A Narrative Approach to Quality Care in Long-Term Care Facilities

Abstract

The negative effects of institutionalization caused partially by homogeneity and uniformity of care prompts the exploration of personal and common meanings of nursing home residents. This study is viewed as an initial step in providing quality care as defined by the resident. Personal and common meanings embedded in the lived lives of five older women residing in a long-term care facility are interpreted using a seven-stage Heideggerian hermeneutical phenomenological approach. An unstructured modified life review format is used to interview each participant on three separate occasions. Three constitutive patterns emerge: dwelling in remembering, living relatedly, and being after loss. These patterns endure across the life span of each woman and continue to endure after admission to the facility. The revelation of common and personal meanings provide new possibilities for the transformation of nursing practice to ensure quality care from the perspective of what is considered meaningful to each resident.

Working together in lifestory telling for residents in aged care facilities: A qualitative study of staff/family collaboration in aged care

“…Life story telling is also reported to lead to more individualised care [26,27] and identification of psychosocial needs that would otherwise remain hidden [28] . This factor is essential in the care of people with dementia who exhibit behavioural and psychological symptoms.…”

Transformation of Story to Practice: An Innovative Approach to Long-Term Care

“…In the Banks-Wallace study, participants usually began their storytellin g by providing a contextual groundingmentioning birth places, dominant values, and concerns while growing up. Long-term care residents begin their stories similarly revealing a continuity of self, culture, values, and meanings throughout their life span and allowing the listener the opportunit y to understand who the residents have been and continue to be (Heliker, 1997;Kaufman, 1986).…”

“…Using the ndings of a recent study by Banks-Wallace (1998), in which the researcher explored the functions of stories by analyzing 115 narratives of 28 women of African descent, I apply emerging themes to the long-term care resident, both in general terms and, more speci cally, in relation to quality care. Further, using exemplars from a phenomenological study of the life stories of long-term care residents (Heliker, 1995(Heliker, , 1997, I demonstrate how stories can guide the planning of nursing care. Finally, I summarize the implications of using this approach as the foundation of an ethics-based nursing care plan.…”

“…Themes that emerge from one's story connect these patterns of being, and enable a continuity of self across the lifespan. A discussion of how themes exemplify meaning can be found in Heliker's (1997) phenomenologica l study of 5 nursing home residents. In an effort to elicit personal and common meanings, the following statement was made: "Tell me about your life."…”

Biographical Research in Nursing Science -- Two Studies as Examples of Method Application

“…When it is related to biographical research, the biography is usually seen as «elective biography». This means that the biography approach is used to explore the history of individuals within a specific period of lifetime, such as the time spent as an inpatient at hospital (11,20) or the time of having a disease (21).…”