Home care workers - an untapped resource in preventing emergency department visits of older people? A qualitative interview study from Sweden

Abstract

Abstract Background: Older people with functional decline and home care are frequent visitors to emergency departments (ED). Home care workers (HCWs) interact regularly with their clients and may play a crucial role in their well-being. This study aims to understand if and how HCWs can help prevent ED visits among home-dwelling older people. Methods: In this qualitative study, 12 semi-structured interviews were conducted with HCWs from Sweden between July and November 2022. Inductive thematic analysis was used to identify barriers and facilitators to prevent ED visits in older home-dwelling people. Results: HCWs want to actively contribute to the prevention of ED visits among clients but observe many barriers that hinder them from doing so. Barriers refer to care organization such as availability to primary care (PC) staff and information transfer; attitudes towards HCWs as co-workers; and client-related factors. Participants suggest that improved communication and collaboration with PC and discharge information from the ED to home care services could overcome barriers. Furthermore, they ask for support and geriatric education from PC nurses which may result in increased respect towards them as competent staff members. Conclusions: HCWs feel that they have an important role in the health management of older people living at home. Still, they feel as an untapped resource in the prevention of ED visits. They deem that improved coordination and communication between PC, ED, and home care organizations, as well as the promotion of proactive care would enable them to add significantly to the improved overall well-being and the prevention of ED visits.