title: Complex caring needs without simple solutions: the experience of interprofessional collaboration among staff caring for older persons with multimorbidity at home care settings.
abstract: BACKGROUND
  Older persons with multimorbidity being cared for at home often have complex needs which cannot be met by one single caregiver. Interprofessional collaboration is therefore considered necessary if care is to be organised according to the needs of the older person. To achieve coherent health care, municipalities and county councils need to develop their collaboration.
  
  
  OBJECTIVE
  The aim of this study was to illustrate how various professionals belonging to homemaker services, home care services in municipality and hospital-based home care services experience collaboration in caring for older persons with multimorbidity.
  
  
  METHODS
  A hermeneutic approach was used. Eleven informants participated in the study and were individually interviewed.
  
  
  RESULTS
  The findings show that collaboration between players comprises various types of experiences which influence not only the staff who are involved in collaboration but also the outcome of the collaboration itself. The informants' experience of collaboration was defined by distrust and trust and by insecurity and security. To focus on patients' needs and to develop the collaboration further, it was important for informants to take the relations into account and have a reflective and questioning approach. This attitude resulted in a feeling of trust and security, and a flexible and critical approach without boundary drawings between basic and specialised care.
  Complex situations cannot be solved with simple models. Instead, a flexible approach appears necessary with focus shifting from structures to interpersonal relations and interactions. Therefore, the different professionals have to work as a transprofessional team where close interactions, flexibility and improvisation are keys to success. The transprofessional team approach is suggested to have the potential to take the competence of all staff into account when high-quality home health care to older persons with multimorbidity is to be provided by multiple caregivers.
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.|School of Health and Society, Kristianstad University, Kristianstad, Sweden.
authors.forename: Anne
authors.initials: A
authors.lastname: Larsen
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Broberger
authors.affiliation: School of Health and Society, Kristianstad University, Kristianstad, Sweden.
authors.forename: Pia
authors.initials: P
authors.lastname: Petersson
mesh_terms: D000368:Aged; D003299:Cooperative Behavior; D006301:Health Services Needs and Demand; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D000071069:Multiple Chronic Conditions
keywords: hermeneutic; home care services; hospital-based home care services; interprofessional collaboration; multimorbidity; older persons