Blurred boundaries: home care workers’ experiences of providing care for people with dementia up to the end of life

There is a lack of evidence on the experiences of the home care workforce on providing care up to the end of life for older people with dementia. Taking an inductive approach, this empirical study explored the subjective experiences and challenges facing the home care workforce caring for people with dementia, up to the end of life. Using semi-structured interviews and Framework Analysis, the experiences of 28 home care workers and their managers (n=12) were investigated in 2016 in a range of home care services in the South-East and London regions of England. The findings suggest that blurred boundaries, the need for communication, the constant flux of a home care worker’s role and their perceptions of a client’s death were important factors in their work. This paper elaborates on the theme of blurred boundaries. The nature of this work may result in personal attachments being formed with older clients and families beyond professional relationship. Many participants described experiencing a conflict between completing a task in the allocated time, alongside having the time to provide relationship-centred care to older people and often their spouses. Operating as a lone worker in situations of potential stress and distress creates environments where rigid employment relationships are hard to sustain. From the managers’ perspective, cultural boundaries and the role of the supervisor in helping maintain boundaries at a distance are explored. The importance of applying these findings to home care practice and human resources management will be discussed