Embedding physical activity within community home support services for older adults in Ireland: a qualitative study of barriers and enablers

Lauren Swan, N. Frances Horgan, Vanda Cummins, Elissa Burton, Rose Galvin, Dawn A. Skelton, Bex Townley, Frank Doyle, Samira B. Jabakhanji, Jan Sorensen, Debbie Rooney, Lisa Murphy, Austin Warters, Maria O'Sullivan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
12 Downloads (Pure)

Abstract

Introduction
In Ireland, over 55,000 older adults are supported in their community by formal home support, amounting to an estimated 23 million care hours annually. There is a growing need to move beyond care, to more proactive approaches to maintain physical function. In a feasibility study, we delivered the “Care to Move” (CTM) program through existing home support services. This qualitative study aimed to explore the experience and perceptions of Health Care Assistants (HCAs), who were trained in and delivered the CTM program.
MethodsWe conducted semi-structured telephone interviews with 22 HCAs [mean age 49.0 ± 10.7 years and female 21/22] involved in the delivery of the program with older adults [n = 35, mean age 82.8 (7.8) years]. Interview transcripts were coded and analyzed thematically to capture barriers and enablers to program delivery.
ResultsBarriers and enablers were identified under three themes i) the CTM approach ii) the home support setting, iii) older adults and physical activity, with iv) delivering care in a crisis and v) future directions further identified. Overall, there was a positive perception of the program’s focus on “movement prompts and motivators”, the “fit” within home support services, and the training provided. Practical challenges of limited time and the task-orientated nature of home support were reported as recurring barriers for CTM. Many HCAs commented on the value and perceived positive benefits of the program for their clients. Though negative perceptions of older adults’ motivation or ability to engage with physical activity were noted. Risk, such as injury or pain, was identified but was not a dominant theme.ConclusionOur findings suggest that embedding physical activity initiatives within home support services could be feasible. Restructuring of services, engaging HCAs, and moving beyond traditional “task-oriented” care models to more personalised proactive approaches may facilitate this initiative and support aging in place
Original languageEnglish
Pages (from-to)223-234
Number of pages12
JournalClinical Interventions in Aging
Volume17
DOIs
Publication statusPublished - 7 Mar 2022

Keywords

  • physical activity
  • integrated care
  • frailty
  • ageing in place
  • home care
  • intervention
  • behaviour change

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