A discourse of silence: professional carers reasoning about death and dying in nursing homes

2011 ◽  
Vol 31 (4) ◽  
pp. 529-544 ◽  
Author(s):  
JANE ÖSTERLIND ◽  
GÖREL HANSEBO ◽  
JANICKE ANDERSSON ◽  
BRITT-MARIE TERNESTEDT ◽  
INGRID HELLSTRÖM
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Death And Dying ◽  
The Elderly ◽  
Analysis Data ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Philosophy Of Palliative Care ◽  
The Moment ◽  
Training And Support

ABSTRACTNursing homes are a setting in which death and dying is common. How death and dying is articulated and the actions that take place in a nursing home constitute a discourse that guides the staff in their work. The aim of this study was to explore the discourse of death and dying in nursing homes from the perspective and understanding of the staff. The study draws on Foucault's discourse analysis. Data are from five focus-group discussions held with 28 staff of four different nursing homes in Sweden. The findings show that the discourse had three characteristics: (a) dying was silent and silenced, (b) emotions were pushed into the background, and (c) attentiveness to death arose after the moment of the elderly person's death. The structure of the discourse was characterised by a movement between two positions, avoiding and confronting death, the main focus being on avoidance. The articulation and practices of silence highlight a need to regard dying as a process that requires attention. One way to ensure appropriate attention could be to instil the philosophy of palliative care in nursing homes, including training and support for the staff in their work. The study demonstrates that nursing-home staff need more knowledge and support to enable them to feel that they do a good job.

The concept of restraint in nursing home practice: a mixed-method study in nursing homes for people with dementia

2011 ◽  
Vol 23 (5) ◽  
pp. 826-834 ◽  
Author(s):  
Sandra A. Zwijsen ◽  
Marja F. I. A. Depla ◽  
Alistair R. Niemeijer ◽  
Anneke L. Francke ◽  
Cees M. P. M. Hertogh
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Focus Group ◽  
Nursing Home Residents ◽  
Developed Countries ◽  
Nursing Home Care ◽  
Care Practice ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
People With Dementia

ABSTRACTIntroduction: Although in most developed countries the use of restraints is regulated and restricted by law, the concept of restraint in nursing home care remains ambiguous. This study aims to explore how care professionals and family members of nursing home residents with dementia in the Netherlands experience and define the concept of restraint.Methods: Individual interviews were held with relatives (n = 7) and key persons (n = 9) in seven nursing homes. We also conducted eight focus group discussions with nursing home staff. In addition, a structured questionnaire was administered to the nurses of participating nursing homes.Results: In the questionnaire, over 80% of the respondents indicated considering “fixation” (e.g. use of belts) as a restraint and 50 to 70% of the respondents regarded other physical interventions, such as geriatric chairs and bedrails, as restraints. The interviews and focus group discussions show that the residents' perception of the intervention, the staff's intention behind the intervention and concerns of privacy are the criteria used by the respondents in defining an intervention as a restraint.Conclusions: When trying to diminish restraint use, it is important to be aware of the “local logic” of care practice and to take into account the fact that, for staff and relatives, an intervention is only regarded as a restraint when it is bothering a resident or when an intervention is used for the sole purpose of restricting freedom and/or when interventions invade the privacy of a resident.

Innovations in Dying in the Nursing Home: The Impact of Market Characteristics

1997 ◽  
Vol 36 (3) ◽  
pp. 227-240 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Pain Management ◽  
Nursing Homes ◽  
Hospice Care ◽  
Descriptive Analysis ◽  
Death And Dying ◽  
The Elderly ◽  
Policy Changes ◽  
Recent Emergence ◽  
The Impact

During the 1980s nursing homes emerged as a dominant site of death for the elderly. This may precipitate more innovative approaches to death and dying in the nursing home and may account for the recent emergence of hospice care and pain management programs in nursing homes. However, the provision of hospice care and pain management in nursing homes are trends about which we have virtually no information. As a first step in examining these phenomena we provide a descriptive analysis of nursing homes that provide hospice care or pain management programs and an analysis of the impact of market characteristics as determinants of nursing homes providing them. Our findings suggest that the provision of pain management programs and hospice care are becoming prevalent in nursing home settings and that nursing homes are quite sensitive to their market environment indicating that policy changes could encourage further increases in these service innovations in death and dying.

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

2022 ◽  
Vol 8 (1) ◽  
pp. 51-66
Author(s):  
Vesna Žegarac Leskovar ◽  
Vanja Skalicky Klemenčič
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Architectural Design ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Evaluation Tool ◽  
Negative Effect ◽  
Disproportionate Number ◽  
Role Of Nursing

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

An Exploratory Study of Patterns of Social Interaction, Organization, and Facility Design in Three Nursing Homes

1973 ◽  
Vol 4 (4) ◽  
pp. 319-333 ◽  
Author(s):  
Lorraine Hiatt Snyder
Keyword(s):  
Nursing Home ◽  
Social Interaction ◽  
Nursing Homes ◽  
Social Environment ◽  
Environmental Analysis ◽  
Exploratory Study ◽  
The Elderly ◽  
Building Codes ◽  
Social Setting ◽  
Extended Care

Three Medicare-certified nursing homes are studied to determine factors of the organization, physical and social environment, and of the individuals that promote or deter social interaction. Social interaction is examined according to three phases: the tendency to congregate, the ability to impersonally interact with others, and the capacity to converse. Since conversation has been linked by others to rehabilitation, its promotion is stressed. Suggestions are made for creating a more functional social setting for the elderly, researching the behavioral basis for nursing home design, and for developing more meaningful building codes. This exploratory study serves as an example of how systematic environmental analysis may provide the direction necessary for implementing an extended care facility's goals.

scholarly journals KEBERMAKNAAN HIDUP PADA LANSIA DI PANTI WREDA

2020 ◽  
Vol 8 (1) ◽  
pp. 82
Author(s):  
Anindita Nova Ardhani ◽  
Yudi Kurniawan
Keyword(s):  
Nursing Home ◽  
Reference Material ◽  
Nursing Homes ◽  
Data Collection ◽  
Good Life ◽  
Developmental Psychology ◽  
Meaning Of Life ◽  
The Elderly ◽  
Good General Condition ◽  
The Subject

The aim of this study was to see the meaning of life in the elderly who live in the nursing home. The benefits that are expected to have in this research include theoretical benefits, which are expected to be a reference material for the development of developmental psychology, especially psychogerontology and practical benefits to be a reference material for psychologists, therapists, counselors, assistants, and readers in an effort to increase the meaning of life. in the elderly in general and in the elderly who live in nursing homes in particular. The subject criteria for the study were the elderly who were still able to communicate with and in good general condition. These criteria are determined on the basis of consideration because this study was conducted using interviews as a method of data collection. The results of this study indicate that the elderly who live in nursing homes have a good life meaning.Keywords: nursing homes, parents, the meaning of life,

scholarly journals Older persons’ thoughts about death and dying and their experiences of care in end-of-life: a qualitative study

BMC Nursing ◽  
2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Johanna Tjernberg ◽  
Christina Bökberg
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
Older Persons ◽  
Death And Dying ◽  
Living Condition ◽  
Care Needs ◽  
Healthy Persons

Abstract Background Few studies have focused on how older persons living in nursing homes perceive their last period of life. Furthermore, previous research on older persons’ perceptions of death and dying is limited. Hence, there is an urgent need to explore their experiences during their final period in life. Aim To explore thoughts about death and dying and experiences of care in end-of-life among older persons living in nursing homes. Methods This study employed a qualitative approach including individual interviews with 36 older persons living in Swedish nursing homes. Questions related to quality of life; physical health; thoughts about death, dying, and the future; and experiences related to the living condition and environment were asked. The interview transcripts were analysed through content analysis. The study was approved by the Regional Ethics Review Board (reference number: 2015/4). Results The analysis resulted in the identification of three main thematic categories: The unavoidable and unknown end of life, Thoughts on control and Living your last period of life at a nursing home. The older persons did not fear death itself but had some worries about dying. Spending the last stage of life at a nursing home contributed to different thoughts and feelings among the older persons. With a few exceptions, older persons characterized life at the nursing home as boring and felt they were surrounded by people who did not belong there. Conclusions This study indicates a need for older persons to talk about death, dying and end-life issues. Furthermore, this study highlighted that the co-residence of cognitively healthy persons and persons with dementia in the same ward adversely affected cognitively healthy persons. This situation resulted in there being not enough time to both handle the care needs of persons with dementia and have the conversations that cognitively healthy persons desired, such as conversations about thoughts about existence, that could have improved their quality of life. Trial registration NCT02708498 Date of registration 16 February 2016.

Elderly Abuse in Turkey

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
I. Icelli
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
High Speed ◽  
The Elderly ◽  
Rural Settlements ◽  
The Poor ◽  
Elderly Abuse ◽  
At Home

In Turkey, in the families who moved from rural settlements into city, the young peoples go to work and the grand parents take care of the little children at home. When the grand parents become old, there will be no one who can take care of them. This situation shows two solutions: to move back to their native environment or to be settled in a nursing home. If they have no where to go, these nursing homes are their only chance.The private nursing and caring homes, from the point of quality, are not in the same equality. The low-quality institutions are more familiar to the abuse. The residents of these institutions expect kindness, affection and warmth, but they never receive these expectations.A new kind of elderly abuse in Turkey is the Automatic Transfer Machines thefts. On the paydays the thief comes next to the machine, offers help to the elderly who came to take his retirement salary from the machine; the thief takes the ATM card, put in the hole, ask the password, enter it and take the money and run with a high speed. The poor old person looks after.There are no criminal codes yet which cover the elderly abuse in Turkey. Those kinds of incidents are taken as ordinary police incidents. The administration is now in preparation of a new program and a new regulation.

scholarly journals Exploring perceptions and attitudes of black Sub-Sahara African (BSSA) migrants towards residential care in England

2020 ◽  
Vol 16 (3) ◽  
pp. 307-315
Author(s):  
Mathew Nyashanu ◽  
Scovia Nalugo Mbalinda ◽  
Fungisai Mushawa ◽  
Mandu Stephene Ekpenyong
Keyword(s):  
Focus Group ◽  
Residential Care ◽  
Social Care ◽  
Death And Dying ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Early 19Th Century ◽  
Content Type ◽  
Health And Social Care ◽  
The Uk

Purpose Since the early 19th century, the UK has seen a decrease in mortality rates and increase in life expectancy. This has increased the number of elderly people being put into residential care. Change in British population demography with the arrival of many Africans from the black Sub-Sahara African (BSSA) countries has increased the need of these services. The purpose of this paper is to explore perceptions and attitude of BSSA towards residential care from potential user perspective. Design/methodology/approach This study was explorative qualitative in nature, using focus group discussions and one-on-one follow up semi-structured interviews. The focus group discussions and interviews were audio recorded and transcribed verbatim. The Silences Framework was used to guide this study, and the collection of data was done using the thematic analysis approach. Findings This study found out that the sense of confinement, lack of ownership, non-provision of culturally friendly food, non-provision of culturally friendly personal care, non-provisional of culturally orientated death and dying care, stigma for being neglected and perceived poor inclusivity leading to loneliness were found to discourage BSSA research participants from taking up residential care in the UK. Research limitations/implications In future, there is need for cross-cultural comparisons of BSSA communities living in the UK and BSSA communities living in Africa or other parts of the world. This may enhance understanding the differences and similarities based on contextual social, political and economic factors. Practical implications There is a need to understand the needs and concerns of new communities in relation to residential care and make necessary changes to enhance diversity and inclusivity. More importantly, the curriculum and professional development courses for staff in health and social care need to factor in the concepts of cultural competency and inclusivity to prepare them for the increasingly changing terrain of social care. Originality/value Owing to the changing demography and diversity in the UK population, there is a need to re-orient and re-design residential care services provision to make it diverse and inclusive of new communities from other cultures.

scholarly journals Elderly Psychological Conditions in the Nursing Home Tresna Werdha (Pstw): A Study Descriptive Riau and West Sumatra Indonesia

2021 ◽  
Vol 9 (E) ◽  
pp. 1393-1397
Author(s):  
Nurvi Susanti ◽  
Zulfan Saam ◽  
Nofrizal Nofrizal ◽  
Zahtamal Tamal ◽  
Nofri Hasrianto
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Descriptive Analysis ◽  
Sampling Technique ◽  
The Elderly ◽  
Research Subjects ◽  
Psychological Condition ◽  
Psychological Conditions ◽  
West Sumatra ◽  
Emotion Memory

The aspects of emotion, memory, motivation and independence are psychological conditions that are often experienced by the elderly who live in nursing homes. experienced by the elderly who are in the nursing home environment. This study aims to describe the psychological condition of the elderly in the Husnul Khotimah Pekanbaru social home for 35 elderly and 45 elderly Sabai Nan Aluih Pariaman nursing home. This research is a descriptive survey. The research subjects were 80 elderly who were taken with the total sampling technique. Data were collected using questionnaire sheets and descriptive analysis, this study shows that the psychological condition of the elderly which includes emotional aspects of the nursing home in the second category of the Husnul Khotimah nursing home is (69%) and the Sabai Nan Aluih nursing home is 73%.(80%) in the Husnul Khotimah nursing home and 69% in the good category in the Sabai Nan Aluih nursing home. Motivational aspectat both nursing homes is in the moderate category (51%) The independence aspect is in the good category (80%) in the Husnul Khotimah nursing home while the sufficient category is 67% in the Sabai Nan Aluih nursing home. Broadly speaking, the aspects of emotion, memory, motivation are good categories, category motivation is sufficient and the category independence is good at the Husnul Khotimah nursing home and sufficient at the Sabai Nan Aluih nursing home.

Sign in / Sign up

Export Citation Format

Share Document