Objective measures and documentation are increasingly used in the care for older people to promote efficiency and productivity. A standardised assessment of functional capacity is one such measure. In this study, we examined the meanings given to standardised functional assessment by care workers who provide long-term care for older people. Gathered from eight Finnish long-term care facilities, the data consisted of one-on-one interviews with practical and registered nurses (n = 24). In the data analysis, we employed the discursive approach. We identified three discourses in the care workers’ talks that differed in the meaning given to standardised functional assessment in the process of care: part of the bureaucracy, a missed opportunity and a threat to person-centred care. Care workers described these assessments as constituting a routine part of their job but expressed uncertainty about their role and the practicalbenefits in actual care work. They even called into question these assessments’ relevance to quality care delivery. To be a meaningful part of care practice, it is essential that there be a shared understanding of the rationale behind functional assessments in the care organisation and that care workers themselves can see the outcomes of these assessments in their daily work.
Family members have always had an important role in the care of older relatives. Recent changes in care policies only serve to underline the family's caregiving role, especially in countries with a traditionally universalistic care regime (Hoppania, 2018;Szebehely & Meagher, 2018; Van den Broek et al., 2019). Although they do not have a legal obligation to provide care for older relatives, family
Family members have important role in care of older people. In residential long-term settings family members can find themselves in an ambiguous situation: officially, responsibility for provision and quality of care rests with the care provider and staff members, but in practice family members participate in caring. This study explores the role of family members in residential long-term care settings, particularly in supporting their older relatives’ functional ability. Developing and maintaining functional ability lies at the very core of healthy ageing policies and long-term care. The data consist of semi-structured interviews with family members (n=16) from eight long-term care facilities in Finland. Thematic analysis yielded three themes: maintaining personhood, engaging in everyday life and monitoring care. Family members in our study were actively involved in care that supported the functional ability of their older relative. However, family members had also conflicting views about who was responsible for care provision. Some participants willingly accepted their caregiver responsibilities even in residential care, while others described their involvement in care not as a matter of choice but rather as one of necessity in order to ensure good quality care. It is important to see the family members’ viewpoint which, based on the results of this study, emphasizes personhood and continuity of care. If they are willing to participate, family should be able to take part in caregiving together with the care staff and their role should be recognized.
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