 “Performance” and Professional Practice in Homecare Services for Seniors: Effects and Possible Actions for Sustainable Development 
Accountability and performance optimization are intended to improve the performance of homecare services (HS) but do not seem to have the desired effects. The lack of decision-making latitude of professionals and, consequently, their insufficient responsiveness would be at fault. This responsiveness is, however, part of their role as change agent, a role that is poorly invested. This article has three objectives : 1) To synthesize knowledge on the role of accountability and performance optimization in the practice of HS professionals ; 2) To describe the role of change agent ; and 3) To explore its teaching.