Home visits for frail older people: a qualitative study on the needs and preferences of frail older people and their informal caregivers.

BACKGROUND: A number of studies have examined the effects of home visits and showed inconsistent results on physical functioning, institutionalisation, and mortality. Despite continuing interest from professionals in home visits for older people, reports on older people's needs and preferences for such visits are scarce. AIM: This qualitative study aims to explore the views and needs of community-dwelling frail older people concerning home visits. DESIGN AND SETTING: A qualitative study including interviews with frail older persons and their informal caregivers living in the area of Nijmegen, the Netherlands. METHOD: Semi-structured interviews were conducted with frail older people and informal caregivers. A grounded theory approach was used for data-analysis. RESULTS: Eleven frail older people and 11 informal caregivers were included. Most participants emphasised the importance of home visits for frail older people. They felt that it would give older people the personal attention they used to receive from GPs but miss nowadays. Most stated that this would give them more trust in GPs. Participants stated that trust is one of the most important factors in a good patient-professional relationship. Further, participants preferred home visits to focus on the psychosocial context of the patient. They stated that more knowledge of the psychosocial context and a good patient-professional relationship would enable the professional to provide better and more patient-centred care. CONCLUSION: Patients' expectations of home visits are quite different from the actual purpose of home visiting programmes; that is, care and wellbeing versus cure and prevention. This difference may partly explain why the effectiveness of home visits remains controversial. Future studies on home visits should involve patients in the development of home visiting programmes