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Systematic literature review on the conceptualisation of autonomy in the nursing home
- Author:
- FELDMANN A
- Publisher:
- University of Twente
- Publication year:
- 2020
- Pagination:
- 39
- Place of publication:
- Netherlands
(Master's thesis, University of Twente). Background: The basic psychological need of autonomy that was identified by the Self-Determination-Theory (SDT) as essential for wellbeing can be often hard to adopt for elderly residents in the environment of nursing homes. This review study constructs the concept of autonomy from the perspective of elderly nursing home residents to gain an understanding of what specifically characterises their autonomy-needs. Methods: A systematic literature review was used to qualitatively synthesise all study records found that provide self-reports of residents on autonomy (n = 15). Relevant themes as described by nursing home residents were identified and compared to the components of autonomy as defined within the SDT to evaluate whether the theory matches the needs of nursing home residents. Results and Conclusion: Five themes as part of the conceptualisation of autonomy by nursing home residents were identified: Choice and control, Independence, Freedom and resources, Being seen and heard and Chosen dependence and competence. These compare to the definition of autonomy within the SDT, which is taking variations in needs into consideration that match the perspectives of nursing home residents. The SDT definition of autonomy was specified here to set a basis for wellbeing interventions in nursing homes to increase resident autonomy. (Edited publisher abstract)
Choice of accommodation: care homes
- Author:
- AGE UK
- Publisher:
- Age UK
- Publication year:
- 2010
- Pagination:
- 14p.
- Place of publication:
- London
This factsheet explains what rights care home residents have to choose which home they will live in when the local authority assists with the funding and arrangement of the placement. It is also relevant to residents who arrange and fund their own residential care to start with but need local authority assistance later on. The rights of individuals to choose their own care home accommodation have been developed over a number of years. Local authorities have a responsibility to provide a range of accommodation to meet identified needs at their ‘usual cost’. In this context ‘top-up’ of care home fees is only appropriate where a genuine choice has been made by a service user to live in a care home that costs more than the ones that the local identified have identified to meet identified eligible needs. The information in this factsheet is correct for the period April 2009 to March 2010.
Resident choice and the survey process: the need for standardized observation and transparency
- Authors:
- SCHNELLE John F., et al
- Journal article citation:
- Gerontologist, 49(4), August 2009, pp.517-524.
- Publisher:
- Oxford University Press
This American study aims to describe a standardized observation protocol to determine if nursing home (NH) staff offer choice to residents during 3 morning activities of daily living (ADL) and compare the observational data with deficiency statements cited by state survey staff. Morning ADL care was observed in 20 NHs in 5 states by research staff using a standardized observation protocol. The number of observations in which choice was not offered was documented for 3 morning ADL care activities and compared with deficiency statements made by surveyors. Staff failed to offer choice during morning ADL care delivery for at least 1 of 3 ADL care activities in all 20 NHs. Observational data showed residents were not offered choice about when to get out of bed (11%), what to wear (25%), and breakfast dining location (39%). In comparison, survey staff issued only 2 deficiencies in all 20 NHs relevant to choice in the targeted ADL care activities, and neither deficiency was based on observational data. Survey interpretative guidelines instruct surveyors to observe if residents are offered choice during daily care provision, but standardized observation protocols are not provided to surveyors to make this determination. The use of a standardized observation protocol in the survey process similar to that used by research staff in this study would improve the accuracy and transparency of the survey process.
Personalisation within a housing context
- Author:
- HEAD Jon
- Journal article citation:
- Working with Older People, 13(2), June 2009, pp.25-27.
- Publisher:
- Emerald
The ways in which Hanover Housing Group is delivering the personalisation agenda and the challenges it faces are described. The Group sees listening, being clear about the choice available and developing more detailed strategies to ensure large scale services can be flexible as all being key to supporting choice. The Up2Us, a pilot project with Housing Associations' Charitable Trust, which aims to empower service users is also briefly discussed.
Care homes: through the eyes of the consumer
- Author:
- P&G PROFESSIONAL
- Publisher:
- English Community Care Association
- Publication year:
- 2006
- Pagination:
- 5p.
- Place of publication:
- London
This report has been commissioned to provide the care sector with invaluable insights into long-term residential care. By evaluating the views of those directly affected by long-term care and listening to the personal experiences of the participants, the study aims to provide a platform for debate surrounding the issues currently present within the sector and to specifically identify the key factors that determine care home choice for residents, staff and relatives. The study was designed to achieve the following objectives: Provide insightful new information of value to care home operators and those working within the sector; Provide a voice for the residents, relatives and staff who make use of long-term care services for older people; Highlight to operators the factors that affect the selection of their services.
Minimising the use of restraint in care homes for older people: making decisions
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2010
- Place of publication:
- London
In this film, three experts – an occupational therapist, a care home adviser who is a co-author of a report on restraint and a geriatrician discuss the complex issue of restraint in care homes. Each expert discusses a different aspect of restraint, considering how care home staff can balance the duty to care with the need to protect residents. To minimise the use of restraint and to help residents live the life they want to achieve, care home staff need to find out about the individuals in their care. Through dialogue and negotiation, they can help residents to exercise choice. The Mental Capacity Act provides a useful framework for decision making and this is explained in full. Note: This film is no longer available to view.
Applying dignity of risk principles to improve quality of life for vulnerable persons
- Authors:
- WOOLFORD Marta H., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 35(1), 2020, pp.122-130.
- Publisher:
- Wiley
Objectives: Freedom of choice impacts quality of life. Expressed through dignity of risk (DoR), nursing home (NH) residents should be afforded the dignity to take risks to enhance well‐being. How DoR is understood and implemented in the context of aged care remains largely unknown. This study explored the meaning and the barriers and facilitators to applying DoR to NH residents. Methods: Qualitative study, comprising semistructured interviews. Senior policy makers and advocate guardians working in the aged care or disability sector were invited to participate. Recruitment continued until data saturation was reached. Two researchers coded interviews, applying inductive and thematic analysis. Results: Fourteen participants took part during 2016‐2017. Analysis demonstrated uniformity in participants' description of DoR, comprising four elements: (a) individuals are at the centre of decision making; (b) life involves risk; (c) individuals must have choice; and (d) DoR is a continuum of experiences. Three main barriers for implementing DoR into practice were identified: (a) balancing autonomy with risks; (b) situational nature of DoR; and (c) taking responsibility for risk. Conclusion: The novel findings provide an explicit understanding of DoR and the facilitators and barriers to applying the principle in the NH setting. These findings inform those who engage in making and implementing choices in the presence of risk for vulnerable clients. To translate the multifaceted elements of DoR into practice requires the development of unambiguous policies/guidelines about who will be responsibility for potential risks that may arise from residents' choices. Further, education programmes supporting care staff/management to enact resident choices in the presence of real or perceived risk are required. (Publisher abstract)
Your care rating: 2016 survey
- Author:
- IPSOS MORI
- Publisher:
- Ipsos MORI
- Publication year:
- 2017
- Pagination:
- 32
- Place of publication:
- London
Reports on the findings from the 2016 Your Care Rating surveys, which gathered the views of residents and their families and friends on the care provided in over a thousand care homes in the UK. A total of 35 care providers took part in the survey. , which is in its fifth consecutive year. A total of 18,786 residents participated in the survey, with a response rate 38 per cent. A separate survey was completed by 10,963 family members and friends, a response rate of 47 per cent. The report discusses the results under the following themes: overall performance; staff and care; choice and having a say; home comforts; and quality of life. The overall results suggest that both residents and their relatives and friends are positive about the care and the service they receive in their care home, with high scores achieved in all aspects of care. The overall rating score has also increased over the five years that the survey has been conducted. Ratings were found to be slightly lower among family and friends than among residents, and there were also differences on specific aspects of care. Areas were respondents were consistently less positive about were the quality and variety of food and the amount of time staff have to talk to residents. (Edited publisher abstract)
Your care rating: 2014 survey
- Author:
- IPSOS MORI
- Publisher:
- Ipsos MORI
- Publication year:
- 2015
- Pagination:
- 31
- Place of publication:
- London
Report presenting a summary of findings from the 2014 Your Care Rating Survey, which is the largest survey of care home residents in the UK. The report provides details of how the survey was conducted and provides a summary of results under four themes: staff and care; home comforts; choice and having a say; and quality of life. The survey was conducted over 29 care providers and obtained views from over 21,000 residents from 1,096 care homes. Findings were analysed to give each home an Overall Performance Rating (OPR) out of 1,000. Although designed primarily for care home residents aged 65 or over, the survey also includes younger adults living in care homes. The overall results of resident feedback paints an encouraging picture of life in care homes from the majority of homes which took part. The overall average overall performance rating score for participating homes was 872 (in line with 871 in 2013) and more than half of the care homes which took part in the previous year improved their OPR score. Within the theme relating to Staff and Care, staff have positive views of the manner in which staff treat them, however a relatively smaller proportion of residents felt staff treat them as an individual and have time to talk. Other findings were that residents were less positive about having a say in their care and about having choice than they were about other aspects of their care, such as feeling safe and secure. Improving residents’ perceptions of having choice and control within their care home and also treating them in a more person centred way may help to improve their experience within their care home. (Edited publisher abstract)
Village life: independence, loneliness, and quality of life in retirement villages with extra care
- Author:
- BEACH Brian
- Publisher:
- International Longevity Centre UK
- Publication year:
- 2015
- Pagination:
- 37
- Place of publication:
- London
Reports on the findings of a survey of residents of seven retirement villages offering extra care support. The report explores whether extra care support can promote greater independence and provide greater choice in planning for later life; reduce social isolation and promote residents’ quality of life. Responses were received by 201 out of a total of 743 residents, representing a response rate of 27.1%. Response are discussed in the following areas: residents' motivations to move into housing with care, and how this reflected on the concepts of independence and control; residents’ experience of loneliness and social isolation; and an analysis of the quality of life in extra housing using the using CASP and OPQOL measures. The final section of the report compares the findings with a sample of older people living in private households in the community. The research found that the average person living in a retirement village experienced half the amount of loneliness (12.17%) than those in the community (22.83%). It also found that living in a retirement village can promote greater independence and provide greater choice in planning for later life and that the communal environment has the potential to reduce social isolation. The report calls on the government to identify ways of working with the private sector to stimulate the building of new good quality retirement housing and to encourage people in early older age to consider making such a move. (Edited publisher abstract)