Resident strategies for making a life in a nursing home: a qualitative study

Abstract

Aim To identify strategies that older adults use to adapt to live in long‐term care. Background The use of long‐term care services has risen and this trend is expected to continue as the population reaches old age. Moving into a long‐term care setting has been documented internationally as an overwhelming life change for many older adults. It has been observed that residents adjust differently over time, but the basis for these differences needs further exploration. Design A qualitative design using grounded theory method was employed. Methods A total of in‐depth interviews were conducted in October 2008–February 2009 with a sample of 21 participants. Participants ranged in age from 65–93 years, 81% women and 19% men; mainly Caucasian with one African American and one Hispanic. Length of stay ranged from 3 days to over 9 years living in long‐term care so that all stages of adjustment were included in the study. Ground theory method was used to analyse the data. Findings The results of this study yielded 21 facilitative strategies. The core category identified was personal resiliency, which served as the underpinning for the strategies used by the participants. Strategies were identified in making the decision to move into long‐term care and in day‐to‐day living. Conclusion Understanding the strategies that facilitate residents to make a successful transition to long‐term care life will assist nurses to intervene in ways that are supportive. The strategies identified in this study may be used to develop interventions for residents that are having difficulty living in long‐term care. Further exploration of how resiliency has an impact on strategies used by residents is clinically relevant, but further research is needed.

Nurses’ clinical decision‐making for preserving nursing home residents’ remaining abilities

“…Another study on resident strategies for making a successful life in an NH (Brandburg et al . ) introduced the theme of ‘personal resilience,’ which is similar to this study's theme, ‘seeing residents’ potential’. Similar to our results regarding nurses’ perspectives on encouraging residents’ self‐care, indicated by the theme ‘writing a personalised chart about each resident's habits, abilities, and needs,’ was the theme ‘conundrum of collaboration’ identified by Singleton (), which reflected the multidisciplinary nature and institutional focus of care.…”

Facilitators and inhibitors of transition for older people who have relocated to a long‐term care facility: A systematic review

“…Brandburg et al (), Iwasiw et al (), Lee (), Lee et al (), Reed and Payton (), Sussman and Dupuis ()…”

“…Lee () found that greater perceived emotional support from co‐residents ( β = 0.342, p < 0.001) and staff ( β = 0.220, p < 0.01) predicted better adjustment to relocation. New connections and relationships seemed to be facilitated by older people having a positive attitude to get along with others (Brandburg et al, ; Falk et al, ; Lee et al, ), joining buddy groups, and taking on advocate and mentor roles to support co‐residents (Hersch et al, ). Establishing new connections and relationships with co‐residents also seemed to be facilitated by factors such as: involvement in the decision to move into the care facility (Iwasiw et al, ); introductions to co‐residents by resident mentors (Reed & Payton, ); family members actively encouraging and facilitating new social networks in the care facility (Davies & Nolan, ; Sandberg et al, ); and older people engaging with meaningful activities and events such as exercise, music, games, and religious activities and services (Brandburg et al, ; Ellis & Rawson, ; Falk et al, ; Hersch et al, ; Iwasiw et al, ; Sussman & Dupuis, ).…”

Factors related to the decision‐making for moving the older adults into long‐term care facilities in Taiwan

“…Interestingly, the older adults in this quadrant tended to have lived in LTC facilities for the longest time. Studies that explored how older adults adapt to LTC living have pointed out that in‐person visits to LTC facilities and decision‐making of moving into LTC facilities are conducive to the adaptation of older adults to living in the LTC facilities . Although the present study could not assess the decision‐making process in the older adults, in‐person visits to LTC facilities seems to be the key influence on the decision‐making of older adults to move into an LTC facility.…”