From Family Involvement to Family Inclusion in Nursing Home Settings: A Critical Interpretive Synthesis

Abstract

The provision of care work by families plays an integral role in the quality of life of older adults living in a nursing home setting. This critical interpretive synthesis examines family members’ perceptions of their roles and responsibilities in nursing home settings and interrogates the structural and relational barriers and enablers to family involvement as they relate to fostering an inclusive environment. Electronic databases and published literature were searched for empirical studies that were conducted in a nursing home setting and described involvement from the perspective of family members. Thirty-two articles published between 2006 and 2016 were included in the review. Although involvement comprised a variety of roles and responsibilities, it was grounded in family–resident relationships, influenced by family–staff relationships, and deeply affected by broader sociopolitical factors. We conclude that involvement should be understood as a democratic process with supporting policies and programs to encourage family inclusion in facility life.

Relational autonomy in end-of-life care ethics: a contextualized approach to real-life complexities

“…Finally, other studies report that the cultural context strongly influences care relationships and concrete decisionmaking [15,43]. For example, ethnicity or common cultural tradition, has proven to be one of the major factors associated with end-of-life preferences [44].…”

Content Analysis of Family Policy Instruments to Promote the Sustainable Development of Families in China from 1989–2019

“…The purpose of employing cooperation and outsourcing is to promote exchanges and cooperation with social forces such as scientific research institutions and enterprises to solve the government's shortage of professionals and issues regarding single service supply and other problems, and to expand family support channels. Reward and encouragement are used to encourage family members to help each other and involve family allowances and flexible working hours, which will enhance intergenerational solidarity and the family care function [27,72]. Government purchases include family care services and public goods that will help meet the basic needs of families.…”

Expected Family Involvement of Family of Elderly Residents in Nursing Homes

“…우리나라에서는 [9]. 무엇보다 요양시설에 입소한 노인은 치매나 뇌 졸중과 같은 만성 질병으로 자신의 욕구 표현과 의사소통에 어려 움을 가지게 된다 [2,9]. 요양시설에서 노인의 자율성과 개별적인 특 성이 고려되지 못한 채 공급자 중심의 돌봄은 요양시설 입소 후 노 인의 부적응과 스트레스가 증가하게 되어, 결국 노인의 삶의 질과 안녕을 저하시킨다 [10,11].…”

“…노인이 요양시설에 입소된 이후, 노인과 가족과의 관계는 완전히 단절된 것이 아니며 노인에게 가족은 가장 중요하고 의미 있는 대 상이다 [9,11]. 무엇보다 가족은 노인이 요양시설 입소 후에도 여전히 노인에 대한 책임과 역할을 가지고 있으며 지속적으로 노인과의 관 계 유지를 원하게 된다 [2,9]. 가족은 요양시설에 상주하지 않지만 노 인의 삶의 질과 돌봄에 있어서 보이지 않는 힘이 있다 [9].…”

“…1990년대에 유럽과 미국을 중심으로 요양시설에서 가족의 중요 성을 인지하여 가족참여에 대한 다양한 연구가 진행되고 있다 [14,15]. 요양시설에서 이루어지는 가족참여의 종류로는 요양시설 방문, 노인과의 연락, 노인에 대한 일차적 간호 제공, 요양시설에서 치료나 간호에 대한 의사결정 등 다양하다 [2][3][4]16]. 요양시설에서 가 족참여를 통해 노인, 가족, 직원, 시설에 다차원적 측면에서 긍정적 인 효과가 나타났다 [9,16].…”