Home care as integrated in older people’s lives: Developing a user-oriented perspective

Research on eldercare has been dominated by a provider-oriented perspective, concerned with the conditions and views of those who provide care. This perspective has been developed in the theories of care, even in approaches to person-centred care. There are striking differences in provider perspective between eldercare and disability studies, where help and services are framed as part of a larger project of having a daily life and being included in society.

A similar approach is needed in studies of home care. The aim of the proposed project is to develop empirical and theoretical knowledge of care as a relational practice, interpreted, accomplished, and negotiated by older people in their daily lives. This perspective will also offer an alternative to ongoing attempts to reduce the user perspective to the level of older people acting as customers on a market.
The project will be informed by pilot interviews that indicate the existence of active strategies which users develop and apply to make care work well. These include practical preparations, emotional activities such as showing an interest in the lives of care staff, or adopting the appropriate care organisation rhetoric to avoid the response ‘We don’t do that’.

The research questions will also focus on the identities, categorisations, and roles played out as part of receiving home care, and how relations, strategies, and the experience of receiving care evolve.

An ethnographic approach with a two-year longitudinal element will be applied and data will be collected as interviews and participant observations with 25 home care users on four occasions. This design will make it possible to study experiences of care use over time. By studying care use in the context of older people’s everyday lives, the project will add important aspects to existing studies of home care and user satisfaction.