title: The experience of empowerment in in-home services delivery.
abstract: In-home health services strive for client-centredness, involvement, and ultimately, empowerment, but economic constraint may undermine these aims. The purpose of this study was to explore the everyday experience of in-home care, with particular attention to the enactment of empowerment in the care partnership. In-depth interviews with a maximally varied sample of clients, informal caregivers, and providers uncovered relationships largely reflecting the traditional expert model of care. Findings afford insights into the unrecognized and undervalued personal knowledge of clients, caregivers, and in-home service providers, the professional and structural hegemony and consequent disempowered group behaviour of those who share the experience of care, and the hesitance of clients to engage as equitable partners in care. Strategies to achieve empowerment approaches to in-home health services are identified.
authors.affiliation: School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London. cmcwill@julian.uwo.ca
authors.forename: C L
authors.initials: CL
authors.lastname: McWilliam
authors.forename: C
authors.initials: C
authors.lastname: Ward-Griffin
authors.forename: D
authors.initials: D
authors.lastname: Sweetland
authors.forename: C
authors.initials: C
authors.lastname: Sutherland
authors.forename: L
authors.initials: L
authors.lastname: O'Halloran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000739:Anecdotes as Topic; D017028:Caregivers / Q000523:psychology* / Q000592:standards; D003657:Decision Making; D007722:Health Knowledge, Attitudes, Practice; D006299:Health Services for the Aged / Q000592:standards*; D006699:Home Care Services / Q000592:standards*; D006701:Home Nursing / Q000523:psychology* / Q000592:standards; D006801:Humans; D008875:Middle Aged; D009864:Ontario; D010358:Patient Participation / Q000706:statistics & numerical data*; D012944:Social Support; D011795:Surveys and Questionnaires