O29 Exploring the nature of home care for people living with dementia through ethnographic observations

Abstract

In the UK, over 8 50 000 people are living with a diagnosis of dementia. Many of these people wish to remain living in their own homes which is often made possible by the support of family carers and paid home care workers. However, home care is a sector that has come under much scrutiny and the workforce is often criticised for providing unsatisfactory care1. At an organisational level there is a high turnover of home care workers who are typically low-paid and receive little training and support2. We have drawn from an ethnographic approach in order to explore the nature of home care first-hand and to develop an understanding of the knowledge and training needs of home care workers. This has involved participant-observations with eight home carers across six varied locations in England, as they provide home care for clients living with dementia. As a participant-observer, we have attempted to become immersed in the reality of home care as it is experienced in the real world for those involved. Qualitative observations have enabled us to go beyond the understanding gained through interviews in order to capture the everyday experience of dementia home care. In this presentation, we will discuss the experience of conducting ethnography in a complex social care setting, faced with challenges of observing in the context of scrutiny and mistrust. The process of engaging home carers and consenting people living with dementia will be shared in order to promote the use of qualitative observations as a way of gaining a more meaningful understanding of health and social care issues within the home care workforce. As part of a wider study, these findings aim to inform the intervention development of a training programme for paid home carers, to aid consistency and accessibility of training amongst the homecare workforce. References Muntaner C, et al. County and organizational predictors of depression symptoms among low-income nursing assistants in the USA. Sci Med 2006;63(6):1454–1465. Livingston G, et al. Making decisions for people with dementia who lack capacity: qualitative study of family carers in UK. BMJ2010;341:c4184.