Autonomy Support of Nursing Home Residents With Dementia in Staff-Resident Interactions
| Autor: | Ramona Backhaus, Jolanda C. M. van Haastregt, Jan P.H. Hamers, Hilde Verbeek, Linda J. M. Hoek, Erica de Vries |
|---|---|
| Přispěvatelé: | Health Services Research, RS: CAPHRI - R1 - Ageing and Long-Term Care, Promovendi PHPC |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
observation
media_common.quotation_subject COMMUNICATION Human physical appearance PERSON-CENTERED CARE 03 medical and health sciences 0302 clinical medicine Nursing PEOPLE Medicine Dementia Humans 030212 general & internal medicine nursing staff autonomy OLDER-ADULTS General Nursing media_common Netherlands business.industry Autonomy support Nursing home Health Policy Social environment NEED General Medicine medicine.disease CHOICE Nursing Homes TIME Long-term care Cross-Sectional Studies Severe dementia LONG-TERM-CARE Geriatrics and Gerontology business Nursing homes 030217 neurology & neurosurgery Autonomy ETHICS dementia |
| Zdroj: | Journal of the American Medical Directors Association, 21(11), 1600-1608. Elsevier Science |
| ISSN: | 1525-8610 |
| DOI: | 10.1016/j.jamda.2020.04.013 |
| Popis: | Objectives: People with dementia living in nursing homes benefit from a social environment that fully supports their autonomy. Yet, it is unknown to what extent this is supported in daily practice. This study aimed to explore to which extent autonomy is supported within staff-resident interactions.Design: An exploratory, cross-sectional study.Setting and Participants: In total, interactions between 57 nursing home residents with dementia and staff from 9 different psychogeriatric wards in the Netherlands were observed.Methods: Structured observations were carried out to assess the support of resident autonomy within staff-resident interactions. Observations were performed during morning care and consisted of 4 main categories: getting up, physical care, physical appearance, and breakfast. For each morning care activity, the observers consecutively scored who initiated the care activity, how staff facilitated autonomy, how residents responded to staff, and how staff reacted to residents' responses. Each resident was observed during 3 different mornings. In addition, qualitative field notes were taken to include environment and ambience.Results: In total, 1770 care interactions were observed. Results show that autonomy seemed to be supported by staff in 60% of the interactions. However, missed opportunities to engage residents in choice were frequently observed. These mainly seem to occur during interactions in which staff members took over tasks and seemed insensitive to residents' needs and wishes. Differences between staff approach, working procedures, and physical environment were observed across nursing home locations.Conclusions and Implications: The findings of this study indicate that staff members support resident autonomy in more than one-half of the cases during care interactions. Nonetheless, improvements are needed to support resident autonomy. Staff should be encouraged to share and increase knowledge in dementia care to better address residents' individual needs. Especially for residents with severe dementia, it seems important that staff develop skills to support their autonomy. (C) 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine. |
| Databáze: | OpenAIRE |
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