Nursing home placement: an exploration of the experiences of family carers

Abstract

This study examines some of the factors leading family carers to place their older relatives in a nursing home. It also explores their thoughts and feelings about their relatives' admission to a nursing home. Analysis of in-depth interviews with relatives (n=10) found that the decision to place an older relative in a nursing home was a difficult one for families. The interviewed carers stated that admission to a nursing home was held off as long as possible but the deteriorating health of the older relative and in some cases their own health meant that there was no other option. Admission to institutional care usually followed a period of prolonged home care and occurred at a time of crisis. Family carers complained that they were given inadequate support from health care professionals and often had no choice in the decision-making process. This was particularly evident in the case of carers whose relative was transferred directly from hospital to a nursing home setting. The majority of carers in this study experienced ambiguous feelings about placing their elderly relative in a nursing home. Feelings of relief that the burden of care had been lifted, contrasted sharply with feelings of guilt that they could not continue with their 'duty of care'. Families also felt a need to justify their decision by emphasizing how friends and other family members agreed that they could not continue with home care in the interests of both their own and the older relative's health. The findings suggest that while many carers are relieved of the physical exhaustion surrounding home care, the emotional turmoil continues long after admission to a nursing home.

Pårørende en betinget ressurs? En kvalitativ studie av pårørende til langtidsbeboere i sykehjem sine erfaringer av egen rolle

“…Til tross for at mange pårørende opplever en lettelse over mindre omsorgsarbeid etter overflytting til sykehjem, er der også pårørende som gir uttrykk for skyldfølelse over ikke å kunne gjøre sin plikt, og at de selv har behov for emosjonell støtte (Bern-Klug & ForbesThompson, 2008;Eika, Espnes, Soderhamn & Hvalvik, 2014;Ryan & Scullion, 2000).…”

A possible innovative association between the concept of inter-generational ambivalence and the emotions of guilt and shame in care-giving

“…In the present times of frequent changes, diverse values, and general instability social relations have changed and are considered to be infused with ambivalence (Bauman 1991). Thus, at present the ambivalence paradigm may better represent the social intergenerational relationships in the family than the solidarity and conXict paradigm, especially when dealing with the institutionalization of an aging parent, a situation shown by research to be inherently charged with ambivalence (Rosenthal and Dawson 1991;Ryan and Scullion 2000).…”

The applicability of the decisional conflict scale in nursing home placement decision among Chinese family caregivers: A mixed methods approach

“…Conversely, appointing one health care surrogate decision maker, a common westernized practice, strongly contradicts the ideals of Chinese collectivism. A health care surrogate decision maker is a trusted family member or friend appointed by an individual to make health care decisions on their behalf when it is medically determined that that individual is no longer able to make health care decisions for either him or herself (Dellasega, Mastrian, & Weinart, 1995;Penrod & Dellasega, 1998;Ryan & Scullion, 2000). For many Chinese families, appointing a single surrogate to make health care decisions for an aging parent independent of collective family decision making strongly defies and violates the traditional value of filial piety resulting in caregiver decisional conflict as well as feelings of inner conflict and regret (Chang & Schneider, 2010).…”