Working and living with home care - a workplace for one, a home for the other

As home care increases and care is moving from nursing homes and hospitals into people’s homes,
there are problem areas that need to be addressed and solved in a better way than today. Nurses and
other home care workers are exposed to serval risks when the patients’ home environment becomes
their workplace. There are also serval risks for the patients when their homes are transferred into
“small hospitals”. This paper presents the initial results from a study to identify the need for
improvements in the physical environment in home care, from the perspective of both employees and
patients, and to generate useful and attractive solutions. Interviews and observations were carried out,
where staff members from three different healthcare teams in one municipality in Sweden were
observed during their care giving shift in patients’ homes. The results indicate that care is often
provided in a specific place in the home. Inadequate resources for hygiene, working surfaces or
lighting result in non-ergonomic work postures, eye strain, and other risks for the practitioner and the
patient. Many situations and activities are not performed in a standardized manner but open to
individual differences. The interviews turned out to be the wrong approach for identifying the need for
improvements, while observations through shadowing proved to be more suitable.
Practitioner Summary: The amount of advanced care and technology being moved into ordinary
homes is increasing. This creates the need for a physical design of the interior of the home
environment which decreases the risks for both staff and patients, and creates a pleasant home
environment. This study identified various objects and work situations that need improvement. Many of
the homes visited lacked support for ergonomic work postures, hygienic work surfaces, adequate
lighting and appropriate places to store materials.