Like a Social Breath: Homecare’s Contributions to Social Inclusion and Connectedness of Older Adults.

Abstract

The detrimental effects of social isolation on health and well-being bring forward the need for increasing social inclusion and connectedness for older, homebound adults. Homecare services may be a source of social inclusion, but the inclusive dimensions and mechanisms of care have been less explored. This study aimed to develop more knowledge on how homecare can contribute to social inclusion by exploring older adults’ experiences with care visits as social encounters. The study utilised interviews with older adults from four municipalities in Norway and Denmark from 2018 to 2019 and drew on a combination of social inclusion theories and Goffmanian microinteractionism. Positive accounts of care encounters comprised three overlapping thematic dimensions: 1) bringing social life into the house, 2) creating connections to the outside world and 3) providing opportunities to participate in a broader array of social roles and identities. Despite variations, care visits could encompass social inclusive and connective aspects that enhanced thriving and wellbeing. Care visits increased opportunities for social participation and support of a valued self and comprised bonding, bridging and linking social capital. Care workers could be important interpersonal network resources at home, providing support and social stimulation, engagement and fun. Moreover, they could bridge to the outside society through conversations or by linking to services (e.g. day centres) that increased social participation and bonding with peers outside the house. The inclusive resources embedded in homecare need to be supported and utilised in policy and practice to increase older people’s inclusion.