Newswise — Relatives play a crucial role as invaluable assets in the present healthcare system. In Norway, the contributions made by relatives equate to nearly the same number of person-years as those provided by public municipal health and care services.
However, the significance and function of relatives in healthcare are undergoing transformation. Shifting demographics, altered social structures, and changes in family dynamics will influence the number of relatives available to support each individual in the future.
To ensure the optimal care and support for our relatives, it becomes imperative to gain deeper insights into their involvement and the extent of support needed across various health service models. This emphasizes the importance of conducting research in this domain. Understanding relatives' roles and needs will enable us to enhance our approach to providing them with the best possible care in the evolving healthcare landscape.
Home hospitals a sustainable solution
The trend of providing treatment in patients' homes is steadily increasing. Home hospitals, a service model that delivers treatment and monitoring for acute or semi-acute conditions, have emerged as an alternative to the traditional in-hospital approach.
International studies have highlighted home hospitals as a favorable solution for patients, presenting a sustainable option for the future. The significance of home hospitals was further emphasized during the corona pandemic.
Despite the growing popularity of home hospitals, there remains a knowledge gap regarding the involvement of relatives and how they perceive their roles when patients receive hospital treatment at home.
To address this, a group of researchers from the Norwegian University of Science and Technology (NTNU) and the Health Innovation Center conducted an investigation. Their findings, published in BMC Health Services Research, shed light on the crucial role relatives play in home hospitals. The study offers valuable insights into how their involvement varies across different phases of the treatment process when hospital care is administered at home.
Preparation for something new and unknown
In the study, participants reported a frenetic preparation phase before their loved ones could come home. However, despite this hectic period, relatives were not significantly involved in the decision-making process concerning opting for home hospital care over traditional hospital treatment.
The patients themselves displayed eagerness to return home, and their relatives shared the same sentiment. The desire to transition to home hospital care was motivated by the benefits it offered not only to the patients but also to their families.
During this phase, relatives expressed diverse information needs. Many found it challenging to cope with the overwhelming amount of information they received.
Adapting to a new everyday life at home
As the treatment shifted to the home setting, relatives expressed a mix of emotions. They felt immense joy at being reunited with their loved ones, yet, they also grappled with worries and uncertainty about the patient's well-being in the home environment.
The initial period at home was marked by stress and uncertainty. However, family members acknowledged the valuable support and follow-up provided by the healthcare personnel who visited them regularly.
The establishment of home hospitals also had a profound impact on the dynamics between the patients and their relatives, for better or worse. While some experienced tensions and conflicts, others found that navigating and confronting these challenges together brought them closer and fostered a shared sense of pride.
Everyday life quickly returned
As the treatment proved effective and the patients showed improvement, their requirements for care, nursing, and support gradually diminished. Consequently, the involvement of relatives in the caregiving process also reduced. Many individuals described this as a smooth transition back to their normal daily routines, resembling life before the patient received treatment in home hospitals.
Relatives expressed overall satisfaction with the home hospital model, and all participants expressed their willingness to contribute as relatives again if the need arose. They found motivation and a sense of purpose in assisting with care, nurturing, and support at home, recognizing the positive impact it had on both the patient's well-being and the family's cohesion.
Useful knowledge for healthcare personnel
The research examining the role and involvement of relatives in home hospitals for adults is groundbreaking in the Norwegian context. Moreover, internationally, only a handful of studies have delved into this topic.
The researchers firmly believe that their study adds novel and significant knowledge that will prove invaluable in shaping future health service models, where hospital treatment is administered in patients' homes, not only within Norway but on a global scale.
Furthermore, they aspire for this newfound understanding of next of kin's involvement and roles throughout various phases of home hospital treatment to serve as a guiding resource for healthcare personnel. By leveraging this information, they hope healthcare providers can offer timely and appropriate support, thus mitigating the risk of adverse consequences experienced by relatives of patients undergoing treatment in home hospitals.
Reference: Karlsen, L., Mjølstad, B.P., Løfaldli, B.B. et al. Family caregiver involvement and role in hospital at home for adults: the patients' and family caregivers' perspective - a Norwegian qualitative study. BMC Health Serv Res 23, 499 (2023). https://doi.org/10.1186/s12913-023-09531-3
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