Patient Life Stories and Current Situation as Told by Carers in Nursing Home Wards

Abstract

Knowing a patient's life story is important for good nursing care of frail and vulnerable elderly people with cognitive impairments. The aim of the study was to compare patients' life stories and current situations as told by carers before and after 1 year of supervision, in which the Resident Assessment Instrument was used as a basis for individualized nursing care. Qualitative content analysis was used to disclose changes and to enable descriptions of patterns. After the intervention, two overall perspectives emerged from the analysis: the patient as a unique person with resources and abilities, despite limitations, and the carers' awareness of their own professional approach. It seemed as if the supervision and the use of a comprehensive and detailed assessment tool contributed to increased knowledge about the patients and to efforts to see them as real persons behind the dementia surface.

Carers' reflections about their video-recorded interactions with patients suffering from severe dementia

“…Mairis (1994) holds that dignity is developed through life experiences, and in line with this ± and as emphasized by carers ± knowledge of patients' background, lived experiences as well as current situations and conditions is important (cf. Hansebo & Kihlgren, 2000a). Carers enabled patients to feel a sense of dignity when they were allowed to be good at something, however small their capabilities might be, as well as when their selfrespect was protected.…”

“…These opinions have been con®rmed in a review of nursing records (Hansebo et al, 1999). Furthermore, a study of patients' life stories as told by carers indicated a clearer perception of the patient as a unique person after the intervention, together with a more explicit awareness among the carers of their own professional approach (Hansebo & Kihlgren, 2000a). In video-recorded morning care sessions of four carers, skills in supporting and con®rming nursing care improved across the intervention (Hansebo & Kihlgren, 2000b).…”

Nursing home care: changes after supervision

“…Polit & Hungler 1999). Every 10th of the 30 stories before and after the intervention was chosen for co‐assessment by a researcher (Hansebo & Kihlgren 2000).…”

Valuing the person’s story: Use of life story books in a continuing care setting

“…The photographs and memorabilia can be used therapeutically to enhance communication between health professionals, residents, caregivers and their families. These LSB can highlight a resident’s unique life history (Hewitt 2000), and be used as a basis for individualized care (Hansebo and Kihlgren 2000). Anderson and colleagues (1992) suggested that it can help to improve assessment and assist in the building of relationships as people listen to each other’s stories (Hansebo and Kihlgren 2000).…”

“…These LSB can highlight a resident’s unique life history (Hewitt 2000), and be used as a basis for individualized care (Hansebo and Kihlgren 2000). Anderson and colleagues (1992) suggested that it can help to improve assessment and assist in the building of relationships as people listen to each other’s stories (Hansebo and Kihlgren 2000). LSW has the potential to provide a greater insight into a person’s needs and behaviors (Johnson 1976; Clarke et al 2003), providing people with a voice and it may help challenge attitudes and beliefs about people (Meninger 2006).…”