Participation in home-based long-term care (SPITEX)
Background
Professional home-based long-term care (Spitex) is becoming increasingly important. More and more older people in Switzerland are making use of the services of a Spitex organization: according to the Federal Statistical Office, demand rose by 61% between 2010 and 2019 and a further increase of 52.3% is expected between 2019 and 2040. The principle of “ambulant before residential” is also promoted by the authorities and has found its way into many ageing strategies, such as the guidelines of the Canton of Basel-Stadt’s old-age care policy. In addition, most people prefer to continue living at home with the help of Spitex rather than moving into a nursing home. Being able to stay in their own four walls, in their familiar neighborhood, is associated with more self-determination, more opportunities to help shape everyday life and more participation in society. This project explores the extent to which this is actually the case and what participation looks like in the context of home-based care.
Objectives
The research project aims to 1) identify how participation in home-based long-term care is negotiated in the literature and then describe how and by whom participation of older people living with home-based long-term care is understood, discussed and practiced. The project also aims 2) to analyze possible unjust or unfair inequalities related to the participation of older people living with home-based long-term care and 3) to contribute to the development of ideas and approaches to promote the participation of older people living with professional home-based long-term care.
Methods
The study focuses on older people who live at home with the help of Spitex, as well as their relatives, Spitex staff and other important people such as potential caregivers or neighbors. The ethnographic study includes various qualitative research methods, such as participation and observation, informal conversations, interviews and document analysis. Participation and observation in particular require a lot of time, but allow us to go into depth and gain insights that cannot be obtained by simply asking questions in an interview, for example. The ethnographic approach also makes it possible to include people with dementia and/or other psychogeriatric illnesses in the research.
The data will be collected in three different Spitex centers in the cantons of Basel-Stadt and Basel-Landschaft. In 2025, intensive field research will be conducted in each center for approximately two months, followed by occasional visits until the end of the project in 2027.
The data will be analyzed on an ongoing basis jointly by the EPICENTRE-PARTICIPATIO team and a SPITEX Basel employee. Objective no. 3 will be achieved in collaboration with the transdisciplinary advisory group.
