Shaping the practice of home care: critical case studies of the significance of the meaning of home

Changes in health-care service delivery have resulted in the transfer of care from formal spaces, such as hospitals and institutions, towards informal settings, such as home. As the home environment not only designates a dwelling but also represents a multitude of meanings such as personal identity, security and privacy that may vary according to the socio-economic and social demographic variables, it presents a complex site for study. This article uses two contrasting in-depth qualitative case studies to refine the application of the Health at Home Model in Home Healthcare Practice (HHMHHCP) (Roush and Cox, 2000). An addition to the original three dimensions of the model (home as familiar, home as centre and home as protector) is suggested--home as locator. Research directions to further understand the role of caregiving in contributing to the experience and meaning of the home environment by informal caregivers are discussed.