Home Care Clients Research Articles

Effect of individually tailored nutritional counseling on frailty status in older adults with protein-energy malnutrition or risk of it: an intervention study among home care clients.

Frailty and protein-energy malnutrition (PEM) are common in older home care clients. In this study, we evaluate the effect of individually tailored dietary counseling on frailty status among home care clients with PEM or its risk aged 75 or older with a follow-up of six months. This intervention study is part of the non-randomized population-based Nutrition, Oral Health and Medication (NutOrMed) study in Finland. The frailty was assessed using the abbreviated Comprehensive Geriatric Assessment (aCGA) and included 15 questions from three different domains: cognitive status (MMSE), functional status (ADL, IADL) and depression (GDS-15). The study population consisted of persons with PEM or its risk (intervention group n = 90, control group n = 55). PEM or its risk was defined by MNA score <24 and/or plasma albumin <35 g/l. Registered nutritionist gave individually tailored nutritional counseling for participants at the baseline and nutritional treatment included conventional food items. The mean age was 83.9 in the intervention and 84.3 in the control group. At the baseline frailty prevalence was 74.4% (n = 67) and after six-month 61.1% (n = 55) in the intervention group and, respectively 74.5% (n = 41) and 80.0% (n = 44) in the control group. The intervention decreased significantly (p < 0.001) the prevalence of frailty in the intervention group, while it increased in the control group. Individually tailored nutritional counseling reduces the prevalence of frailty among vulnerable home care clients with PEM or its risk. In the nutritional treatment of frailty, adequate intake of protein and energy should be a cornerstone of treatment.

Predictors, Diagnoses, and Costs of Emergency Department Visits among Home Care Clients

ObjectivesTo examine factors, diagnoses, and costs associated with emergency department (ED) visits among home care clients. DesignA prospective 1-year follow-up study. Settings and ParticipantsMore information is needed regarding the reasons and costs associated with ED visits by home care clients. Participants were persons aged ≥65 years living in Eastern Finland and receiving regular home care services (n = 293). MethodsData collection included clients’ demographics, health status (Charlson Comorbidity Index), medication use, assessments of physical (Timed Up and Go) and cognitive functioning (Mini-Mental State Examination), Basic and Instrumental Activities of Daily Living, mood (Geriatric Depression Scale, GDS-15) and health-related quality of life [HRQoL, EuroQol (EQ-5D-3 L)]. Logistic regression and univariate analyses of variance were conducted. The costs (total and per person-year) of ED visits were calculated. ResultsThe number of ED visits was 775 during the follow-up (mean 350 days). The likelihood of ED visits was reduced by better HRQoL and increased by a higher GDS-15 score, longer TUG times, and a history of heart failure and decreased glomerular infiltration. The most common primary diagnoses for ED visits were heart failure (8.4%), atrial fibrillation (4.0%), respiratory infection (4.0%), and cystitis (3.5%). The total costs of all ED visits during the follow-up were 251,247 € and internal medicine and surgery accounted for 142,726 € and 89,212 € of the cost, respectively. The costs per person-year were 981 €. Conclusions and ImplicationsHRQoL, depressive symptoms, mobility, and heart and renal failure were associated with the number of ED visits. The most common reasons for ED visits were chronic heart conditions and infectious diseases and the highest costs were incurred by internal medicine treatment. With advanced care planning and active symptom screening and cooperation of home care nurses and physicians, some of the ED visits, for example due to heart failure, might be preventable.

What contributes to a decline in cognitive performance among home care clients? Analysis of interRAI data from across Canada

BackgroundThe current study examined potential risk factors for experiencing a decline on the interRAI Cognitive Performance Scale (CPS).MethodsThis was a retrospective cohort study using secondary data collected with the Resident Assessment Instrument for Home Care (RAI-HC) for all assessments completed in Canada between 2001 and 2020. Eligible home care clients included individuals 65+, with at least two assessments completed within 12 months, and who had a CPS score of zero at baseline (n = 146,187). A decline on the CPS was defined as any increase (i.e., worsening) on the CPS score between the two assessments.ResultsThe mean age of the sample was 80.6 years (standard deviation = 7.7), 67.9% were female and 44.5% were widowed. At the time of the second assessment, 25.2% experienced a decline on their CPS score. In the final multivariate model, age, having a diagnosis of Alzheimer’s dementia/other type of dementia, physical inactivity, and having a caregiver at risk of experiencing burden were the most significant predictors of experiencing the outcome.ConclusionsRoughly one-quarter of Canadian home care clients experienced a cognitive decline, over an average of seven months. Since there are some modifiable risk factors for this outcome, it is important to identify and flag these factors as early as possible. Early identification of modifiable risk factors allows clinicians to create care plans that can optimize the well-being of the client and their family.

Pan-Canadian estimates of the prevalence and risks associated with critical wandering among home care clients.

We used clinical assessment records to provide pan-Canadian estimates of the prevalence and risks associated with recent (within the last 3 days) critical wandering among home care clients, with and without dementia. The data source is interRAI Home Care (interRAI HC) assessments. The population was all long-stay home care clients assessed between 2004 and 2021 in seven Canadian provinces and territories (N=1,598,191). We tested associations between wandering and cognition and dementia diagnoses using chi-square tests and logistic regression. Approximately 84% of the sample was over the age of 65. The overall rate of recent wandering was 3.0%. Dementia diagnosis was strongly associated with two to four times higher rates in the prevalence of recent critical wandering. InterRAI HC offers insights into the wandering risk of home care clients. This information should be used to manage risks in the community and could be shared with first responders. In all the study regions combined, the rate of recent wandering is 3.0%. Dementia was associated with 18 times greater prevalence of recent critical wandering. Home care clients at risk of wandering have complex clinical profiles that pose important risks for their health and well-being. Collaboration and information sharing between search and rescue and health professions is essential for managing risks related to critical wandering.

Cost-effectiveness of protein-rich meals and snacks for increasing protein intake in older adults

ObjectivesTo investigate the cost-effectiveness of protein-rich meals and snacks for increasing protein intake in home-dwelling older adults. DesignCost effectiveness analysis from a randomized controlled trial, the Power Meals study. SettingParticipants were randomized into one of three groups for eight weeks: a protein-rich meal, snack and bread (Protein), a regular meal (Normal) and a control group without meal service (Control). ParticipantsHome-dwelling home care clients, caregivers and care recipients aged ≥ 65 years (n = 65). MeasurementsProtein intake was assessed by a three-day food diary at the end of the study. Cost for the daily diet was estimated by using Finnish grocery store databases and the prices of the food service. The cost-effectiveness was assessed by an incremental cost-effectiveness ratio (ICER). ResultsCosts for the daily diet in the Protein (8.35 €/d) and the Normal (7.94 €/d) groups were significantly higher than in the control group (5.65 €/d) (p < 0.001). Incremental cost-effectiveness analysis showed that increasing protein intake was cost-effective in the Protein group as incremental cost-effectiveness ratio was 8.11 in the Protein, 8.72 in the Normal and 6.45 in the Control group. ConclusionsIncluding protein rich meals and snacks in a diet increases protein intake in home-dwelling older adults cost-effectively.

Determinants of received care time among Finnish home care clients and assisted living facility residents: a time-motion study

BackgroundAgeing populations and care workforce shortages across Europe are causing challenges for care services for older people. Therefore, it is paramount that limited care resources are allocated optimally, based on the clients’ care needs. Multiple functioning-related factors have been identified that determine the amount of care time clients receive, while organizational and other factors remain largely unexplored. The aim was to examine how various individual and organizational factors are associated with clients’ received care time in different care settings.MethodsCross-sectional observational study design with data from time and motion study, registers, and surveys was used. In total, 1477 home care clients and 1538 residents from assisted living facilities with 24/7 service participated, from 61 Finnish care units. Linear mixed-effect modeling was used to examine the association between individual and organizational-level variables and received care time.ResultsPhysical functioning was the strongest predictor of received care time in both care settings. In home care, greater pain, more unstable health, and higher team autonomy were associated with increased care time. In assisted living, depressive mood and higher staffing level of the organization were associated with care time. Clients who received informal care also received significantly more care time from nurses in both care settings.ConclusionsPhysical functioning was the main driver of received care time. Interventions that maintain or improve physical functioning can help restrain the growing need of care resources, although it is important to ensure that each client receives care according to their holistic care needs.

Applying Newly Identified Financially Focused Home Care Quality and Performance Indicators In Alberta's $23.5B/annum Health System - Preliminary Findings

Through a multi-phased mixed-method research program including an international scoping review and a modified-Delphi panel with expert policy/academic/operational representatives from across Canada, three health-system, financially focused quality and performance home care indicators were identified. This presentation will provide preliminary results of the application of the three financial indicators on overall health-system measures, system utilization and population outcomes within the province of Alberta. The time-period covered is the last five years data leading up to the start of the deceleration of the covid-19 global pandemic. Based on provincial annual financial reporting, baseline 2016/17 fiscal year home care expenditures were $585K, this rose to significantly to $716M for fiscal year 2019/20, with the most significant increase (13%) occurred between the 2017/18 and 2018/19 years. Prior to 2016/17 home care expenditures increased at a rate less than 3%. These significant home care investments increased the percent of the overall expenditures in Alberta from 3.94 to 4.6%. Furthermore, the average annual expenditures per home care client rose from $5,417 to $6,112. During this same time-period, numerous health-system indicators shifted to more favorable positions, with notable decreases in acute care days prior to death, number of those waiting in hospital for LTC, and preventing/delaying the need for LTC overall. Based on comparisons of home care investments on the overall health-system and key health-system performance indicators focused on measuring system efficiencies, preliminary examinations suggest that significant home care focused investments in Alberta significantly improved health-system performance, efficiencies, and overall outcomes for the population.

Prognosis of fall risk in home care clients: A noninvasive approach using survival analysis

Abstract Aim The present study has designed, implemented, and evaluated a machine learning model that can predict fall risk and fall occurrence in community-dwelling elderly based on their home care usage. Subjects and methods A dataset consisting of 2542 weekly home care records for 1499 citizens (59% female, 41% male) with a mean age of 77 years (SD 10 years) was collected from a large municipality in Denmark. The data were recorded between January 1, 2021, and December 31, 2021. The dataset was divided into two cohorts. Subsequently, five machine learning-based survival analysis models were trained and evaluated using cross-validation. Results The CoxBoost model showed the best discriminative performance with a mean 0.64 (95% CI 0.57–0.72) Harrell’s concordance index, indicating better ranking than chance-level by 14% on average. However, the model could not accurately predict when the next fall would take place. Conclusions The proposed method enables professionals to assess individual fall risk by using home care records from an Electronic Health Record (EHR) system. This facilitates the initiation of targeted fall-prevention programs for those at highest risk. Additionally, it is expected that a risk-based approach can lead to a lower number needed to treat (NNT), indicating greater effectiveness of health interventions.

Identifying cost-based quality and performance indicators for home care: a modified delphi method study

BackgroundThis study, part of a multi-study program, aimed to identify a core set of cost-based quality and performance indicators using a modified Delphi research approach. Conceptually, this core set of cost-based indicators is intended for use within a broader health system performance framework for evaluating home care programming in Canada.MethodsThis study used findings from a recently published scoping review identifying 34 cost-focused home care program PQIs. A purposive and snowball technique was employed to recruit a national panel of system-level operational and content experts in home care. We collected data through progressive surveys and engagement sessions. In the first round of surveying, the panel scored each indicator on Importance, Actionable, and Interpretable criteria. The panel set the second round of ranking the remaining indicators’ consensus criteria. The panel ranked by importance their top five indicators from operational and system perspectives. Indicators selected by over 50% of the panel were accepted as consensus.ResultsWe identified 13 panellists. 12 completed the first round which identified that 30 met the predetermined inclusion criteria. Eight completed the ranking exercise, with one of the eight completing one of two components. The second round resulted in three PQIs meeting the consensus criteria: one operational and two systems-policy-focused. The PQIs: “Average cost per day per home care client,” “Home care service cost (mean) per home care client 1y, 3y and 7y per health authority and provincially and nationally”, and “Home care funding as a percent of overall health care expenditures.”ConclusionsThe findings from this study offer a crucial foundation for assessing operational and health system outcomes. Notably, this research pioneers identifying key cost-based PQIs through a national expert panel and modified Delphi methodology. This study contributes to the literature on PQIs for home care and provides a basis for future research and practice. These selected PQIs should be applied to future research to test their applicability and validity within home care programming and outcomes. Researchers should apply these selected PQIs in future studies to evaluate their applicability and validity within home care programming and outcomes.

Patterns of Multidimensional Social Exclusion Among Older Home Care Services Recipients.

The guiding principle of current aging policies has been to promote older adults to live in their private homes, but little attention has been paid to social exclusion of older adults receiving home-based care. The aim of this study is to increase understanding on different patterns of multidimensional social exclusion among older adults receiving formal home care services, and through this to shed light on the possible challenges of current aging-in-place policies. The survey data were collected in 2022 among older adults aged 65 to 102 years receiving home care services in Finland and merged with administrative data (n = 733). A latent class analysis was used to identify different types of social exclusion. Multinomial logistic regression modeling examined factors associated with different social exclusion types. Four social exclusion types were identified: (1) not excluded (16.9%), (2) homebound economically excluded (40.1%), (3) excluded from social relations (28.6%), and (4) multidimensionally excluded (14.3%). Poor self-rated health and poor functional ability significantly increase the risk of being multidimensionally excluded or homebound economically excluded. The group using home care and medical services the most are the most multidimensionally excluded. The group living in urban areas are more likely to be excluded from social relations. Different types of social exclusion should be acknowledged when addressing social exclusion among home care clients. Enhanced measures should be developed to support older adults using home and healthcare services the most, as they are at high risk of severe exclusion.

Problematizing Dominant Assumptions about Unpaid Support through Exploring Case Study Profiles of Older Home Care Clients

Despite efforts to acknowledge diversity among unpaid caregivers, Canadian research, advocacy, practice, and policy tend to be based in and to reproduce dominant social and institutional expectations and assumptions about who provides unpaid support and why, and what this support looks like. The objective of thtudinal, qualitative research study. In that study, qualitative case study interviews were conducted with twelve home care clients, their identified family or friend caregiver, home care aide, case coordinator, and agency supervisor (129 interviews in total). Case study profiles compiled over time generated deeper information about the availability and capacity of informal sources of support for these clients, which prompted abductive analysis in relation to dominant assumptions typically made about caregivers in research, policy, and practice. Specifically, only one case (participant) had a caregiver whose profile closely matched dominant conceptualizations. In the remaining eleven cases, we found situations wherein: (a) caregivers grappled with physical or mental health challenges limiting their participation in care (sometimes meaning the client is themselves a caregiver, or the caregiver is also receiving home care services); (b) caregivers facing burnout sought to delimit their participation in care; (c) caregivers’ participation was limited by older adults’ reluctance to accept their help; (d) caregivers were largely unavailable, unreliable, or peripheral; or (e) client’s unpaid support networks were diffuse without a clearly central or identifiable “caregiver.” Findings are used to nuance and problematize widely held assumptions about caregivers, particularly their availability and capacity. Discussion highlights the need for research, policy, and programs related to unpaid caregiving to better reflect the lived realities of this support for older adults and often overlooked sources of diversity in caregiver circumstances and roles.

Profiling the medical, functional, cognitive, and psychosocial care needs of adults assessed for home care in Ontario, Canada: The case for long-term 'life care' at home.

Calls to leverage routinely collected data to inform health system improvements have been made. Misalignment between home care services and client needs can result in poor client, caregiver, and system outcomes. To inform development of an integrated model of community-based home care, grounded in a holistic definition of health, comprehensive clinical profiles were created using Ontario, Canada home care assessment data. Retrospective, cross-sectional analyses of 2017-2018 Resident Assessment Instrument Home Care (RAI-HC) assessments (n = 162,523) were completed to group home care clients by service needs and generate comprehensive profiles of each group's dominant medical, functional, cognitive, and psychosocial care needs. Six unique groups were identified, with care profiles representing home care clients living with Geriatric Syndromes, Medical Complexity, Cognitive Impairment and Behaviours, Caregiver Distress and Social Frailty. Depending on group membership, between 51% and 81% of clients had identified care needs spanning four or more Positive Health dimensions, demonstrating both the heterogeneity and complexity of clients served by home care. Comprehensive clinical profiles, developed from routinely collected assessment data, support a future-focused, evidence-informed, and community-engaged approach to research and practice in integrated home-based health and social care.

Coaching Home Care Clients to Prepare Their Homes for Safe Care Visits: A Mixed-Methods Study to Evaluate a Nurse-Led Educational Intervention Process.

Assuring home care (HC) workers' safety is challenging because the work environment is a private home. This paper presents the process evaluation for a proof-of-concept safety intervention study to assess whether nurse-led safety coaching, using motivational interviewing and a safety handbook, could enable HC clients to improve safety in their homes. The process evaluation objectives were to (i) document the intervention's implementation progress and (ii) assess the intervention's dose delivery, dose reception, and fidelity. Five agencies employing liaisons (n = 5) and nurse managers (NMs, n = 8) implemented this study's intervention and control arms. NMs assigned to the intervention arm (n = 6) coached 34 clients. Process evaluation metrics were assessed with mixed-methods data from (i) surveys completed by NMs during the intervention, (ii) postintervention audio-recorded and transcribed interviews (n = 6) with NMs and liaisons, and (iii) study progress tracking tools. The delivered dose efficiency was 85%, measured by the distribution of safety handbook copies to clients. About 94% of clients (n = 32) were considered "engaged" or "maybe engaged" during the safety coaching. Most coached clients (n = 30) were reachable for follow-up by NMs to assess intervention progress. Despite challenges, the intervention was implemented with good fidelity. Safety coaching can be applied in many HC contexts in larger populations.

Collaborative medication reviews in community pharmacies-Drug-related problems and the process of communicating them with physicians: A retrospective validation study.

Cooperation between practicing community pharmacists (PPs) and primary care physicians has traditionally been limited, with scarce communication on therapeutic issues. The aim of this study was to assess how PPs communicate in writing with physicians regarding (1) the clinically relevant problems they have identified in patients' medications and (2) recommendations to solve the problems to identify development needs in the communication process. This retrospective validation study assessed medication reviews conducted by PPs in collaboration with home care nurses, practice nurses, and physicians for 46 older (≥65 years) home care clients in the Municipality of Lohja, Finland. The therapeutic and communicative appropriateness of clinically relevant drug-related problems (DRPs) identified by PPs and reported in writing to physicians was blindly evaluated by (1) an accredited pharmacist (AP) and (2) two physicians specialized in geriatric pharmacotherapy. Descriptive statistical analysis was conducted to compare the assessments. The PPs (n = 13) identified 189 DRPs and made 4.1 recommendations per patient in 46 written reports to physicians. Of the PPs' written recommendations for medication changes, 46% (155/334) were the same as those by the AP. The two specialized physicians evaluated 69% and 67% of PPs' recommendations to be clinically relevant. The way the DRPs and recommendations to solve them were communicated was evaluated as appropriate in 38% and 38%, respectively, of the case reports written by the PPs. The PPs were able identify DRPs quite well, particularly inappropriate medication use, according to current care guidelines and formularies. It was found that improvement was needed in the communication of DRPs in written reports with physicians. Interprofessional learning by working in care teams would be suitable for strengthening patient care-oriented competencies.

Estimated mortality risk and use of palliative care services among home care clients during the last 6 months of life: a retrospective cohort study.

In Canada, only 15% of patients requiring palliative care receive such services in the year before death. We describe health care utilization patterns among home care users in their last 6 months of life to inform care planning for older people with varying mortality risks and evolving care needs as they decline. Using population health administrative data from Ontario, we performed a retrospective cohort study involving home care clients aged 50 years and older who received at least 1 interRAI (Resident Assessment Instrument) Home Care assessment between April 2018 and September 2019. We report the proportion of clients who used acute care, long-term care, and palliative home care services within 6 months of their assessment, stratified by their predicted 6-month mortality risk using a prognostic tool called the Risk Evaluation for Support: Predictions for Elder-life in their Communities Tool (RESPECT) and vital status. The cohort included 247 377 adults, 11.9% of whom died within 6 months of an assessment. Among decedents, 50.6% of those with a RESPECT-estimated median survival of fewer than 3 months received at least 1 nonphysician palliative home care visit before death. This proportion declined to 38.7% and 29.5% among decedents with an estimated median survival between 3 and 6 months and between 6 and 12 months, respectively. Many older adults in Ontario do not receive any palliative home care before death. Prognostic tools such as RESPECT may improve recognition of reduced life expectancies and palliative care needs of individuals in their final years of life.

Home Care Worker Continuity in Home-Based Long-Term Care: Associated Factors and Relationships With Client Health and Well-Being.

Despite the importance of provider continuity across healthcare settings, continuity among home care workers who provide hands-on long-term care is understudied. This project describes home care worker continuity, identifies factors associated with increased continuity, and examines associations between continuity and client outcomes. We conducted a retrospective cohort study of clients receiving Medicaid-funded home-based long-term care (n = 3,864) using insurance plan and home care agency data from a large nonprofit organization. We estimated home care worker continuity for clients between 6-month clinical assessments using Bice-Boxerman scores. We then used generalized estimating equations to model associations between home care worker continuity and (1) client characteristics (e.g., cognitive impairment), and (2) client functional, health, and psychosocial outcomes. While home care worker continuity was lowest for clients receiving the most weekly care hours, a range of continuity existed across all levels of care need. Those who were male, older, Asian/Pacific Islander/Native American, cognitively impaired, and functionally impaired had lower continuity. Higher home care worker continuity was significantly associated (p < .05) with fewer falls, a higher likelihood of functional improvement/stabilization, and fewer depressive symptoms. The finding that home care worker continuity is associated with the health and well-being of home-based long-term care clients underscores the importance of building high-quality relationships in long-term care. Continued efforts are necessary to understand and advance home care worker continuity and to identify other aspects of the home care experience that benefit those receiving long-term care at home.

Rehabilitation Therapy and Multimorbidity: A Retrospective Cohort Study

Aims Home care rehabilitation therapists can address the functional health needs of those with multimorbidity. This study described individuals with multimorbidity receiving home care rehabilitation therapy and examined the relationship between receipt of rehabilitation therapy and hospital utilization. Methods The cohort included long-stay home care clients experiencing multimorbidity who were discharged from an inpatient rehabilitation setting (N = 5,234) between 2007 and 2015. Multivariable logistic regression was used to examine the association between receipt of rehabilitation therapy and hospitalization. Results Nearly 40% of this cohort had 5+ chronic conditions. Those receiving only rehabilitation therapy were less likely to be readmitted to the hospital (OR = 0.68; 95% CI: 0.51–0.92), and less likely to use emergency services (OR = 0.80; 95% CI: 0.66–0.97) at the 3-month timeframe. Similar trends were observed at the 12-month timeframe. Conclusions Individuals with multimorbidity have complex health needs and home care rehabilitation therapists aid in sustained discharges and influence subsequent health utilization.

Use of oral health care services among older home care clients in the context of an intervention study.

An increasing number of care-dependent older people living at home need external support to receive regular dental care. To investigate the use of oral health care services among old home care clients who participated in an intervention study focusing on oral self-care and nutrition. This study employed data from the multidisciplinary Nutrition, Oral Health and Medication (NutOrMed) intervention study with a population-based sample of 245 home care clients (74% female) aged 75 or more divided in intervention (n = 140) and two control groups (n = 105). The data were collected through interviews at baseline and 6-month follow-up. At baseline, 43% of participants reported visits to oral health care within the previous year. At 6-month follow-up, this proportion was 51%. In the intervention group, the corresponding figures were 46% and 53%, and in the controls 39% and 48%. Adjusted regression analyses showed that this change was statistically significant (p = 0.008). In addition, higher education and toothache or other discomfort related to teeth or dentures at baseline were associated with increased use after the 6-month follow-up (OR = 1.1, 95% CI = 1.0-1.2; OR = 3.4, 95% CI = 1.5-7.9) but being edentulous indicated the opposite (OR = 0.2, 95% CI = 0.1-0.4). Belonging to the intervention group was not associated with increased use. In older adults, any efforts to raise awareness of oral health are of great potential to increase use of services.

Family and friend caregiver satisfaction and utility of passive remote monitoring technology utilized by frail home care clients

Family and friend caregiver satisfaction and utility of passive remote monitoring technology utilized by frail home care clients

Finnish telehomecare workers' satisfaction with the inclusion of telehomecare in older adults' home care and factors associated with it

AbstractBackgroundTelehomecare in older adults' home care in Finland is mainly video‐mediated check‐up and reminder calls with home care clients. Home care workers have reported mixed attitudes and feelings towards utilisation of technologies and remote services in their work.ObjectivesThe aim of this cross‐sectional study was to investigate Finnish telehomecare workers' satisfaction with the inclusion of telehomecare in older adults' home care. Another aim was to examine what factors are associated with this satisfaction.MethodsThe data were collected with an electronic quantitative email survey. Five Finnish older adults' home care organisations participated as the target organisations of the study. Two of the organisations were located in large cities, one in a medium‐sized provincial centre and two in rural municipalities. Three organisations provided telehomecare services with centralised service models and two with decentralised service models. In total, the organisations had 103 telehomecare workers to whom the survey was directed.ResultsThe telehomecare workers were mostly satisfied with (55.8%) or felt neutral about (20.9%) the inclusion of telehomecare in older adults' home care. Satisfaction was strongly related to the workers' experience of telehomecare making their work easier, improving interaction and enhancing relationships of trust with clients as well as decreasing workload. Application of telehomecare to overcome the workers' physical restrictions, and also their perceptions of being able to influence whether to start working in telehomecare, were strongly related to their satisfaction with the inclusion of telehomecare in home care.ConclusionsThe results confirm that telehomecare job positions function well as relocated job positions in home care when workers have musculoskeletal problems or injuries. However, it is important that workers' willingness to work in telehomecare is also respected. From the telehomecare workers' perspective, good interaction and trustful relationships with clients are important factors that produce good care and increase satisfaction with telehomecare.Implications for practiceTelehomecare may have a positive impact on the home care workers’ job satisfaction. The homecare workers need training in the use of new technologies. In addition, they need to be able to decide themselves whether they start working in telehomecare or not.