Staff's perspectives on the organization of homecare services to people with dementia-A qualitative study

Aims: The aim of the study was to explore the experiences of homecare staff about the impact of the organization of homecare services for people with dementia. Design: This study has a qualitative, exploratory design based on a phenomenological-hermeneutic approach, using individual in-depth interviews with homecare staff to collect data. Methods: A convenience sample of 14 homecare staff from five municipalities participated in the study. Main topics introduced: (a) how homecare services for people with dementia are organized and (b) challenges in respondents' everyday practice of caring for people with dementia. Interviews were conducted from October to December 2017. Results: Three main themes were identified from the interviews. (a) Complexity and need for individualized facilitated homecare services; homecare services were described as complex in regard to both the patient and the service. The complexity of the service made it challenging to tailor the service to the individual patient. (b) The importance of trust and relationships; establishing trust in the relationship between the patient and the staff resulted in better-quality care. This was crucial for identifying the patient's need for help. (c) Organizational challenges; homecare services could be vulnerable to changes in the organization. Practical tasks and following the daily scheduled task list were often prioritized at the expense of an individually tailored service.