Person-Centered Home Care: Exploring Worker-Client Relationships Using an Intersectional and Critical Disability Framework

• Published in: Journal of applied gerontology Vol. 43; no. 1; pp. 101 - 109
• Main Authors: Spring, Lauren, Funk, Laura, Kuryk, Kaitlyn, Warner, Grace, Macdonald, Marilyn, Burke, Rosanne, Keefe, Janice M.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2024; SAGE PUBLICATIONS, INC
• Subjects: Aged; Canada; Client relationships; Home and Community-Based Care; Home Care Services; Home health care; Humans; Interpersonal relations; Intersectional Framework; Intersectionality; Older people; Patient-Centered Care; Policy making; Workers; Canada; home and community based care and services; home care; person-centered care; qualitative methods
• ISSN: 0733-4648; 1552-4523; 1552-4523
• DOI: 10.1177/07334648231201837

More research is needed into how “person-centered care” (PCC) manifests in home care (HC) worker-client relationships. Qualitative data were collected at three time points from twelve HC workers and others to better understand how approaches to care shape the pathways of older adult HC clients with chronic conditions in two Canadian health jurisdictions. This paper uses critical disability and intersectionality frameworks to highlight ways in which PCC enables social and instrumental benefits for workers’ and clients. It also exposes difficulties in being flexible and developing interpersonal relationships because of HC policies. Workers also acknowledged risks when trying to prioritize client preferences, sometimes drawing distinctions between reasonable and unreasonable demands. Implications for enhanced training and support for workers around navigating flexibility and boundaries and using a relational approach to PCC are discussed, as are implications for policy-making that protect all parties.