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Home as a place for providing health care : elderly care recipients’ experience Sohoolian, Sohila

Abstract

Home care is a relatively new field for rehabilitation professionals, including occupational therapists. Despite the "client-centered" practice guidelines, the focus of Occupational Therapy (OT) home care research has not been on the client's experience. This study aimed to gain insight into the care recipients' experiences of home care Occupational Therapy (OT) services particularly home modifications recommended by occupational therapists. In order to better understand the care recipients' experience of home care OT, observation of the home modifications and of living and housing conditions of the care recipients was made. A qualitative research approach was used to explore the individuals' experiences from their standpoint. Semi- structured, in-depth interviews were conducted with long-term home care recipients in the Greater Vancouver area. Observations of home modifications were carried out with the care recipients or their family members present. Two main themes emerged from the stories of the participants. The first theme 'The Importance of Home, Neighborhood and Community Resources' sets the context in which the participants of the study experienced home care OT services. Under this theme, socio-economic status, living and housing conditions, reliance on home care services and community resources and renegotiating the meaning of home and neighborhood are discussed. The second theme 'The Experience of Home Care Occupational Therapy' describes the impact of OT services on the participants' daily lives, the role of occupational therapists as a source of knowledge, advocate and social support. The participants described their experiences of home care OT services as positive and enabling. However, their emphasis of OT services depended on their living, housing Conditions and the level of community resources (formal and/or informal) available to them. Occupational therapists played multiple roles of expert, social support and advocate for those participants with low income and no family or limited social contact. The conceptual bases of the study are drawn from occupational therapy's client-centered approach, feminist sociology and social geography. Individual-focused practice, the importance of everyday life experiences in generating knowledge and the importance of "the space" and "the place" in shaping the experience of disability are the central themes of these conceptual approaches. The findings of the study inform the above theoretical concepts. Issues related to client-centered practice and enabling environments are discussed in this paper. Limitations of the study and directions for future research are outlined.

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