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‘It’s not just the word care, it’s the meaning of the word…(they) actually care': caregivers’ perceptions of home-based primary care in Toronto, Ontario

Published online by Cambridge University Press:  17 May 2017

TRACY SMITH-CARRIER ,
THUY-NGA PHAM ,
SABRINA AKHTAR ,
GAYLE SEDDON ,
MARK NOWACZYNSKI  and
SAMIR K. SINHA
TRACY SMITH-CARRIER*
Affiliation:
School of Social Work, King's University College at Western University, London, Ontario, Canada.
THUY-NGA PHAM
Affiliation:
South East Toronto Family Health Team, Toronto, Canada. Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
SABRINA AKHTAR
Affiliation:
Department of Family and Community Medicine, University of Toronto, Toronto, Canada. Home-Based Care Program, Toronto Western Family Health Team, University Health Network, Toronto, Canada.
GAYLE SEDDON
Affiliation:
Community Programs, Toronto Central Community Care Access Centre, Toronto, Canada.
MARK NOWACZYNSKI
Affiliation:
Department of Family and Community Medicine, University of Toronto, Toronto, Canada. House Calls: Interdisciplinary Healthcare for Homebound Seniors, SPRINT Senior Care, Toronto, Canada.
SAMIR K. SINHA
Affiliation:
Department of Medicine, Sinai Health System and University Health Network, Toronto, Canada. Department of Medicine, University of Toronto, Toronto, Canada. Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
*
Address for correspondence: Tracy Smith-Carrier, School of Social Work, King's University College at Western University, 266 Epworth Avenue, FB 106, London, Ontario, Canada, N6A 2M3 E-mail: tsmithca@uwo.ca
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Abstract

The frail and homebound older adult populations currently experience difficulties accessing primary care in the medical office. Given this fundamental access to care problem, and the questionable care quality that arises when navigating a labyrinthine health-care system, these populations have typically been subject to inadequate primary care. To meet their needs better, growing research stresses the importance of providing comprehensive home-based primary care (HBPC), delivered by an inter-professional team of health-care providers. Family care-givers typically provide the majority of care within the home, yet their perceptions of HBPC remain under-researched. The purpose of this study was to explore unpaid care-givers' perceptions of and experiences with HBPC programmes in Toronto, Canada. We conducted qualitative inductive content analysis, using analytic procedures informed by grounded theory, to discover a number of themes regarding unpaid care-givers' understandings of HBPC. Findings suggest that, compared to the standard office-based care model, HBPC may better support unpaid care-givers, providing them assistance with system navigation and offering them the peace of mind that they are not alone, but have someone to call should the need arise. The implications of this research suggest that HBPC could be a model to help mitigate the discontinuities in care that patients with comorbid chronic conditions and their attendant unpaid care-givers experience when accessing fragmented health, home and social care systems.

Keywords

care-givinghome-based primary carehome carehome visitsrelational careperson-centred carefamily-centred care
Type
Article
Information
Ageing & Society , Volume 38 , Issue 10 , October 2018 , pp. 2019 - 2040
Copyright
Copyright © Cambridge University Press 2017 

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