Visitors and Resident Autonomy: Spoken and Unspoken Rules in Assisted Living

Bennett, Colleen R.; Frankowski, Ann Christine; Rubinstein, Robert; Peeples, Amanda; Pérez, Rosa; Nemec, Mary; Tucker, Gretchen

doi:10.1093/geront/gnv079

Cited by 15 publications

(26 citation statements)

References 20 publications

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“…This was evidence of unclear boundaries in ownership between the staff and the older person; an example of this was a resident who wished to show the flowcharts to visitors. This confirms that implicit or explicit rules can suppress the resident's autonomy, as previously described [10]. These frustrations indicate that at least some of the older persons were empowered by the project, which is rarely reported in the literature.…”

Section: The Importance Of Taking Older Persons' Competencies and Persupporting

confidence: 86%

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A health concept with a social potential: an interview study with nursing home residents

et al. 2020

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Background: A qualitative, interview-based study was embedded in a randomized intervention trial, the Older People Exercise and Nutrition (OPEN) study. Participants in the OPEN study were encouraged to conduct sessions of sit-to-stand (STS) exercises combined with Oral Nutritional Supplements (ONS) intake. The aim was to describe the older persons' perceptions and experiences of being given the daily opportunity to perform the STS exercise and drink ONS. Methods: In-depth interviews were conducted in six nursing homes with the participants using a semi-structured interview guide. One or two individual interviews were performed with each included participant. Twenty-three NH residents (16 women and 7 men) participated in the qualitative study. Their ages ranged between 76 and 96 years, and their Mini Mental State Examination (MMSE) scored between 8 and 29. The transcribed interviews and field notes written during the visits were analyzed inductively following a constant comparative method described in Grounded Theory. Results: The exercise and nutritional intervention was described as highly practical by the NH residents, who claimed it also had a social aspect as they felt acknowledged and empowered to engage others in the combined intervention. Experiences of the intervention ranged from neutral to mainly positive and could be sorted into 5 categories: 1. Perceived hopes and expectations, 2. Health-related driving forces, 3. Appreciated daily activities, 4. A concept easy to perform and integrate into daily life, 5. A beneficial health concept for all. The intervention created perceived benefits on various health aspects due to participants feeling energized and stronger. An overall theme was identified as A health concept with a social potential, as participants feel acknowledged and strong enough to help others. Conclusions: The intervention was described by participants as a health concept that could potentially be beneficial for a broader spectrum of NH residents. The findings indicate that health concepts, such as STS/ONS, might contribute to a more meaningful day for older people, even vulnerable NH residents approaching the end of life.

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Section: The Importance Of Taking Older Persons' Competencies and Persupporting

confidence: 86%

“…The Swedish Social Service Act emphasizes that all NH residents should receive care that meets their individual needs [8]. Studies have shown that many older people's needs for autonomy and participation in their daily life are unmet when they are admitted to either NH [9] or assisted-living facilities [10].…”

Section: Introductionmentioning

confidence: 99%

A health concept with a social potential: an interview study with nursing home residents

et al. 2020

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Section: Introductionmentioning

confidence: 99%

A health concept with a social potential: an interview study with nursing home residents

Vikström¹,

Grönstedt

Cederholm

et al. 2020

Preprint

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Background A qualitative, interview-based study was embedded in a randomized intervention trial, the Older People Exercise and Nutrition (OPEN) study. Participants in the OPEN study were encouraged to conduct sessions of STS exercises combined with ONS intake. The aim was to describe older persons’ perceptions and experiences of using sit-to-stand (STS) exercises and Oral Nutritional Supplements (ONS) in their daily life. Methods In-depth interviews were conducted in six nursing homes with the participants using a semi-structured interview guide. One or two individual interviews were performed with each included participant. Twenty-three NH residents (16 women and 7 men) participated in the qualitative study. Their ages ranged between 76 and 96 years, and their Mini Mental State Examination (MMSE) scored between 8 and 29. The transcribed interviews and field notes written during the visits were analyzed inductively following a constant comparative method described in Grounded Theory. Results The exercise and nutritional intervention was described as highly practical by the NH residents, who claimed it also had a social aspect as they felt acknowledged and empowered to engage others in the combined intervention. Experiences of the intervention ranged from neutral to mainly positive and could be sorted into 5 categories: 1. Perceived hopes and expectations, 2. Health-related driving forces, 3. Appreciated daily activities, 4. A concept easy to perform and integrate into daily life, 5. A beneficial health concept for all The intervention created perceived benefits on various health aspects due to participants feeling energized and stronger. An overall theme was identified as A health concept with a social potential, as participants feel acknowledged and strong enough to help others. Conclusions The intervention was described by participants as a health concept that could potentially be beneficial for a broader spectrum of NH residents. The findings indicate that health concepts, such as STS/ONS, might contribute to a more meaningful day for older people, even vulnerable NH residents approaching the end of life.

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“…Residents fear the loss of relationships, which may add to the resistance of moving. While in theory visitors may come and go at any time, AL facilities have differing policies about guests signing in and out or signing a waiver of risk in some cases, which can make visitation challenging (Bennett et al, 2015).…”

Section: Emotional Attachment: Home Is Where the Heart Ismentioning

confidence: 99%

“…Adjustment to the AL includes negotiating both old and new networks of association, and the ability of the residents to do so depends in part on their personality and the presence of family or friends, who may facilitate this process (Bennett et al, 2015).…”

Section: Emotional Attachment: Home Is Where the Heart Ismentioning

confidence: 99%

Transitions to Assisted Living Within a Continuing Care Retirement Community

Scott¹

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Purpose/Aims: The purpose of this study was to explore the lived experience of older single women who moved from their independent homes to the assisted living setting, both situated within a Continuing Care Retirement Community (CCRC). Rationale: Anecdotally, CCRC transitions have been viewed as either one dreaded possible step toward the end of life or a supportive place to open a new chapter in older adults' lives. However, no studies have actually examined this experience among older single women, who comprise a large proportion of people making this transition. Background: Older adults move to assisted living within a CCRC when the independent home becomes too much for them to manage or their physical or psychological needs require support. The transition is common but challenging for older women, many of whom are recently widowed and facing increasing frailty. They must plan and execute the move with the help of the facility and family members, if available. Methods: This study employed a hermeneutical phenomenological research approach to explore the lived experience of 17 older women who moved from their independent homes to assisted living within two CCRCs. Themes developed from individual participant interviews were analyzed using Van Manen's research approach to data analysis. Findings: Three major themes surfaced from the interviews: preplanning, executing, and adjusting to the transition. Older women had foreknowledge of the on-campus assisted living and had their names on the waiting list. Even with facility familiarity and family and staff assistance, the move was challenging, and adjustment was difficult when participants had physical or sensory impairments. Implications: Opportunities exist for nurses in assisted living to incorporate supportive strategies into the plans of care for residents during the transition time between independent living and assisted living. However, further research is needed to specifically investigate the factors promoting satisfying transitions in order to develop strategies to improve adjustment. Findings may also provide information for health care policy makers, assisted living administrators, and those seeking to improve the health of the rapidly aging population.

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Visitors and Resident Autonomy: Spoken and Unspoken Rules in Assisted Living

Abstract: Our data underscore the importance of resident autonomy and quality of care in relation to visitors and visiting, especially how this relationship is affected by inconsistent and confusing formal and informal visiting policies in AL.

Cited by 15 publications

References 20 publications

A health concept with a social potential: an interview study with nursing home residents

A health concept with a social potential: an interview study with nursing home residents

A health concept with a social potential: an interview study with nursing home residents

Transitions to Assisted Living Within a Continuing Care Retirement Community

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