Nav-CARE pilot research was funded by the Canadian Frailty Network 2014-2015. The following was the impact of Nav-CARE on both volunteers and older adults:
- Volunteers found the role satisfying and meaningful
- Volunteers would do the role again and recommend it to others
- Volunteers reported that continuing education and support were essential
- Nav-CARE clients described volunteers as good listeners, caring,
personable, outgoing, friendly, patient, positive, capable, conscientious, kind, non-intrusive, and diligent in finding out what they did not know
- Nav-CARE clients rated the service as highly important to their care
Nav-CARE clients described 4 primary benefits of being a part of the Nav-CARE program:
- Making good decisions for both now and future
- Having a surrogate safety net
- Supporting engagement with life
- “Making life more livable” in the presence of illness”
“Everything comes at you so fast and there are so many decisions to make and you’re all sixes and sevens and when your volunteers come out we can sit and talk about this, and it help us to understand a little more why they’re [healthcare] doing this or that. And oh, what a difference that makes.” (NCARE Participant)
The overall goal of the Nav-CARE program is to improve the quality of life of adults living at home with serious illness. Adults living at home with serious illness, particularly those who do not yet qualify for home-based nursing care, often live with unmet needs and heavy symptom burden resulting in poor quality of life. Many do not know the services that are available to assist them. Previous research has demonstrated the value of using trained navigators to visit in the home to provide psychosocial support, education, guidance on advance care planning and connection to community and health resources. These navigators engage older adults to identify the services and resources available and to connect them to those resources using a best-fit, client-centred approach.
“She asked, ‘how are things going’ and then I opened up my mouth and we started to talk about what I felt we needed to talk about. It didn’t seem like she was on about this or that, or we must talk about this today. It was more fitting of my needs each time.” (NCARE Participant)
Volunteer navigators have baseline competency in palliative care and/or supporting older adults (either in a volunteer or health care provider capacity). Training in navigation consists of a two-day workshop that addresses five basic competencies: screening, advocating, facilitating community connection, coordinating access to services and resources and promoting active engagement. Curriculum for volunteers and coordinators, based upon navigation competences developed by a group of international experts in palliative care, has been prepared and piloted. Volunteers are supported by a nurse navigator coach, a volunteer coordinator, and a local health care provider who has also received training in navigation. This navigation partnership provides services to a currently underserved population while at the same time increasing the capacity of volunteers and health care providers through collaboration. Older adults are visited in the home by the volunteer every 2-3 weeks over the project period. Volunteers fill out structured visit logs that outline the services provided and experiences with the volunteer role including challenges encountered. Research data is also collected on quality of life, volunteer self-efficacy, program satisfaction, and older adult engagement. Volunteer Navigators meet monthly as a group with the nurse navigator coach to share their experiences.
“It showed us that other people have got the same problems, have the same feelings…it gives us an uplifting…if someone’s there just to put a hand on your shoulder we know we’re going through it with other people.” (NCARE Participant)
With funding from the Max Bell Foundation 2017-2020; CIHR 2016-2019; Canadian Cancer Society Research Institute 2016-2018; BC Centre for Palliative Care 2016; Covenant Health 2015-2017, the program is being adapted and tailored across diverse social and geographic contexts across Canada with volunteers primarily based within hospice who are connected to primary care services. The goal is to create a sustainable program that can be implemented widely in the Canadian context.