Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology
Abstract Background Studies on care networks of home-dwelling older adults often focus on network composition. However, looking at network mechanisms (negotiation, navigation and contagion) can be helpful to improve the support generated by the care network. A European study on diabetes patients ide...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-04404-0 |
| _version_ | 1797397738909859840 |
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| author | Wendy Kemper-Koebrugge Marian Adriaansen Miranda Laurant Michel Wensing |
| author_facet | Wendy Kemper-Koebrugge Marian Adriaansen Miranda Laurant Michel Wensing |
| author_sort | Wendy Kemper-Koebrugge |
| collection | DOAJ |
| description | Abstract Background Studies on care networks of home-dwelling older adults often focus on network composition. However, looking at network mechanisms (negotiation, navigation and contagion) can be helpful to improve the support generated by the care network. A European study on diabetes patients identified network types based on interaction, which can be beneficial (generative, proxy) or detrimental (struggling, avoidant) to support. This study explored whether these network types are present in care networks of home-dwelling older adults in the Netherlands, and how these types manifest in composition or mechanisms. Methods The present study is a cross‐sectional qualitative study of care networks supporting 19 home‐dwelling older adults. Face-to-face interviews were conducted with the older adult and their informal and formal caregivers between March and September 2016. Network composition and mechanisms were abstracted from content analysis of interview transcripts, then network type was determined for each network. Results Three of the 19 networks had only one respondent and were excluded, yielding 16 for analysis: eight proxy networks, three generative networks, two avoidant networks, one struggling network, and two possibly hybrid networks. In the proxy networks, all negotiation and navigation were centralised by the proxy. In generative networks, negotiation was possible if the older adult could reciprocate, and the network supported this. In avoidant networks, informal and formal caregivers had to deal with an older adult who refused support. In the struggling network, the underlying problem could not be addressed. Furthermore, two networks could either be hybrid network types or networks in a transition process from generative to proxy network. Conclusion Our results suggest that the network typology developed in the context of diabetes patients is relevant and mostly replicable in networks of multi-morbid older adults. We found that a care network typology based on mechanisms offered additional information beyond network composition. It also appears that the network type can change over time, but more research is needed to confirm this. This study suggests that interventions in avoidant or struggling networks are difficult. Also, actions of network participants seemed aimed at developing proxy networks. Interventions designed to develop or maintain generative networks seem underused. |
| first_indexed | 2024-03-09T01:15:32Z |
| format | Article |
| id | doaj.art-4b53cadd2c0a4a278dbc2b6884049b4f |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-09T01:15:32Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-4b53cadd2c0a4a278dbc2b6884049b4f2023-12-10T12:31:00ZengBMCBMC Geriatrics1471-23182023-12-012311910.1186/s12877-023-04404-0Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typologyWendy Kemper-Koebrugge0Marian Adriaansen1Miranda Laurant2Michel Wensing3Radboud University Medical Center, Radboud Institute for Health Sciences, IQ HealthcareHAN University of Applied Sciences School of Health StudiesRadboud University Medical Center, Radboud Institute for Health Sciences, IQ HealthcareRadboud University Medical Center, Radboud Institute for Health Sciences, IQ HealthcareAbstract Background Studies on care networks of home-dwelling older adults often focus on network composition. However, looking at network mechanisms (negotiation, navigation and contagion) can be helpful to improve the support generated by the care network. A European study on diabetes patients identified network types based on interaction, which can be beneficial (generative, proxy) or detrimental (struggling, avoidant) to support. This study explored whether these network types are present in care networks of home-dwelling older adults in the Netherlands, and how these types manifest in composition or mechanisms. Methods The present study is a cross‐sectional qualitative study of care networks supporting 19 home‐dwelling older adults. Face-to-face interviews were conducted with the older adult and their informal and formal caregivers between March and September 2016. Network composition and mechanisms were abstracted from content analysis of interview transcripts, then network type was determined for each network. Results Three of the 19 networks had only one respondent and were excluded, yielding 16 for analysis: eight proxy networks, three generative networks, two avoidant networks, one struggling network, and two possibly hybrid networks. In the proxy networks, all negotiation and navigation were centralised by the proxy. In generative networks, negotiation was possible if the older adult could reciprocate, and the network supported this. In avoidant networks, informal and formal caregivers had to deal with an older adult who refused support. In the struggling network, the underlying problem could not be addressed. Furthermore, two networks could either be hybrid network types or networks in a transition process from generative to proxy network. Conclusion Our results suggest that the network typology developed in the context of diabetes patients is relevant and mostly replicable in networks of multi-morbid older adults. We found that a care network typology based on mechanisms offered additional information beyond network composition. It also appears that the network type can change over time, but more research is needed to confirm this. This study suggests that interventions in avoidant or struggling networks are difficult. Also, actions of network participants seemed aimed at developing proxy networks. Interventions designed to develop or maintain generative networks seem underused.https://doi.org/10.1186/s12877-023-04404-0Older adultCare networkInformal careQualitative methodologiesNetwork typeNetwork mechanisms |
| spellingShingle | Wendy Kemper-Koebrugge Marian Adriaansen Miranda Laurant Michel Wensing Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology BMC Geriatrics Older adult Care network Informal care Qualitative methodologies Network type Network mechanisms |
| title | Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology |
| title_full | Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology |
| title_fullStr | Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology |
| title_full_unstemmed | Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology |
| title_short | Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology |
| title_sort | care networks of home dwelling older adults in the netherlands proof of concept of a network typology |
| topic | Older adult Care network Informal care Qualitative methodologies Network type Network mechanisms |
| url | https://doi.org/10.1186/s12877-023-04404-0 |
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