'We, not them and us?' Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes This study describes relatives' and staffs' experiences of each other in their relationships and interactions in connection with the care of old people with dementia living in nursing homes. The aim was to identify obstacles and promoters concerning these interactions. A qualitative method was used. Data were collected from 27 hours of observations of group discussions about relatives' and staffs' communication, interactions and experiences. Three different groups, with eight participants, relatives, staff and a group leader in each, met six times during a period of 3 months. Findings indicate that the experiences that relatives and staff have of each other are related to issues about influence, participation, trust and measures to avoid conflicts. These conclusions build on concrete descriptions about care, activities, competence, communication and visits given by research participants. Experiences of situations were sometimes contradictory between relatives and staff. This implies that the potential for cooperation between relatives and staff in care of the elderly is not fully utilized. Suggestions for enhancing the relationships between relatives and staff are: pre-planned informal, individual conversations between relatives and staff; development of ways to give regular two-way feedback about matters concerning the resident and the relationship between staff and relatives; giving staff credit for measures taken to facilitate relatives' involvement in the nursing home care; measures to improve documentation about families' involvement; and working together with minor practical tasks.
The aim was to illuminate elderly persons' experiences of living with venous leg ulcer. Fifteen persons 74-89 years of age with active leg ulcer were interviewed. Data were analysed utilizing a phenomenological-hermeneutic approach inspired by Ricoeur. The analysis includes dialectic movement between understanding and explanation of the text as a whole and its parts. In the structural analysis four themes were identified: emotional consequences of altered body image, living a restricted life, achievement of well-being in connection with a painful wound and bandage, and struggle between hope and despair with regard to a lengthy healing process. The comprehensive understanding indicated that the meaning of living with venous leg ulcer can be understood as a dialectal relationship between, on the one hand the feeling of being imprisoned in the body, the bandage and the home, and on the other hand, hope of freedom from a burdensome body. The results indicate that the concept, body of image, is vitally relevant to the caring of elderly people with venous leg ulcer. The study shows the importance of recognizing the persons' perceptions of their leg ulcers and the impact of these perceptions on well-being. Nurses can thereby anticipate problems and provide more sensitive care.
Family members do not give up their involvement in the life of their older relatives when they move to an institution. Relatives feel that it is they who take the initiative to establish a working relationship with the staff at the nursing home. Relatives want more spontaneous information from staff, particularly about residents' daily lives, and there is a need for relatives to have opportunities to talk with staff under relaxed conditions. Staff behaviour and activities towards residents and relatives are a source of many feelings for relatives. Relatives' understandings of the challenges faced by staff are not communicated to staff, nor are positive or negative experiences explicitly passed on to staff.
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