Patient autonomy in home care: Nurses’ relational practices of responsibility

Jacobs, Gaby

doi:10.1177/0969733018772070

Cited by 39 publications

(55 citation statements)

References 31 publications

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“…Despite the fact that most older people want to live in their own homes for as long as possible (de Bruin et al, ; Turjamaa, Hartikainen, Kangasniemi, & Pietilä, ), some dislike it because they feel that their home is a lonely and unsafe environment. Therefore, it is essential to take into account older people's rights to make decisions about their own lives (Jacobs, ; Zhang et al, ). Smart home systems can help older people, but they also pose significant ethical challenges, such as privacy, autonomy, dignity, safety and trust, and it is important to consider these issues (Sánchez, Taylor, & Bing‐Johnsson, ).…”

Section: Introductionmentioning

confidence: 99%

How smart homes are used to support older people: An integrative review

Turjamaa

Pehkonen

Kangasniemi

2019

Int J Older People Nursing

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Background The number of healthy older people is increasing, and most of them want to live in their own homes for as long as possible. Smart home technology can support living at home, but synthetised knowledge of previous studies about their suitability for the everyday lives of older people is rare. Methods Data for this integrated review were obtained by searching the PubMed, CINAHL and Scopus databases from 2012 to 2019, based on inclusion and exclusion criteria, and then carrying out quality appraisals of the papers that were selected. Results We identified 944 papers, and 16 were included in the review. According to our analysis, smart home solutions for older people focused on devices for daily and healthy living and older people's safety. The smart home solutions they discussed were used to help older people carry out everyday activities and lead healthier and more fulfilled lives, by improving their physical safety and social communication. Older people reported that smart homes improved their sense of security, quality of daily life and activities and provided them with information about the care they could receive. However, research on older people playing an active role in developing smart home technology was lacking. Conclusion The existing literature focused on evaluating daily activities with routine measurements. There has been a lack of research that has focused on older people's experiences as the end users of this technology. However, the papers lacked data on how older people could maintain their social relationships and become more proactive in daily living. Implications for practice With further development, smart homes can be used to support older people to perform daily activities and help them maintain their social relationships. These steps will ensure that they can continue to live independently in their own homes for longer.

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Section: Introductionmentioning

confidence: 99%

How smart homes are used to support older people: An integrative review

Turjamaa

Pehkonen

Kangasniemi

2019

Int J Older People Nursing

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“…16 Nurses need continuous support for reflecting on ethics in order to enhance quality assurance in healthcare. 94 Jacobs 95 also states that support regarding moral sensitivity, critical thinking, and trans-professional working should be part of their professional development as nurses. However, research indicates that nurses are not always aware of ethical dimensions in their work.…”

Section: Introductionmentioning

confidence: 99%

Dealing with ethical and existential issues at end of life through co-creation

Hemberg

Bergdahl

2019

Nurs Ethics

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Background In research on co-creation in nursing, a caring manner can be used to create opportunities for the patient to reach vital goals and thereby increase the patient’s quality of life in palliative home care. This can be described as an ethical cornerstone and the goal of palliative care. Nurses must be extra sensitive to patients’ and their relatives’ needs with regard to ethical and existential issues and situations in home care encounters, especially at the end of life. Aim The aim of this study was to explore nurses’ experiences of dealing with ethical and existential issues through co-creation at the end of life in palliative home care. Research design, participants, and research context The material consisted of texts from interviews with 12 nurses in a home care context. A hermeneutical approach was used, and the method was inspired by a thematic analysis. Ethical considerations Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. Ethical permission to conduct the study was given from organizations that participated in this study. Findings A main theme and four subthemes emerged. The main theme was “Deep co-creative relationships are needed to manage ethical and existential issues at the end of life.” A model was created to display the findings and relations between ethical issues and situations and the need for a deep trustful caring relationship to solve problems in palliative home care. Discussion Together, the themes can be considered as a tool for learning and dealing with ethical and existential issues at the end of life in home care. The themes can also be seen as a part of nurses’ ethical competence within this context. Conclusion The quality of life at the end of life can be improved through co-creation, despite difficult ethical and existential issues. Future research should focus on co-creation from the patients’ perspective.

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“…From an ethical point of view, it is very important to recognize that spousal caregivers have the same needs and autonomy as other service uses when decisions are made and goals are set with regard to their caregiving role [21,22]. These goals should be agreed in collaboration with community service providers and relatives.…”

Section: Introductionmentioning

confidence: 99%

Experiences of Older Spousal Caregivers for Caring a Person with a Memory Disorder

2020

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Memory disorders have become a major public, social, and health concern among the aging population, and many of those who are affected are cared for at home by their spouse. The aim of this qualitative study was to describe the individual experiences of 10 older caregivers who were looking after a spouse with a memory disorder in 2016. Data were collected from volunteers who were recruited from a memory clinic at a Finnish health center using the thematic interview method and processed using inductive content analysis. The participants were six female and four male caregivers who had been married for over 10 years. The results indicated that caring for a spouse with a memory disorder involved a number of factors. These included the impact of social networks and changes in their everyday life, collaboration with service providers, and the caregivers’ well-being. However, our study showed that caregivers felt that the formal multiprofessional services they received were fragmented, which means that they were less likely to provide a holistic approach to caregivers’ situations. Better multiprofessional cooperation is needed in the community, including services such as memory clinics, home care and practical services, day centers, and short-term respite in care homes.

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Patient autonomy in home care: Nurses’ relational practices of responsibility

Abstract: The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together.

Cited by 39 publications

References 31 publications

How smart homes are used to support older people: An integrative review

How smart homes are used to support older people: An integrative review

Dealing with ethical and existential issues at end of life through co-creation

Experiences of Older Spousal Caregivers for Caring a Person with a Memory Disorder

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