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Gibson K, Brittain K, McLellan E, Kingston A, Wilkinson H, Robinson L. 'It's where I belong': what does it mean to age in place from the perspective of people aged 80 and above? A longitudinal qualitative study (wave one). BMC Geriatr 2024; 24:524. [PMID: 38886645 PMCID: PMC11184740 DOI: 10.1186/s12877-024-05139-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Most people want to remain at home as they age. Ageing in place - remaining at home and connected to the community - is a national and international policy priority; however, to better understand how policy might be implemented, a more nuanced understanding is required about older adults' lived experiences of ageing in place, especially the experiences of those aged 80 and above. OBJECTIVE To describe and explore the social processes which enable ageing in place from the perspective of community-dwelling older people (80+). METHODS Forty-six respondents (80-100+ years) participated in the first wave of a longitudinal qualitative study set in North East England. Semi-structured interviews were conducted in participants' homes between June 2022 and January 2023. Interviews were analysed using reflexive thematic analysis. RESULTS Participants positioned their homes as a place of freedom and as the antithesis of a 'care home'. Remaining in place was important for all participants; a key priority for them was to remain physically active to enable this. However, many participants faced significant hurdles to remaining in place. These were primarily related to health and mobility issues. Some participants were able to overcome such barriers by drawing on financial resources and available social networks. CONCLUSION The home is central to understanding older peoples' (80+) experiences of ageing. In a socio-political context which promotes ageing in place, the social factors shaping experiences of ageing in place must be considered. This involves attending to the challenges of later life, particularly health and especially mobility and physical function. Currently, those with resources (social and economic) are better equipped to respond to such challenges, thus potentially exacerbating widening inequalities in ageing. By foregrounding the perspectives of those ageing in place alongside social factors shaping their experiences, our study has important implications for policy and health and social care. We show that a more equitable allocation of resources is vital to fulfil the ageing in place policy agenda. Furthermore, we highlight a need to recognise commitments to ageing in place displayed by people aged 80 and above, especially when remaining in place becomes difficult to achieve.
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Affiliation(s)
- Kate Gibson
- Population Health Sciences Institute, Health Innovation Neighbourhood, Newcastle University, Newcastle upon Tyne, UK.
| | - Katie Brittain
- Population Health Sciences Institute, Health Innovation Neighbourhood, Newcastle University, Newcastle upon Tyne, UK
| | - Emma McLellan
- Population Health Sciences Institute, Health Innovation Neighbourhood, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Kingston
- Population Health Sciences Institute, Health Innovation Neighbourhood, Newcastle University, Newcastle upon Tyne, UK
| | - Heather Wilkinson
- Advanced Care Research Centre, Edinburgh University, Usher Building, Edinburgh Bioquarter, UK
| | - Louise Robinson
- Population Health Sciences Institute, Health Innovation Neighbourhood, Newcastle University, Newcastle upon Tyne, UK
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Bae S, Kim D. Improving home-like environments in long-term care units: an exploratory mixed-method study. Sci Rep 2024; 14:13243. [PMID: 38853152 PMCID: PMC11162995 DOI: 10.1038/s41598-024-62328-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/15/2024] [Indexed: 06/11/2024] Open
Abstract
Although the number of older adults requiring care is rapidly increasing, nursing homes have long faced issues such as the absence of a home-like environment. This exploratory mixed-method study investigated how residents (n = 15) in a long-term care unit in South Korea perceive home-like features and privacy in their living spaces. The results indicated that most participants were satisfied with the homeliness and privacy of their environment, but some were unhappy with the level of privacy. Most participants had low scores on the Geriatric Depression Scale and the Pittsburgh Sleep Quality Index, indicating low levels of depression and sleep disorders. Sleep quality was affected by factors such as sensory environment, staff visits, and room temperature. Although participants appreciated social support and private rooms, they expressed a desire for larger rooms. Overall, this study provides preliminary insights into older adults' views on their living spaces in long-term care with implications for improving their quality of life.
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Affiliation(s)
- Suyeon Bae
- Department of Housing and Interior Design, Age Tech-Convergence Major, Kyung Hee University, Seoul, South Korea.
| | - Dayoung Kim
- Department of Housing and Interior Design, Age Tech-Convergence Major, Kyung Hee University, Seoul, South Korea
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Abstract
BACKGROUND Interest in strengthening residents' autonomy in nursing homes is intensifying and professional caregivers' experience ethical dilemmas when the principles of beneficence and autonomy conflict. This increased focus requires expanded knowledge of how residents experience decision-making in nursing homes and how being subject to paternalism affects residents' dignity. RESEARCH QUESTION/AIM This study explored how residents experience paternalism in nursing homes. RESEARCH DESIGN This study involved a qualitative interpretive design with participant observations and semi-structured interviews. The interpretations were informed by Gadamer's hermeneutics. PARTICIPANTS AND RESEARCH CONTEXT Eleven residents were interviewed after a period of participant observation in two nursing homes. ETHICAL CONSIDERATIONS The study was performed in accordance with the Helsinki declaration. The Regional Ethics Committee (REK) permitted the researcher to perform participant observation in the nursing homes. The use of audio recordings of interviews was registered and supervised by Sikt - Norwegian Agency for Shared Services in Education and Research. The resident's consent was assessed continuously. Three interviews were terminated for ethical reasons. FINDINGS The resident interviews revealed that residents found it obvious for caregivers to possess the decision-making authority in nursing homes. When residents explained their views, three main themes emerged: (1) To be included even though caregivers make the decisions, (2) Surrender to dependency, and (3) Adherence to nursing home norms. CONCLUSIONS Residents submit to their caregivers and give caregivers the responsibility and function as leaders. Paternalism was experienced as dignifying in situations where it contributed to residents being able to live according to second order desires and values, and when it implied respect and appraisal of residents' capabilities. Paternalism was experienced as debasing when residents felt left out, and when residents felt that their capabilities were underestimated. This also included their capability to withstand paternalistic influence.
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Affiliation(s)
- Anne Helene Mortensen
- Faculty of Health, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Dagfinn Nåden
- Faculty of Health, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Dag Karterud
- Faculty of Health, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Vibeke Lohne
- Faculty of Health, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Groenvynck L, Khemai C, de Boer B, Beaulen A, Hamers JPH, van Achterberg T, van Rossum E, Meijers JMM, Verbeek H. The perspectives of older people living with dementia regarding a possible move to a nursing home. Aging Ment Health 2023; 27:2377-2385. [PMID: 37099667 DOI: 10.1080/13607863.2023.2203693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/04/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND/OBJECTIVES Moving into a nursing home is often an unavoidable life event for older people living with dementia. It is associated with negative emotions and outcomes. Research capturing their perspectives is scarce. This study aims to identify how older people living with dementia perceive a potential life in a nursing home and to understand their (future) care wishes. MATERIALS AND METHODS This study is part of the European TRANS-SENIOR research network. The study followed a qualitative phenomenological methodology. Semi-structured interviews with 18 community-dwelling older people living with dementia were conducted between August 2018 and October 2019 (METCZ20180085). A stepwise interpretive phenomenological analysis was performed. RESULTS The majority of community-dwelling older people feared the idea of potentially moving to a nursing home. The participants associated a possible move with negative perceptions and emotions. Additionally, this study emphasized the importance of knowledge of current and past experiences with care when identifying the participant's wishes. They wanted to remain (a) individuals, who are (b) autonomous and have (c) social contacts if they would move to a nursing home. DISCUSSION/IMPLICATIONS This study showed how past and current care experiences can educate/inform healthcare professionals on the future care wishes of older people living with dementia. The results indicated that listening to the wishes, and life stories of people living with dementia could be a way of identifying 'a suitable time' to suggest a move to a nursing home. This could improve the transitional care process and adjustment to living in a nursing home.
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Affiliation(s)
- Lindsay Groenvynck
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Chandni Khemai
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Bram de Boer
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Audrey Beaulen
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Jan P H Hamers
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Erik van Rossum
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- Zuyd University of Applied Sciences, Academy of Nursing, Research centre on Community Care, Heerlen, The Netherlands
| | - Judith M M Meijers
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- Zuyderland Care, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Hilde Verbeek
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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Lynch B, Ryan AA, O’Neill M, Penney S. The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literature. BMC Geriatr 2022; 22:873. [PMID: 36396991 PMCID: PMC9672635 DOI: 10.1186/s12877-022-03503-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background: As care homes play an important role in the lives of an increasing number of older people, it is pivotal to understand how residents’ and their families engage in decision-making about their care and support. Internationally, there is an increasing emphasis in long-term care settings on the right of residents to be actively involved in all aspects of decision-making about their care and support. However, the steps necessary to achieving a culture of shared decision-making in long-term care settings remain unclear. The aim of this literature review is to summarise what is known in the literature about the factors that influence care home residents’ and families’ engagement with decision-making about their care and support. Methods: An integrative literature reviews was carried out, guided by the methodological framework proposed by Whittemore and Knafl (2005). CINAHL, Medline Ovid and ProQuest Health and Medical databases were searched for relevant articles from 2011 to 2021. A three-step method was used, including the use of reference and citation management software to manage search results and identify duplicate citations. Abstracts and full texts were reviewed by two reviewers. Details of the selected articles were then extracted using the Data Extraction Form. Results: In total, 913 articles were located and 22 studies were included in the final analysis. The thematic analysis identified three main themes that illustrate the complexities of shared decision-making in care homes: (a) a positive culture of collaborative and reciprocal relationships; (b) a willingness to engage and a willingness to become engaged; and (c) communicating with intent to share and support rather than inform and direct. Conclusion: The implementation of shared decision-making in care homes is highly dependent on the support and nurturing of collaborative and reciprocal relationships between residents, families, and staff. Part of this process includes ascertaining the willingness of residents and families to become engaged in shared decision-making. Communication skills training for staff and guided approaches that view decision-making as a supportive process rather than a once off event are essential prerequisites for implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03503-8.
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Martín-Carbonell M, Riquelme-Marín A, Fernández-Daza M, Ortigosa-Quiles JM, Méndez-Mateo I. Exploring the Psychometric Properties of the Questionnaire on Family Members Adapting to an Older Adult's Admission to a Nursing Home (CAFIAR-15) in a Colombian Sample. Behav Sci (Basel) 2021; 12:4. [PMID: 35049615 PMCID: PMC8773060 DOI: 10.3390/bs12010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 12/29/2022] Open
Abstract
Institutionalization to a nursing home can be one of the most significant and traumatic events in a senior's life, and for their family. For this reason, it is especially important to have validated instruments that evaluate the family member's adaptation to admitting the senior to a nursing home. The study included 139 family members recruited equally in two types of institutions (low-income nursing home (LINH) vs. high-income nursing home (HINH)). A sociodemographic questionnaire with questions to study antecedents and conditions for care and the Questionnaire for Admitting an Older Adult to a Nursing Home (CAFIAR-15) were used. Examining the communalities indicated that four of the five items in factor 3 presented communalities lower than 0.30 and differences in the factorial structure of the CAFIAR-15 were found. There were differences in the antecedents and conditions for care between the relatives of the older adults at LINH and HINH. Cultural differences and differences between LINH and HINH may be the basis for flaws in the conceptual validity of the CAFIAR-15 in the Colombian sample.
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Affiliation(s)
- Marta Martín-Carbonell
- Psychology Department, Cooperative University of Colombia, Troncal del Caribe S/N, Santa Marta 47002, Colombia;
| | - Antonio Riquelme-Marín
- Department of Personality, Assessment and Psychological Treatments, University of Murcia, 30100 Murcia, Spain; (A.R.-M.); (J.M.O.-Q.)
| | - Martha Fernández-Daza
- Psychology Department, Cooperative University of Colombia, Troncal del Caribe S/N, Santa Marta 47002, Colombia;
| | - Juan Manuel Ortigosa-Quiles
- Department of Personality, Assessment and Psychological Treatments, University of Murcia, 30100 Murcia, Spain; (A.R.-M.); (J.M.O.-Q.)
| | - Inmaculada Méndez-Mateo
- Department of Evolutionary and Educational Psychology, University of Murcia, 30100 Murcia, Spain;
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