Resident perceptions of opportunity for communication and contribution to care planning in residential aged care

Abstract

Background and Aim Irrespective of age, communication is a tool of expression and a key daily activity meeting the human need for social interaction and connection. The introduction of consumer‐directed care (CDC) emphasises the importance of communication to provide consumers with the opportunity to exercise choice over the care they receive. As consumer‐directed care progresses, it is hypothesised that the feasibility of shared decision‐making and care planning in residential aged care will be largely determined by the communication opportunities afforded to the residents. Therefore, the aim of this study was to explore resident perceptions of the opportunities they have to communicate, including the opportunity to express their care preferences and contribute opinions about their care. Design A qualitative inductive design was adopted. Methods An individual interview format was used to gather the perspectives of 102 residents. Data were analysed using qualitative content analysis to generate themes illustrating patterns in participant views. Findings Overall, residents desired increased involvement in their care planning and increased opportunity for more meaningful communication and social opportunities. Residents described the negative impact of the communication difficulties they face on their communication and the need for support and activities to be tailored to residents' individual communication needs. Conclusions To facilitate resident participation in CDC and meet resident desire for increased social communication, further investment in resources to support resident–staff communication and accommodate residents’ individual communication needs is required. Implications for Practice By highlighting communication as a stand‐alone activity and a priority of residents, the findings of this study raise the profile of communication and demonstrate the need for explicit allocation of care time and specialist services to support resident–staff communication and social communication in residential aged care. Such support must be tailored to meet residents’ individual communication needs and be coupled with increased staff training in providing communication support. Without facilitating resident communication and increasing the opportunity to communicate, shared decision‐making and care planning in residential aged care consistent with person‐centred and consumer‐directed models of care will be limited.

How Important Are Choice, Autonomy, and Relationships in Predicting the Quality of Life of Nursing Home Residents?

“…Social relationships and close bonds with other residents and staff were seen as central to QoL, as was the opportunity to engage in meaningful leisure activities. Key findings from Ball et al (2000) are consistent with those of later studies exploring resident perceptions of nursing home life (Bennett et al, 2020; Layte et al, 2013; Milte et al, 2016; Nakrem et al, 2011), signifying the importance of choice, autonomy, and meaningful connection to both staff and other residents. Central to the findings of these studies was residents’ desire to be respected, to maintain one’s rights and responsibilities, and a sense of oneself as an individual.…”

“…Aged care staff are residents’ primary communication partners, yet conversations between residents and staff are overwhelmingly task-focused, thereby preventing meaningful connections (Bennett et al, 2015; Carpiac-Claver & Levy-Storms, 2007; Savundranayagam, 2014). Both residents and staff indicate that lack of staff time impedes their ability to engage in meaningful conversation with residents (Bennett et al, 2015, 2020), and that resident communication difficulties are a barrier to communication among residents (Bennett et al, 2020).…”

Resident and informal caregiver involvement in medication-related decision-making and the medicines’ pathway in nursing homes: experiences and perceived opportunities of healthcare professionals

“…Overall, the opportunities should take into account communication difficulties that have previously been mentioned by older adults as an important barrier to being involved in medication decision-making [ 28 ]. Likewise, the need for communication support, tailored to the resident’s individual needs, should be tackled [ 29 ].…”

Comparisons on factors affecting residents fulfilling self-determination in ethno-specific and mainstream nursing homes: a qualitative study

“…The organisational factors such as no choice, predetermined choices and restricted choices for residents existed in food services, activities of daily living (ADLs) support, leisure and social activities existed in mainstream nursing homes [18] . Moreover, lack of opportunities for residents to freely communicate preferences and participate in care planning contributed to the unmet preferences [19] . As a result, residents' sense of autonomy was undermined and satisfaction with care services was low [18] .…”