Home care for patients with dirty homes: a qualitative study of the problems experienced by nurses and possible solutions

BMC Health Serv Res. 2022 May 3;22(1):592. doi: 10.1186/s12913-022-07988-2.

Abstract

Background: Home-care nurses are often the first care professionals to enter a dirty home. The perceived problems and support needs of home-care nurses in these situations are largely unknown.

Objective: To examine the problems home-care nurses encounter in caring for patients living in dirty homes, and possible solutions for these problems.

Design: Qualitative descriptive research.

Setting: Communities across the Netherlands.

Participants: Twenty-three participants to investigate the problems or needs experienced, and 20 participants to investigate solutions. Participants included patients, home-care nurses and other professionals working in the community.

Methods: Semi-structured interviews were conducted with 23 participants and analysed according to the principles of deductive thematic analysis. Subsequently, in interviews with 4 (representatives of) patients and four focus-group sessions with 16 professionals, the problems found were validated and solutions to the problems discussed.

Results: Ten subthemes emerged that were clustered into three main themes: 'dilemmas arise in choosing the right nursing care'; 'cooperation and an integrated approach are often necessary, but lacking'; 'home-care nurses have insufficient competencies'. Seven possible solutions were found: (1) strengthening collaboration between organizations in the community; (2) involving others sooner; (3) case management; (4) person-centred care; (5) taking more time; (6) providing home-care nurses with tools and support services; and (7) strengthening the competencies of nurses.

Conclusions: Care for patients with a dirty home is complex. An integrated person-centred care approach is often necessary and home-care nurses need extra support to provide such care. Interventions should not only focus on patients, but address the nurses, the organization, and the collaboration between organizations in the community.

Keywords: Hoarding; Home-care nurses; Integrated care; Person-centred care; Self-neglect.

MeSH terms

  • Focus Groups
  • Home Care Services*
  • Humans
  • Netherlands
  • Qualitative Research