Emergent Situations When Older Homebound Women had Fortuitous Help and a Typology of Helpers who were Involved

Health care services are typically viewed as institutions or agencies offering professional care or care supervised by professionals. The concept of availability of health care services involves the degree to which persons can readily find professional care. Few scholars have considered the relevance of these notions to life-circumstances of older homebound women who experience emergent situations (ES) at home such as falls, unintentional injuries, or health problems. During a larger descriptive phenomenological study of the experience of reaching help quickly, 33 of 40 homebound women, aged 85–98 years, who were living alone, reported 57 situations of interest during open-ended interviews over 18 months. The purposes of this facet of the study were (a) to describe the life-world of women who had fortuitous help with ES at home, (b) to categorize helpers involved, and (c) to elaborate the reported influence of such situations on recognizing the risk of being unable to reach help quickly in the future. Life-world was featured by having help right now from someone on the scene. We categorized involved helpers into six types, including four previously identified types of home care helpers as well as (a) “on-the-spot” helpers, acquaintances not among the woman's home care helpers and (b) “at-this-scene-only” helpers, who were not likely to encounter the woman afterwards. In these ES, the home – not the health care institution – was the setting. On-the-scene helpers served as critical health care resources. In contrast to the typical focus on availability of health care services in a public space, availability of on-the-scene helpers in the home, a private space, was critical to the well-being of these old homebound women. This work raises new notions about availability of health care services for older homebound women and offers new perspectives on the key support network concepts of proximity and frequency of contact.