Understanding Change in Home Care Pathways Over Time Through Longitudinal Qualitative Inquiry

Longitudinal qualitative inquiry from a social gerontological perspective can offer unique insights into older adults’ wellbeing and home care service trajectories. This temporal case study of 12 older home care clients analysed 136 interviews over three time points with 53 home care network actors in Manitoba and Nova Scotia. Many clients and families grappled with service changes almost daily, even if the level or type of service appeared officially stable. The pandemic added further disruption, shaping clients’ lives, wellbeing, and relationships, as well as their access to and use of service. Notably, changes in clients’ wellbeing and needs for help were not necessarily straightforward nor always apparent to case coordinators, especially when these were tied to social, emotional, or relational wellbeing, or to clients’ living arrangements, housing, family, and community integration. Findings can enhance theorizing of change for older adults receiving home care and guide equity-informed policy and practice.