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This is an adaptation of the opening address given by Sister Elizabeth Davis to the Canadian Healthcare Association’s intramural session for its Distance Education programme. The intramural session is an intensive week of plenary and programme‐specific sessions, working groups and student presentations.

Posits that Canadian home care services compete with hospitals and other community and public health agencies for scarce financial resources but as yet regional authorities are not responsible for paying physicians. Investigates all the various facets of home care services and concludes that by using joint ventures, there may be the possibility of making informed decisions for the Canadian healthcare system.

Within the existing health care system, a significant percentage of Americans over the age of 65 will have need of extended health care. Yet the extended care industry has little information as to how consumers will make a choice among placement options. The results of this study describe both the need recognition and pre‐selection search stages of the decision process and the impact of need recognition on subsequent search activity. The information obtained from an influential person as the problem is being defined appears to have a complex relationship with pre‐selection search, with initial information leading to less search but additional information increasing search activity. Contrary to previous studies, pre‐selection search was found to be fairly extensive, increasing with time availability.

The purpose of this paper is to develop an Internet of medical things (IoMT)-based geriatric care management system (I-GCMS), integrating IoMT and case-based reasoning (CBR) in order to deal with the global concerns of the increasing demand for elderly care service in nursing homes.

The I-GCMS is developed under the IoMT environment to collect real-time biometric data for total health monitoring. When the health of an elderly deteriorates, the CBR is used to revise and generate the customized care plan, and hence support and improve the geriatric care management (GCM) service in nursing homes.

A case study is conducted in a nursing home in Taiwan to evaluate the performance of the I-GCMS. Under the IoMT environment, the time saving in executing total health monitoring helps improve the daily operation effectiveness and efficiency. In addition, the proposed system helps leverage a proactive approach in modifying the content of a care plan in response to the change of health status of elderly.

Considering the needs for demanding and accurate healthcare services, this is the first time that IoMT and CBR technologies have been integrated in the field of GCM. This paper illustrates how to seamlessly connect various sensors to capture real-time biometric data to the I-GCMS platform for responsively supporting decision making in the care plan modification processes. With the aid of I-GCMS, the efficiency in executing the daily routine processes and the quality of healthcare services can be improved.

The purpose of the current study is to assess the efforts to control fraud in the home health care industry in the USA by examining the problems that criminal justice officials confronted in their attempts to control home health care fraud and abuse.

Attention is given to the history of the home health care industry in the USA, the types of fraud found in the health care field in general, and the officials who are given the duty of controlling health care fraud.

The results of this study suggest that the problems fraud control officials face in their response to home health care offenders are similar to those confronted in the response to white‐collar offending, but also similar to those confronted in the response to many conventional offenses.

Highlights the problems in controlling fraud and abuse in the US home care health field.

About five per cent of ‐ generally very frail ‐ older people live in long‐term care in the UK; approximately a fifth of all deaths occur in care homes. Depression and dementia are prevalent mental health conditions in care homes; depression is reported in around a third of residents and dementia in two thirds. While there is some evidence about efficacy of medication in treating psychiatric and behavioural symptoms among residents, much less is known about the potential role of psychosocial interventions in enhancing mental health and quality of life. Quality of care varies widely across the carehome sector including support from primary and specialist health and quality and level of training. In terms of enhancing care quality, there is evidence that investing in staff training and conditions, establishing good links with healthcare providers, and developing care standards that genuinely promote good practice are likely to improve resident quality of life. This is an exciting area for research development and practice innovation for the future; taking account of users perspective, holds particular potential.

Precarious work, characterized by low wages, unpredictable schedules and hours, physical hazards, and stressful psychosocial conditions, is a significant problem in the twenty-first century US economy. It most harshly affects women, racial/ethnic minorities, and immigrants. Caring labor jobs often involve precarious work and home health aide jobs are among the most precarious of these. With an ageing population creating high demand and a decline in the number of available workers, a societal crisis looms. The purpose of this paper is to discuss a business form that could positively impact the home care work environment.

This paper reviews previous research to call for closer examination of worker cooperatives as a means to reduce precarious work among home health care workers.

Worker cooperatives provide opportunities for economic empowerment for impoverished and marginalized workers. Cooperative Home Care Associates, a worker cooperative in the home care industry, reports better outcomes to workers than similar conventionally governed businesses.

This paper reviews results of a study comparing three organizational forms in the home health industry. Although there are relatively few worker cooperatives in the USA, future research should investigate this structure both where there is a low-wage labor force, and in general.

Better outcomes for employees in the worker cooperative suggest that this is a viable business form for workers in precarious work environments.

The paper highlights the features of an organizational form that could help alleviate social ills caused by precarious work.

This paper considers the structure and function of a business form little studied in the management discipline. Based on their unique features and possibilities, worker cooperatives should be of interest to equality, diversity, and inclusion scholars; and to strategy, organizational behavior, and entrepreneurship scholars.

The study refers to a health-care organization engaged in adopting “home health care” as a new object of activity. This study aims to explore how the reconfiguration of the object influences the transformative perspective, affecting not just a service but a broader approach and meaning behind patient care. It also investigates the main contradictions at play and the levers to support inter-organizational learning while facing the new challenges and change processes.

The work is based on a qualitative and ethnographic methodology directed to examine cultural, practical and socio-material aspects. The activity theory is assumed as a powerful approach to understand collective learning and distributed agency processes.

The renewal of the new object of work is analyzed as a trigger for shifts in representations, cultural processes and collective support implemented by the organization. Three agentic trajectories – technical, dialogical and collaborative agency – were cultivated by the management to deliver home health care through joint exercises of coordination and control, dialogical spaces and collaborative process.

The data collection was disrupted by the pandemic. A follow-up study would be beneficial to inquire how the learning processes shifted or were influenced by the contextual changes.

This contribution provides a practical framework for health-care organizations aiming to navigate and explore the physiological tensions and contradictions emerging when the object of work is changed.

The paper develops the field of intra- and inter-organizational learning by presenting an intertwined and structural connection between these processes and the renewing of the object of work. It advises that processes of transformation must be handled with attention to the critical and collective dynamics that accompany sustainable and situated changes.

The paper describes the size, nature and trends in home care, including telemedicine and hospital at home, emphasising the independent sector's contribution and highlighting the importance of home care to health and social care. It identifies a funding and capacity crisis, outlines the likely impact of any further reduction and explores contributory recruitment, training and commissioning practice issues.

Care of older persons in their own homes has in recent years received much attention in Ireland. The proponents of domiciliary care draw on both economic and quality of life arguments, many of which are identifiable in policy documents since the 1950s. However, little detailed analysis of the evolution of the formal care services for older persons, and the shift in emphasis from institutional to domiciliary care, has been presented. The paper aims to focus on the issues.

Using archival, administrative and policy sources, the authors traced the changing nature of formal care policies in Ireland, and analysed changes in key organising principles and features, including subsidiarity, the role of the Church and the basis of entitlements (residual vs universal).

The first type of formal care to emerge was institutional, and did not adhere to the subsidiarity principle as it was mostly delivered by the State. Subsidiarity came to the fore more clearly with the establishment of the earliest home care services by religious and voluntary organisations. The current trend towards cash‐for‐care (home care packages) is arguably a modern‐day manifestation of the arm's length attitude that the subsidiarity principle recommends the State take.

The fact that care services are increasingly delivered by private sector companies and informal carers operating in the grey market increases the complexity of the care regime and therefore makes the task of developing social care regime classifications more complicated; it also means that regulation of the care sector in Ireland is a particularly urgent task that is yet to be undertaken in a comprehensive manner.

The policy challenges involved in attempts to regulate the complex care mix are considerable.

The paper utilises both historical methods and policy analysis to highlight the changing meaning of key concepts such as subsidiarity.