Ontario’s Home First Approach, Care Transitions, and the Provision of Care: The Perspectives of Home First Clients and Their Family Caregivers

• Main Author: English, Christine
• Other Authors: Queen's University (Kingston, Ont.). Theses (Queen's University (Kingston, Ont.))
• Language: en; en
• Published: 2013
• Subjects: home support workers; home health care; community care; older home support clients; elder care; discharge planning; relationships; family relationships; nursing home; Ontario health care; Canadian health care; placement; Home First; transition management; care transitions; aging in place; maintaining independence; caregiving; community health and support services; community long-term care; family carers; frail seniors; client satisfaction; hospital discharge; health care; older people; aged; frail elderly; aging; elderly; supportive home care; client perspectives; long-term care; quality of care; evaluation of services; care planning; risk; decisions; case management; communication; independence; home care; constraints on care provision; qualitative research; family caregivers; nursing home placement; qualitative description; program evaluation; alternative level of care; patient discharge; self-care; formal care; aged care; informal care; post-discharge care; home support; community support services; health services research
• Online Access: http://hdl.handle.net/1974/8037

Home First is an Ontario transition management approach that attempts to reduce the pressure on hospital and Long Term Care (LTC) beds through early discharge planning, the provision of timely and appropriate home care, and the delay of LTC placement. The purpose of this qualitative descriptive study was to obtain descriptions from South Eastern Ontario Home First clients and their family caregivers of their experiences with and thoughts about care transitions, the provision of care, and the Home First approach. The goal was to enable insight into the Home First approach, care transitions, and the provision of care through access to the perspectives of study participants. Nine semi structured interviews (and one or more follow-up calls for each interview) with Home First clients discharged from hospitals in South East Ontario and their family caregivers were conducted and their content analyzed. All participating Home First clients were pleased to be home from hospital and did not consider LTC placement a positive option. All had family involved with their care and used a mix of formal and informal services to meet their care needs. Four general themes were identified: (a) maintaining independence while responding (or not) to risks, (b) constraints on care provision, (c) communication is key, and (d) relationship matters. Although all Home First clients participating in the study were discharged home successfully, a sense of partnership between health care providers, families, and clients was often lacking. The Home First approach may be successfully addressing hospital alternative level of care issues and getting people home where they want to be, but it is also putting increasing demands on formal and informal community caregivers. There is room for improvement in how well their needs and those of care recipients are being met. Health professionals and policy makers must ask caregivers and recipients about their concerns and provide them with appropriate resources and information if they want them to become true partners on the care team. === Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-05-23 16:10:53.323