Complicated Interactions in Home Care: An Ethnographic Study

In this qualitative ethnographic study, we aimed at increasing understanding of what makes interactions between staff, users, and relatives in home care services complicated, how these interactions are experienced and how home care practice can be developed to better address these interactions. The study was conducted in Reykjavik, the capital of Iceland, and data were collected from January 2021 to February 2022. In this article we present findings reflecting the experiences of the staff. Home care work involves frequent interactions with service users and their relatives, and the quality of these interactions can influence both care provision and overall well-being. This qualitative ethnographic study aimed to enhance understanding of what makes interactions among staff, service users, and relatives in home care services complex, how these interactions are experienced, and how home care practice might be developed to better address them. The study draws on observations of interactions between staff and service users, as well as semi-structured interviews with service users, relatives, and staff, involving a total of 35 participants. Three themes were developed from the data, informed by the theoretical background (emotional labor and care practices approach). They were: (a) frictions and emotional difficulties, (b) home and workplace, and (c) problems associated with substance use. The findings show that staff need to be aware of how they communicate with users and their relatives and understand the emotional impact of complicated interactions. Managers of Home Care organizations play an important role in supporting and guiding staff concerning complex interactions.