The CARE (Combined Assessment Of Residential Environments) profiles: a new approach to improving quality in care homes

Constructing the meaning of quality of life for residents in care homes in the Lebanon: perspectives of residents, staff and family

AIM

Located in two care homes in Lebanon, the study explores the perspectives of quality of life for a sample of older residents, care staff and family caregivers.

BACKGROUND

Quality of life for older people living in care homes is traditionally reported in the literature as a Westernised construct and so far little is known about its meanings from an Arabic cultural perspective and context. There is also a knowledge gap about the conditions of older people living in care homes in Lebanon.

METHOD

The study was a qualitative exploration of perspectives of quality of life of older residents, care staff and family caregivers. Two care homes for older people situated in Beirut took part in the study. Between 2010 and 2011 semi-structured interviews were undertaken with a sample of 20 residents, eight family caregivers and 11 care staff. Data were analysed using the constant comparative method.

FINDINGS

Four categories emerged from this analytical process: (i) maintaining family connectedness; (ii) engaging in worthwhile activities; (iii) maintaining and developing significant relationships; and (iv) holding and practicing spiritual beliefs. The emergence of these categories confirmed the complex, interrelated and multidimensional nature of quality of life for residents and other stakeholders.

CONCLUSION

The findings supplement an emerging body of knowledge about the composition of quality of life for older residents in Lebanon. Improving the quality of life of older residents will require action in respect of all of the domains identified in study.

IMPLICATIONS FOR PRACTICE

Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care.

Transitions in care homes: towards relationship‐centred care using the ‘Senses Framework’

Long‐term care in general, and care homes in particular, have never enjoyed high status as a place to live and work. This remains the case. In large part this marginalised position is due to the continued failure to value the contribution that care homes make to supporting frail and vulnerable older people. In order to promote a more positive vision of what can be achieved in care homes, this paper argues for the adoption of a relationship‐centred approach to care. The need for such a model is described, and how it might be applied using the ‘Senses Framework’ is considered. It is argued that adopting such a philosophy will provide a clearer sense of therapeutic direction for staff working in care homes, as well as more explicitly recognising the contribution that residents and relatives can make to creating an ‘enriched environment’ of care.