Physical activity uptake, adherance and effects among home care clients.

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In the three local government areas of Maribyrnong, Brimbank, and Melton, “home care” is available for people who are impaired in their ability to self care (cooking, dressing, bathing) or undertake domestic cleaning. Home care services are provided in clients’ homes by home care workers employed by the local government. People who request home care have their domestic care requirements determined by home care assessors, also employed by local government. Home care assessors also monitor clients’ home care needs through routine follow up checks. Home care workers and home care assessors practice a passive care model in which home care is delivered to clients without any requirement for client involvement. A drawback of this passive care model is that already functionally limited clients may have their physical capacity further reduced through dependence on other people. Three municipal councils, the Dept of Health and Ageing, and Victorian University Exercise Rehabilitation Unit will combine resources to develop an active service model of home care. Home care assessors and home care workers will be trained to identify physical activity need, and plan, implement and support physical activity with home care clients. Once home care workers and assessors have completed this training, home care clients will be invited to volunteer to participate in the active service model of home care. The active service model pilot will run for 6 months. During the active service model of home care, home care assessors and home care workers will interact with clients with the same frequency as in the current passive care model. As well as assessing home care requirements, home care assessors will identify physical activity needs and opportunities. Clients will participate in identifying physical activity needs, and planning physical activities that they a) want to undertake, and b) feel they can undertake with the supervision or assistance of their home care workers. An accredited exercise physiologist will be available throughout the project to support clients, home care workers, and home care assessors in constructing exercise / physical activity plans. Clients who volunteer to receive home care under this model will be asked to complete a battery of pencil and paper questionnaires at the beginning, middle, and end of 6 months. Using these questionnaires, the researchers will seek information about clients’ motivations toward physical activity, physical activity uptake, the continuation of physical activity over time (adherance), and any health effects (physical function, mental well-being, social function) of physical activity.

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