Transition in care: family carers′ experience of nursing home placement

Abstract

This paper explores families' experience of nursing home placement, which emerged as a significant aspect of a larger hermeneutic phenomenological study of family caring in nursing homes. Hermeneutic analysis of 14 family carers' stories of nursing home placement uncovered five shared meanings: experiencing a loss of control; being disempowered; feeling guilt, sadness and relief simultaneously; possessing a sense of failure; and having to make a forced and negative choice. Discussion of the findings focuses upon the importance of family carer support during the transition period from home care to nursing home care and the subsequent benefits realized as a result of having received such support. Particular emphasis is placed upon how such support assists family carers to begin the process of reconstructing a valued and positive identity through which new possibilities for meaningful caring within a nursing home context can be realized.

Between worlds: the experiences and needs of former family carers

“…There is a considerable body of literature on the guilt experienced by carers as they place their care receiver in a nursing home (Keefe & Fancey, 2000;Kellett, 1999). However, there is less literature examining experiences of guilt during the post-death transition.…”

“…For example, the guilt that accompanies a nursing home placement (Argyle et al, 2010;Keefe & Fancey, 2000;Kellett, 1999), the perception that it is the 'last resort' (Argyle et al, 2010;Noonan et al, 1999;Pearson et al, 2003;Wackerbarth, 1999), as well as the stigmatisation of nursing homes (Pearson et al, 2003;Sandberg et al, 2002a), have all been well documented.…”

“…The transition and post-placement period were viewed as an extremely stressful time due to the complex feelings associated with placement as well as the strain of negotiating new relationships with the staff and the relative (Noonan et al, 1999;Pearson et al, 2003;Wackerbarth, 1999). Research studies have also identified a wide array of complex emotions for the carer including guilt, anxiety, sadness, relief, a sense of failure, disempowerment and a loss of control (Argyle et al, 2010;Keefe & Fancey, 2000;Kellett, 1999).…”

Family involvement in residential long-term care: A synthesis and critical review

“…Reasons why family members visited included being faithful to the relative, being the 'eyes and ears' of the resident, and being family. Kellett (1998Kellett ( , 1999 examined family members' perceptions of caregiving in NHs. A series of semi-structured interviews with a small number of family members (N = 14) elicited several important themes in the process of family involvement.…”

Family members' strategies when their elderly relatives consider relocation to a residential home — Adapting, representing and avoiding

“…As concerns family members, in several countries they are increasingly expected to play a more significant role both in the initial decision to seek help and subsequently in selecting a residential home (Davies & Nolan, 2003;Dellasega & Mastrian, 1995;McAuley, Travis & Safewright, 1997). Correspondingly, previous research within the area has largely been focused on the family members' uncertainty and their need to validate the decisions they make (Dellasega & Mastrian, 1995;Penrod & Dellasega, 1998;Ryan & Scullion, 2000), as well as on the lack of available information and support mechanisms (Flynn Reuss, et al, 2005;Kellett, 1999). Sandberg, Lundh & Nolan (2002) have studied the roles of adult children who support a caregiving parent in the placement process of an often life-long partner.…”