Background: Older adults make up the majority of the population accessing domiciliary care services. Evidence from national and international studies suggest a significant association between having access to home care and support and older adults’ ability to remain at home. Few studies have explored the contribution night-time domiciliary care makes to older adults’ ability to achieve night-time personal wellbeing goals. This thesis aims to explore the existing evidence on the availability, delivery, impacts and outcomes of night-time domiciliary care. Evidence will be offered from the findings of a three-phase project to contribute to understanding of this area.
Methods: A scoping review of papers published in English during the last seven years will retrieve international evaluations of overnight care at home services to provide contextual information to the research. Descriptive analysis of anonymised service data routinely collected by an overnight service operating in north west Wales will explore such factors as: who is using the service; the presenting problems of people who need unscheduled overnight
care and support; and how unscheduled care and support is delivered. Qualitative semistructured interviews conducted with older adults that have received unscheduled care and support at home and their unpaid carers will explore how the service impacted their ability to achieve personal wellbeing outcomes. Finally, a questionnaire developed to monitor older adults’ satisfaction and outcomes will be piloted to ascertain its usability and acceptability and to determine whether this will be a useful way for the service to collect feedback in future.
Findings: Domiciliary night care staff can play an integral role in meeting the overnight care and support needs of older adults who wish to be cared for at home by delivering timely, individualised, person-centred care. Study participants perceived that having access to overnight care and support at home enhanced older adults’ ability to maintain a sense of independence and autonomy and supported unpaid carers to continue to provide care. A lack of information and a lack of service visibility were barriers to older adults’ and unpaid carers’
ability to access care and support at home.
Implications: A rapidly ageing population is expected to increase demand for care at home at the same time as social care budgets are being capped. Supporting unpaid carers is crucial to ensure the future sustainability of adult social care and to meet older adults’ personal wellbeing needs. Involving service users in the design and development of overnight care and support at home services may help to ensure service delivery meets the needs and preferences of older adults.
Conclusion: Findings from this thesis contribute to understanding of overnight care and support services’ contribution to the wellbeing of older adults and the wellbeing of unpaid carers. More evidence is needed on the impact and outcomes of delivering overnight care and support at home to the older population to help inform service commissioning. Recommendations for further research are offered.