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Exploring homecare for people living with dementia using an ethnographic approach

Leverton, Monica; (2021) Exploring homecare for people living with dementia using an ethnographic approach. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Background: Most people living with dementia prefer to remain in their own homes. Support from homecare services can enable this, yet homecare workers often receive limited training and support. Aim: To learn and understand from the experiences of homecare workers how they can be better trained and supported in their role, and how they can support independence in people living with dementia. Methods: I conducted a systematic review of observation methods used to study homecare. This informed the design of my ethnographic study, comprising participant observations with 16 homecare workers and 17 clients living with dementia, and 82 qualitative interviews with people living with dementia, family carers, homecare staff and health and social care professionals. I triangulated the data and thematically analysed the findings. I used my findings to inform the coproduced NIDUS-Professional training and support intervention. Findings: The value of homecare relationships and the significance of the home were two prominent, overarching findings. Relationships between homecare workers, clients, family carers and other health and social care professionals were often complex to navigate, yet were key to meeting the needs of people living with dementia. Care provision in the home setting transitioned the environment into a hybrid space between the clients’ domestic space and the homecare workers’ workplace. Conclusion: In highlighting the significance of the home for people living with dementia, I posit the importance of responsive, person-centred and home-centred care. Relational and emotional aspects of homecare are central to workers’ training and support. Establishing interdependent, collaborative relationships with clients can enable meaningful decision-making and active participation in daily tasks. Recognising and valuing homecare workers’ position amongst multidisciplinary dementia-care services, alongside managerial and peer support, may reduce some of the role’s associated challenges. Moving towards professionalisation of the homecare workforce is a clear direction for future research, policy and practice.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Exploring homecare for people living with dementia using an ethnographic approach
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
Keywords: Dementia, Social care, Home care, Qualitative methods, Ethnography
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10136703
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