Development, piloting and feasibility of a complex intervention for the prevention of insufficient home care for older people - Prev-It (Prevention of insufficient home care of community-dwelling older adults)

Project background

As our society ages, the proportion of people in need of care will continue to rise in the coming years. The majority of them are already being cared for at home by relatives. As the carers themselves are often already at an advanced age and are exposed to a great deal of stress as part of their caring role, this can be abruptly interrupted by accidents, illness or overload, for example. The acute lack of care in the home that then occurs not only poses a risk for the individual person, but also a challenge for society as a whole.

Project objective

The Prev-It project aims to develop a complex intervention to prevent care shortages in the home. This consists of advice, guidance, training and the development of a concept for a care crisis service. In two model regions in the city and district of Rosenheim, a participatory training concept is to be developed for care advisors who advise people in need of care and their relatives on how to plan their care situation in advance and prevent underuse. In addition, a coordination office is to be set up, staffed by a community health nurse. This nurse will provide advice, guidance and training on primary and secondary prevention of underuse, for example at group and community level. The intervention is tested for feasibility and acceptance. In addition, the basis for the development of a care crisis service for emergencies of acute underuse will be created and implications for implementation derived.

The goals of Prev-It are:

1) Participatory and interdisciplinary development of the training concept for nurse consultants and the CHN

2) Piloting and testing the feasibility and acceptance of the training concept for nurse consultants and the CHN

3) Testing the feasibility of the new coordination office

4) Development of implications (principles and prerequisites) for a nursing crisis service in the event of acute care shortages in the home on the basis of an interdisciplinary needs assessment and systematic literature research.

Project procedure

A complex intervention based on the framework for the development and evaluation of complex interventions of the UK Medical Research Council (MRC) (Skivington et al. 2021) is to be developed, piloted and tested for feasibility and acceptance in the Rosenheim model region. To this end, a logical model will be developed and outcomes identified in a participatory and interdisciplinary manner. A process evaluation will be carried out in parallel to the feasibility test. During the project, a systematic literature review and needs assessment will be carried out to identify implications for a care crisis service.

Innovation

The intervention developed is intended to avoid unnecessary hospital admissions and thus reduce the burden on the individual and the costs to society. The project thus helps to close a gap in the healthcare system. In addition, the intervention can help to raise awareness in society as a whole of the risk of inadequate care.