Employers, home support workers and elderly clients: identifying key issues in delivery and receipt of home support.

The Nexus Home Care Project examines the experiences of employers, home support workers and elderly clients and their family members in the delivery and receipt of home support services. The primary purpose of this research is to identify salient issues in the delivery and receipt of home support services to elderly individuals from the perspective of employers, home support workers and clients. The data for this study, funded by the Canadian Institutes of Health Research, are derived from in-depth interviews with home support employers (n=11), home support workers (n=32) and elderly clients (n=14) in British Columbia. Employers emphasized recruitment and retention and the increasing complexity of client needs, and raised questions regarding the appropriateness of home support as a part of the healthcare continuum. Home support workers stressed scheduling and time demands, the tension in providing intimate ongoing care at an emotional distance and the balance between tasks outlined in the care plan and the needs and wants of elderly clients. Elderly clients indicated an ongoing need to prepare for and manage services and expressed a need for companionship. Findings are discussed as they inform and extend our understanding of the key tensions in home support. Strategies for addressing these tensions are also identified.