‘We, not them and us?’ Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes

Abstract

'We, not them and us?' Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes This study describes relatives' and staffs' experiences of each other in their relationships and interactions in connection with the care of old people with dementia living in nursing homes. The aim was to identify obstacles and promoters concerning these interactions. A qualitative method was used. Data were collected from 27 hours of observations of group discussions about relatives' and staffs' communication, interactions and experiences. Three different groups, with eight participants, relatives, staff and a group leader in each, met six times during a period of 3 months. Findings indicate that the experiences that relatives and staff have of each other are related to issues about influence, participation, trust and measures to avoid conflicts. These conclusions build on concrete descriptions about care, activities, competence, communication and visits given by research participants. Experiences of situations were sometimes contradictory between relatives and staff. This implies that the potential for cooperation between relatives and staff in care of the elderly is not fully utilized. Suggestions for enhancing the relationships between relatives and staff are: pre-planned informal, individual conversations between relatives and staff; development of ways to give regular two-way feedback about matters concerning the resident and the relationship between staff and relatives; giving staff credit for measures taken to facilitate relatives' involvement in the nursing home care; measures to improve documentation about families' involvement; and working together with minor practical tasks.

Practice style in the nursing home: dimensions for assessment and quality improvement

“…Similarly, staff members are often uncomfortable questioning family's requests in fear of jeopardizing their relationship with the family (Hertzberg and Ekman, 2000) Communication is devalued or discounted Because a resident has dementia, staff members at times assume that she does not know what she is saying, and therefore her preferences are ignored. Often staff members' perceptions are used as a standard to which residents' statements and requests are compared, resulting in invalidation of the residents' point of view.…”

“…When finally the door was unlocked, she just sat quietly in the room Residents often try to go outside and must be offered a safe way to do so, even when the weather is not optimal. Preferably, there would be a door to the outside that a resident could control on his/her own (Namazi and Johnson, 1992) Family involvement Communication with family members is often limited Both staff members and family members reported that only essential information such as major health or care changes is provided spontaneously to relatives, leaving them frustrated while trying to find out more information on their own (Hertzberg and Ekman, 2000)nition, financial remuneration, or certificates of appreciation. Inclusion in care decisions, such as care planning.…”

A qualitative metasynthesis

“…Hertzberg and Ekman 21 found that staff and families reported difficulties sharing and obtaining information from each other. In addition, staff tended not to communicate disagreement with families' perceptions or preferences, even when they found family involvement problematic.…”

Conceptualizaciones sobre la atención a personas con demencia en residencias de mayores

“…Asimismo, los escasos estudios que analizan la atención proporcionada a residentes con demencia desde el punto de vista familiar coinciden en señalar que la prestación de cuidados de alta calidad requiere equilibrio entre los aspectos técnicos del cuidado, los conocimientos personales y biográficos del residente 17 , y la interacción positiva entre los profesionales y los familiares 17,18,19 . Además, sabemos que la participación de los familiares en ciertos aspectos del cuidado reduce su angustia, aumenta la satisfacción con la atención 16 y mejora las relaciones con el personal asistencial 5,10,20 .…”