Older people's experiences of care in nursing homes: a meta‐synthesis

Abstract

Aim To integrate the current international knowledge and enhance our understanding of the experiences of older people of being cared for in nursing homes. Background There is a lack of integrated knowledge to help face the challenge of providing care to older people in nursing homes. Understanding the experiences of older people regarding their own care leads to interventions for reducing older people's suffering, while living in nursing homes. Methods Keywords describing the experiences of being cared for in nursing homes were used to systematically search electronic databases for qualitative research articles. A meta‐synthesis study employing the interpretative meta‐ethnography approach devised by Noblit and Hare was carried out to analyse seven qualitative articles identified during the search process. Findings Seven studies included in this meta‐synthesis were published between 2007 and 2015. The experiences of older people of being cared for in nursing homes were expressed by the metaphor ‘retaining the meaning of being alive’. Older people wished for a homelike place where they would be delivered care with the consideration of all its humanistic aspects. While conflict between their expectations and organizational demands damaged this sought ideal, adjustment to life conditions and taking an active role led to a feeling of being alive. Discussion This meta‐synthesis integrates our knowledge on organizational and administrative demands, and personal factors influencing the provision of individualized care in nursing homes. Limitations The mental functionality of older people that suffer from dementia might impact on their ability to be involved in research and have a ‘voice’ in terms of their experience of being cared for in nursing homes. Conclusion and Implications for Nursing The institutional character of the nursing home restricts older people's decision‐making. The challenge in nursing home care is to balance the tensions between the individual needs and the collective dimensions of care. Implications for Nursing Policy Nurse policymakers need to consider the ambience in nursing homes, develop a caring culture for the provision of a holistic care to older people and make the nursing home as close to a home as possible.

Adjusting to life in a residential aged care facility: Perspectives of people with dementia, family members and facility care staff

“…It was common for residents to report having little opportunity to exert day‐to‐day choice within the facility. This is concerning, given consistent findings within the literature of the importance of autonomy in later life (Vaismoradi et al, ), and established associations between residents' autonomy and both adjustment and mental health (Brownie et al, ; Davison, McCabe, Knight, & Mellor, ). In contrast to residents' perceptions of their care, staff reported that they were aware of the importance of autonomy and aimed to enhance autonomy as a core component of their person‐centred care approach.…”

“…Previous research has indicated that regimentation and loss of privacy and autonomy are major obstacles to residents' adjustment to RAC (Lee et al, ). In addition, it has been suggested that organisational rules and processes impact on residents' perceptions of care (Vaismoradi, Wang, Turunen, & Bondas, ). Within this context, the current findings highlight the importance of staff finding ways to organise daily routines and provide consistency without being restrictive or overly rigid.…”

Nursing home staff experiences of implementing mentorship programmes: A systematic review and qualitative meta‐synthesis

“…In addition, insufficient trainers and a lack of standardized training are important factors affecting the quality of care (Woo, Milworm, & Dowding, 2017). There are an increasing number of studies on residents' experiences and satisfaction with nursing home care (Vaismoradi, Wang, Turunen, & Bondas, 2016). Hence, more emphasis should be placed on nursing staff education, training and supervision in an attempt to promote quality of care.…”

The Art of Ageing Well

“…One meta‐synthesis investigating the experiences of people in nursing homes found it to be somewhat imperfect . Quotes from each of the studies analyzed in the meta‐synthesis highlight the positive experiences of some people: “Since they have to do things, what I value most is that they [the care staff] go about them with good will.” However, it also highlighted several negative experiences: “at times, it seems they move us like furniture. They're all rushing, non‐stop… they must satisfy their timetable needs; therefore if they need to take everyone to breakfast they do.”…”