Skip to main content Accessibility help
×
Home

Developing personal relationships in care homes: realising the contributions of staff, residents and family members

  • CHRISTINE BROWN WILSON (a1), SUE DAVIES (a2) and MIKE NOLAN (a3)

Abstract

Personal relationships are an integral part of living, working and visiting in care homes, but little research has made relationships the main focus of enquiry, and there have been few studies of the perspectives of residents, staff and family members. The study reported here sought to redress this neglect. Using a constructivist approach, the nature and types of relationships between residents, staff and family members were explored in three care homes in England using combined methods including participant observation, interviews and focus groups. The data collection and analysis occurred iteratively over 21 months and three types of relationships were identified: ‘pragmatic relationships’ that primarily focus on the instrumental aspects of care; ‘personal and responsive relationships’ that engage more fully with the particular needs of individual residents; and ‘reciprocal relationships’ that recognise the roles of residents, staff and family members in creating a sense of community within the home. This paper explores the contributions made by staff, residents and family members in the development of these relationships. The findings enhance our understanding of the role of inter-personal relationships in care home settings and of the factors that condition them. The implications for developing improved practice in care homes are also considered.

Copyright

Corresponding author

Address for correspondence: Christine Brown Wilson, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL, United Kingdom. E-mail: christine.brownwilson@manchester.ac.uk

References

Hide All
Baldwin, N., Harris, J. and Kelly, D. 1993. Institutionalisation: why blame the institution? Ageing & Society, 13, 1, 6981.
Barnes, M. 2005. The same old process? Older people, participation and deliberation. Ageing & Society, 25, 2, 245–59.
Bebbington, A., Darton, R. and Netten, A. 2001. Care Homes for Older People. Volume 2, Admissions, Needs and Outcomes. Personal Social Services Research Unit, University of Kent, Canterbury, Kent, UK. Available online at http://www.pssru.ac.uk/research.php#Prog04 [Accessed 4 October 2006].
Beringeer, T. R. O. and Crawford, V. L. S. 2003. Admissions to elderly care institutions in the United Kingdom. Reviews in Clinical Gerontology, 13, 1, 95101.
Bouisson, J. and Swendsen, J. 2003. Routinization and emotional well being: an experience sampling investigation in an elderly French sample. Journals of Gerontology: Psychological Sciences, 58, 5, P280–2.
Bowers, B. J., Fibich, B. and Jacobson, N. 2001. Practice concepts. Care-as-service, care-as-relating, care-as-comfort: understanding nursing home residents' definitions of quality. The Gerontologist, 41, 4, 539–45.
Brechin, A. 1998. What makes for good care? In Brechin, A., Walmsley, J., Katz, J. and Peace, S. (eds), Care Matters: Concepts, Practice and Research in Health and Social Care. Open University Press, Buckingham, UK, 170–85.
Brown Wilson, C. R. 2007. Exploring Relationships in Care Homes: A Constructivist Inquiry. Unpublished Ph.D thesis, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK.
Daly, M. 2002. Care as a good for social policy. Journal of Social Policy, 31, 2, 251–70.
Davies, S. 2001. Wanting What's Best for Them: Relatives' Experiences of Nursing Home Entry: A Constructivist Inquiry. Unpublished Ph.D thesis, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK.
Davies, S. 2003. Creating community: the basis for caring partnerships in nursing homes. In Nolan, M. R., Lundh, U., Grant, G. and Keady, J. (eds), Partnerships in Family Care. Open University Press, Maidenhead, Berkshire, UK, 218–37.
Davies, S. and Nolan, M. R. 2004. ‘Making the move’: relatives' experiences of the transition to a care home. Health and Social Care in the Community, 12, 6, 517–26.
Davies, S. and Brown Wilson, C. 2007. Creating a sense of community. In National Care Homes Research and Development Forum, ‘My Home Life’. Quality of Life in Care Homes: A Review of the Literature. Help the Aged, London, 6584. Available online at http://www.helptheaged.org.uk/engb/WhatWeDo/AboutUs/Publications/wd_publicat_280206.htm [Accessed 20 June 2007].
Department of Health 2000. National Service Framework for Older People. Stationery Office, London. Available online at http://www.doh.gov.uk/nsf/pdfs/nsfolderpeople.pdf [Accessed 4 August 2002].
Deutschman, M. 2001. Redefining quality and excellence in the nursing home culture. Journal of Gerontological Nursing, 27, 8, 2836.
Duncan, M. T. and Morgan, D. L. 1994. Sharing the caring: family caregivers' views of their relationships with nursing home staff. The Gerontologist, 34, 2, 235–44.
Evans, M. 1999. Reconciling Conflicting Values in Health Policy. Pathfinder Technical Series Paper 9, Policy Futures for Health, The Nuffield Trust, London. Available online at http://www.nuffieldtrust.org.uk/ecomm/files/Policy_Futures_9_Ethics.pdf [Accessed 8 August 2008].
Evers, H. 1981. Multidisciplinary teams in geriatric wards: myth or reality? Journal of Advanced Nursing, 6, 3, 205–14.
Finlay, L. 2002. ‘Outing’ the researcher: the provenance, process and practice of reflexivity. Qualitative Health Research, 12, 4, 531–45.
Gaugler, J. E. 2005. Staff perceptions of residents across the long-term care landscape. Journal of Advanced Nursing, 49, 4, 377–86.
Gjerberg, E. 1995. Nursing home quality: different perspectives among residents, relatives and staff, a qualitative study. Vard I Norden: Nursing Science and Research in the Nordic Countries, 15, 4, 49.
Godfrey, M., Townsend, J. and Denby, T. 2004. Building a Good Life for Older People in Local Communities: The Experience of Ageing in Time and Place. Joseph Rowntree Foundation, York, UK. Available online at http://www.jrf.org.uk/bookshop/details.asp?pubID=631 [Accessed 21st May 2006].
Grasser, C. 1996. Reciprocity in staff/resident interactions in nursing homes. Journal of Women and Aging, 8, 1, 519.
Grau, L., Chandler, B. and Saunders, C. 1995. Nursing home residents' perceptions of the quality of their care. Journal of Psychosocial Nursing, 33, 1, 3541.
Guba, E. G. and Lincoln, Y. S. 1989. Fourth Generation Evaluation. Sage, Newbury Park, California.
Gubrium, J. F. and Holstein, J. A. 2002. Handbook of Interview Research: Context and Method. Sage, Thousand Oaks, California.
Haggstrom, E., Skovdahl, K., Flackman, B., Kihlgren, A. L. and Kihlgren, M. 2005. Work satisfaction and dissatisfaction: caregivers' experiences after a two-year intervention in a newly opened nursing home. Journal of Clinical Nursing, 14, 1, 919.
Hertzberg, A. and Ekman, S. 2000. ‘We, not them and us?’ Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes. Journal of Advanced Nursing, 31, 3, 614–22.
Hertzberg, A., Ekman, S. and Axelsson, K. 2001. Staff activities and behaviour are the source of many feelings: relatives' interactions and relationships with staff in nursing homes. Journal of Clinical Nursing, 10, 3, 380–8.
Howse, K. 2007. Long-term care policy: the difficulties of taking a global view. Ageing Horizons, 2, 6, 111. Available online http://www.ageing.ox.ac.uk/publications/ageing-horizons/ [Accessed 20 December 2007].
Jackson, E. M. 1997. Dimensions of care in five United States nursing homes: identifying invisible work in care-giving. International Journal of Nursing Studies, 34, 3, 192200.
Kane, R. A., Caplan, A. L., Urv-Wong, E. K., Freeman, I., Aroska, M. and Finch, M. 1997. Everyday matters in the lives of nursing home residents: wish for and perception of choice and control. Journal of the American Geriatrics Society, 45, 9, 1086–93.
Kellett, U. M. 1998. Meaning-making for family carers in nursing homes. International Journal of Nursing Practice, 4, 2, 113–9.
Lincoln, Y. S. and Guba, E. G. 1985. Naturalistic Inquiry. Sage, Newbury Park, California.
Lindgren, C. L. and Murphy, A. M. 2002. Nurses' and family members' perceptions of nursing home residents' needs. Journal of Gerontological Nursing, 28, 8, 4553.
Mattiasson, A. and Andersson, L. 1997. Quality of nursing home care assessed by competent nursing home patients. Journal of Advanced Nursing, 26, 6, 1117–24.
McGilton, K. S. and Boscart, V. M. 2007. Close care provider-resident relationships in long-term care environments. Journal of Clinical Nursing 16, 11, 2149–57.
McGilton, K. S., O'Brien-Pallas, L. and Pringle, D. 2001. The Effect of a Relationship Entering Program of Care on Residents, Family Members and Care Providers. Paper presented at the 17th World Congress of the International Association of Gerontology, Vancouver, July.
Meyer, J. 2007. Keeping the workforce fit for purpose. In National Care Homes Research and Development Forum, My Home Life – Quality of Life in Care Homes: A Review of the Literature. Help the Aged, London, 130–47. Available online at http://www.helptheaged.org/Publications/ [Accessed 20 June 2007].
Minkler, M. 1996. Critical perspectives on ageing: new challenges for gerontology. Ageing & Society, 16, 4, 467–87.
Mitchell, P. and Koch, T. 1997. An attempt to give nursing home residents a voice in the quality improvement process: the challenge of frailty. Journal of Clinical Nursing, 6, 6, 453–61.
Moyle, W., Skinner, J., Rowe, G. and Gork, C. 2003. Views of job satisfaction and dissatisfaction in Australian long-term care. Journal of Clinical Nursing, 12, 2, 168–76.
Netten, A., Darton, R. and Williams, J. 2003. Nursing home closures: effects on capacity and reasons for closure. Age and Ageing, 32, 3, 332–7.
Nolan, M. R., Grant, G. and Keady, J. 1996. Understanding Family Care. Open University Press, Buckingham, UK.
Nolan, M. R., Davies, S. and Grant, G. (eds) 2001. Working with Older People and Their Family members. Open University Press, Buckingham, UK.
Nolan, M. R., Lundh, U., Grant, G. and Keady, J. (eds) 2003. Partnerships in Family Care. Open University Press, Maidenhead, Berkshire, UK.
Nolan, M. R., Brown, J., Davies, S., Nolan, J. and Keady, J. 2006. The Senses Framework: Improving Care for Older People Through a Relationship Centred Approach. GRip Report, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK.
Perkinson, M. A. 2003. Defining family roles within a nursing home setting. In Stafford, B. (ed.), Gray Areas: Ethnographic Encounters with Nursing Home Culture. SAR Press, Santa Fe, New Mexico, 235–61.
Pillemer, K., Hegerman, C., Albright, B. and Henderson, C. 1998. Building bridges between family members and nursing homes staff: the partners in caregiving programme. The Gerontologist, 38, 4, 499503.
Rantz, M. J., Zwygart-Stauffacher, M., Popejoy, L., Grando, V., Mehr, D. R., Hicks, L. L., Conn, V., Wipke-Tevis, D., Porter, R., Bostick, J. and Meridean, M. 1999. Nursing home care quality: a multidimensional theoretical model integrating the views of consumers and providers. Journal of Nursing Care Quality, 14, 1, 1637.
Raynes, N. 1998. Involving residents in quality specification. Ageing & Society, 18, 1, 6578.
Reed, J. 1992. Individualised care: some implications. Journal of Clinical Nursing, 1, 1, 712.
Reed, J. and Bond, S. 1991. Nurses' assessment of elderly patients in hospital. International Journal of Nursing Studies, 28, 1, 5564.
Reed, J., Cook, G. and Stanley, D. 1999. Promoting partnership with older people through quality assurance systems: issues arising in care homes. NT Research, 4, 5, 353–63.
Rodwell, M. K. 1998. Social Work Constructivist Research. Garland, New York.
Ronch, J. 2004. Changing institutional culture: can we re-value the nursing home? Journal of Gerontological Social Work, 43, 1, 6182.
Ryan, A. A. and Scullion, H. F. 2000. Nursing home placement: an exploration of the experiences of family carers. Journal of Advanced Nursing, 32, 5, 1187–95.
Sandberg, J. 2001. Placing a Spouse in a Care Home for Older People: (Re)-Constructing Roles and Relationships. Ph.D thesis, Medical Dissertations 710, Faculty of Health Sciences, Linköping University, Sweden. Available online at http://www.bibl.liu.se/liupubl/disp/disp2001/med710s.pdf [Accessed 11 December 2008].
Sandberg, J., Lundh, U. and Nolan, M. R. 2001. Placing a spouse in a care home: the importance of keeping. Journal of Clinical Nursing, 10, 3, 406–16.
Sandberg, J., Nolan, M. R. and Lundh, U. 2002. ‘Entering a new world’: empathic awareness as the key to positive family/staff relationships in care homes. International Journal of Nursing Studies, 39, 5, 507–15.
Seddon, D., Jones, K. and Boyle, M. 2002. Committed to caring: carer experience after a relative goes into nursing or residential care. Quality in Ageing, 3, 3, 1626.
Stanley, D. and Reed, J. 1999. Opening Up Care: Achieving Principled Practice in Health and Social Care Institutions. Arnold, London.
Thorman Hartig, M. 1998. Expert nursing assistant activities. Western Journal of Nursing Research, 20, 5, 584601.
United Nations Organisation (UNO) 2002. World Population Ageing 1950–2050. Department of Economic and Social Affairs, UNO, New York. Available online at http://www.un.org/esa/population/publications/worldageing19502050/index.htm [Accessed 21 June 2007].
Wells, T. 1980. Problems in Geriatric Nursing. Churchill Livingstone, Edinburgh.
Wilde, B., Larsson, G., Larsson, M. and Starrin, B. 1995. Quality of care from the elderly person's perspective: subjective importance and perceived reality. Aging (Milan, Italy), 7, 2, 140–9.
Zisberg, A., Young, H., Scepp, K. and Zysberg, L. 2007. A concept analysis of routine: relevance to nursing. Journal of Advanced Nursing, 57, 4, 442–53.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed