The Sense of Security and Associated Factors Among Older Home Care Clients: A Register Study

Abstract

Aim: This study aimed to explore a sense of security and the factors associated with it among older home-dwelling people who are receiving professional home care. Design: A cross-sectional register study. Method: Register data from the Finnish Institute of Health and Welfare were used for the study. The data were collected between September 2021 and October 2022 from home-dwelling older adults living in one well-being service county in Finland and receiving home care services (N = 5759). The standardized Resident Assessment Instrument for Home Care (InterRAI-HC) was used for the data collection. Descriptive statistics and binary logistic regression analysis were applied to identify the determinants of a sense of security. Outcome Measures: A subjective sense of security. Results: There was a significant association between a higher subjective sense of security and younger age (aged 85+ OR = 0.982, p < 0.001, 95% CI = 0.97–0.99), male gender (OR = 1.866, p < 0.001, 95% CI = 1.60–2.18), no deficiencies in housing conditions (OR = 1.224, p < 0.001, 95% CI = 1.10–1.37), strong and supportive relationships with family (OR = 1.614, p < 0.001, 95% CI = 1.32–1.98), and having had no falls during the past 90 days (OR = 1.351, p < 0.001, 95% CI = 1.17–1.56). Study Limitations: The main limitation of the study is that the register data had been collected by numerous home care professionals and within different home care settings, which may explain the relatively low effect sizes. Conclusions: Strong family support manifested as the primary societal explanatory factor for a sense of security, whereas home care support services did not play a contributing role. Promoting and enabling good and active family relationships and involving families in the planning of care is a strategy that home health care providers can use to support a sense of security and well-being among older adults living at home.