Family involvement in timely detection of changes in health of nursing homes residents: A qualitative exploratory study

Abstract

Aims and objectivesTo explore family perspectives on their involvement in the timely detection of changes in their relatives' health in UK nursing homes.BackgroundIncreasingly, policy attention is being paid to the need to reduce hospitalisations for conditions that, if detected and treated in time, could be managed in the community. We know that family continue to be involved in the care of their family members once they have moved into a nursing home. Little is known, however, about family involvement in the timely detection of changes in health in nursing home residents.DesignQualitative exploratory study with thematic analysis.MethodsA purposive sampling strategy was applied. Fourteen semi‐structured one‐to‐one interviews with family members of people living in 13 different UK nursing homes. Data were collected from November 2015–March 2016.ResultsFamilies were involved in the timely detection of changes in health in three key ways: noticing signs of changes in health, informing care staff about what they noticed and educating care staff about their family members' changes in health. Families suggested they could be supported to detect timely changes in health by developing effective working practices with care staff.ConclusionFamilies can provide a special contribution to the process of timely detection in nursing homes. Their involvement needs to be negotiated, better supported, as well as given more legitimacy and structure within the nursing home.Relevance to clinical practiceFamilies could provide much needed support to nursing home nurses, care assistants and managers in timely detection of changes in health. This may be achieved through communication about their preferred involvement on a case‐by‐case basis as well as providing appropriate support or services.

Finding the fundamental needs behind resistance to care: Using the Fundamentals of Care Practice Process

“…It is therefore essential to be extremely vigilant in emphasising this dimension of family nursing care. In Mrs. Morgan's situation, as in most similar situations, the intimate partner relationship is extremely important as it influences the PA’s quality of life, well‐being and health, and may even slightly decrease the rate of infection and hospitalisation (Gaugler, ; Powell et al, ; Roberts & Ishler, ; Zimmerman, Gruber‐Baldini, Hebel, Sloane, & Magaziner, ). Thus, Mrs. Morgan's scenario illustrates how Florence integrates the immediate family.…”

Experiences and involvement of family members in transfer decisions from nursing home to hospital: a systematic review of qualitative research

“…These reviews analyzed the transfer process in view of nursing staff and general practitioners [13, 14, 16]. Several studies indicated that family members may play an important role in the NH, for example in the timely detection of changes in NHR’s health status [17] or acting as decision maker for the resident in case of dementia [18]. However, until now there does not exist an overview summarizing the perspectives of family members.…”

Development and Exploration of Psychometric Properties of the Family Adjustment Questionnaire for Admitting an Older Adult to a Nursing Home (CAFIAR)

“…With regard to this connection, difficulties faced to obtain cooperation from the nursing home directors and relatives of the older adults admitted is relevant, which have also been reported by other authors [ 41 ]. The above may be due to the fact that, in our culture, it is commonly believed that individuals send their older relatives to live in a nursing home because they do not want to take on their care anymore [ 42 , 43 ], which leads to their refusal to provide information, for fear of stigma.…”