hollander, M. J. (2003). Rationing home care resources: How discharged seniors cope. Home Health Care Services Quarterly, 22(2), 31–42.CrossRefGoogle ScholarPubMed
Lo, A. T., Gruneir, A., Bronskill, S. E., & Bierman, A. S. (2015). Sex differences in home care performance: A population-based study. Women’s Health Issues, 25(3), 232–238.CrossRefGoogle ScholarPubMed
Markle-Reid, M., Browne, G., & Gafni, A. (2013). Nurse-led health promotion interventions improve quality of life in frail older home care clients: Lessons learned from three randomized trials in Ontario, Canada. Journal of Evaluation and Clinical Practice, 19(1), 118–131.CrossRefGoogle ScholarPubMed
Markle-Reid, M., McAiney, C., Forbes, D., Thabane, L., Gibson, M., Browne, G., … Busing, B. (2014). An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms. BMC Geriatrics, 14(62), 1–23.CrossRefGoogle ScholarPubMed
Markle-Reid, M., Weir, R., Browne, G., Roberts, J., Gafni, A., & Henderson, S. (2006). Health promotion for frail older home care clients. Journal of Advanced Nursing, 54(3), 381–395.CrossRefGoogle ScholarPubMed
Marchildon, G. (2013). Health systems in transition: Canada (2nd ed.). Toronto, ON: University of Toronto Press.Google ScholarPubMed
Martin-Matthews, A., & Sims-Gould, J. (2008). Employers, home support workers and elderly clients: Identifying key issues in delivery and receipt of home support. Healthcare Quarterly, 11(4), 69-75.CrossRefGoogle ScholarPubMed
McWilliam, C. L., Vingilis, E., Ward-Griffin, C., Higuchi, K., Stewart, M., Mantler, T., … The Champlain Community Care Access Centre Collaborative Group. (2014). An evaluation of the effectiveness of engaging Canadian clients as partners in in-home care. Health and Social Care in the Community, 22(2), 210–224.CrossRefGoogle ScholarPubMed
Mery, G., Wodchis, W. P., & Laporte, A. (2016). The determinants of the propensity to receive publicly funded home care services for the elderly in Canada: A panel two-stage residual inclusion approach. Health Economics Review, 6(1), 8–016-0086-6. Epub 2016 Feb 25.CrossRefGoogle ScholarPubMed
Mierdel, S., & Owen, K. (2015). Telehomecare reduces ER use and hospitalizations at William Osler health system. Studies in Health Technology and Informatics, 209, 102–108.Google ScholarPubMed
Mitchell, L. A., Strain, L. A., & Blandford, A. A. (2007). Indicators of home care use in urban and rural settings. Canadian Journal on Aging, 26(3), 275–280.CrossRefGoogle Scholar
Mofina, A. M., & Guthrie, D. M. (2014). A comparison of home care quality indicator rates in two Canadian provinces. BMC Health Services Research, 25(14), 37–6963-14-37.CrossRefGoogle Scholar
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D.G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097.CrossRefGoogle ScholarPubMed
National Collaborating Centre for Methods and Tools. (2016). Quality assessment tool for quantitative studies. Hamilton, ON: McMaster University. Available from https://merst.ca/wp-content/uploads/2018/02/quality-assessment-tool_2010.pdfGoogle Scholar
Neufeld, E., Hirdes, J. P., Perlman, C. M., & Rabinowitz, T. (2015). Risk and protective factors associated with intentional self-harm among older community-residing home care clients in Ontario, Canada. International Journal of Geriatric Psychiatry, 30(10), 1032–1040.CrossRefGoogle ScholarPubMed
Nugent, L. S. (2007). Can’t they get anything better? Home support workers call for change. Home Health Care Services Quarterly, 26(2), 21–39.CrossRefGoogle Scholar
Paddock, K., & Hirdes, J. P. (2003). Acute health care service use among elderly home care clients. Home Health Care Services Quarterly, 22(1), 75–85.CrossRefGoogle ScholarPubMed
Payette, H., Boutier, V., Coulombe, C., & Gray-Donald, K. (2002). Benefits of nutritional supplementation in free-living, frail, undernourished elderly people: A prospective randomized community trial. Journal of American Dietetic Association, 102(8), 1088–1095.CrossRefGoogle ScholarPubMed
Romanow, R. (2002). Building on values: The future of health care in Canada. Saskatoon, SK: Commission on the Future of Health Care in Canada. Available from http://publications.gc.ca/collections/Collection/CP32-85-2002E.pdfGoogle Scholar
Rosenfeld, P., & Russell, D. (2012). A review of factors influencing utilization of home and community-based long-term care: Trends and implications to the nursing workforce. Policy, Politics, & Nursing Practice, 13(2), 72–80.CrossRefGoogle ScholarPubMed
Scott, V. J., Votova, K., & Gallagher, E. (2006). Falls prevention training for community health workers: Strategies and Actions for Independent Living (SAIL). Journal of Gerontological Nursing, 32(10), 48–56.Google Scholar
Sibbald, B. (2015). Election 2015: Party platforms on health issues. Canadian Medical Association Journal, 187(17), E487–E492.CrossRefGoogle ScholarPubMed
Sims-Gould, J., Byrne, K., Beck, C., & Martin-Matthews, A. (2013). Workers’ experiences of crises in the delivery of home support services to older clients: A qualitative study. Journal of Applied Gerontology, 32(1), 31–50.CrossRefGoogle ScholarPubMed
Sims-Gould, J., Byrne, K., Craven, C., Martin Matthews, A., & Keefe, J. (2010). Why I became a home support worker: Recruitment in the home health sector. Home Health Care Services Quarterly, 29(4), 171–194.CrossRefGoogle ScholarPubMed
Sims-Gould, J., & Martin-Matthews, A. (2010). Strategies used by home support workers in the delivery of care to elderly clients. Canadian Journal on Aging, 29(1), 97–107.CrossRefGoogle ScholarPubMed
Siroka, S. (2007). Canadian perceptions of the health care system. Toronto, ON: HCC/CCS. Available from http://www.queensu.ca/cora/_files/PublicPerceptions.pdfGoogle Scholar
Statistics Canada. (2011). Immigration and ethnocultural diversity in Canada: National household survey. Ottawa, ON: Author. Available from http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-010-x/99-010-x2011001-eng.pdfGoogle Scholar
Szczerbinska, K., Hirdes, J. P., & Zyczkowska, J. (2012). Good news and bad news: Depressive symptoms decline and undertreatment increases with age in home care and institutional settings. American Journal of Geriatric Psychiatry, 20(12), 1045–1056.CrossRefGoogle ScholarPubMed
Tong, C. E., Sims-Gould, J., & Martin-Matthews, A. (2016). Types and patterns of safety concerns in home care: Client and family caregiver perspectives. International Journal for Quality in Health Care, 28(2), 214–220.CrossRefGoogle ScholarPubMed
Tousignant, M., Dubuc, N., Hébert, R., & Coulombe, C. (2007). Home-care programmes for older adults with disabilities in Canada: How can we assess the adequacy of services provided compared with the needs of users? Health and Social Care in the Community, 15(1), 1–7.Google ScholarPubMed
Turcotte, M. (2014). Canadians with unmet homecare needs. Ottawa, ON: Statistics Canada. Available from http://www.statcan.gc.ca/pub/75-006-x/2014001/article/14042-eng.htmGoogle Scholar
Turcotte, P. L., Larivière, N., Desrosiers, J., Voyer, P., Champoux, N., Carbonneau, H., … Levasseur, M. (2015). Participation needs of older adults having disabilities and receiving home care: Met needs mainly concern daily activities, while unmet needs mostly involve social activities. BMC Geriatrics, 15(95), 1–14.CrossRefGoogle ScholarPubMed
Wilkins, K., & Beaudet, M. P. (2000). Changes in social support in relation to seniors’ use of home care. Health Reports, 11(4), 39–47.Google Scholar
World Health Organization. (2017). Mental health of older adults. Geneva, CHE: Author. Available from http://www.who.int/mediacentre/factsheets/fs381/en/Google Scholar
Zhu, M., Chen, W., Hirdes, J. P., & Stolee, P. (2007). The K-nearest neighbor algorithm predicted rehabilitation potential better than current Clinical Assessment Protocol. Journal of Clinical Epidemiology, 60(10), 1015–1021.CrossRefGoogle ScholarPubMed
Zhu, M., Zhang, Z., Hirdes, J. P., & Stolee, P. (2007). Using machine learning algorithms to guide rehabilitation planning for home care clients. BMC Medical Informatics and Decision Making, 7(41), 1–13.CrossRefGoogle ScholarPubMed