Preventing and Approaching Crises for Frail Community-dwelling Patients Through Through Innovative Care (PRACTIC)

Preventing and approaching crises for frail community-dwelling patients through innovative care (PRACTIC). Participatory action research in a cluster randomised controlled trial. The primary purpose of this study is to test the effectiveness of an adapted version of a bio-psychosocial person centred model (TIME) to prevent and resolve crises for frail community-dwelling people receiving home care services. The investigators have formulated the following research questions (RQ):RQ1: Can the TIME model adapted for home care service, prevent, and resolve crises in frail people receiving home care services? RQ2: Which participant characteristics or organizational factors are associated with the effect of the TIME model? RQ3: What are the experiences of the users of home care services on how crises were approached during the trial?

Inclusion Criteria for patients:in need of home care servicesa score ≥5 on the Clinical Frailty Scale (indicating mild to severe frailty)perceived by the home care service as being in an unstable situation with a high risk for acute institutionalisation or showing resistance to care.Exclusion Criteria for patients:- expected short life expectancy (i.e., <4 weeks).Inclusion criteria for next of kin (for RQ3):being next of kin of a user of home care services who meets the above mentioned inclusion criteriaregular contact with the patient (i.e., at least once a week).