The Lived Experience of Person-Centred Care in Residential Homes in New Zealand and Singapore: The perspectives of Residents, Frontline Caregivers and Family Members
Ageing is an inevitable part of life. The intent to age gracefully and in a dignified manner is held as important by many, but a number of challenges can influence an individual’s ability to control their lives at an older age. Frailty, associated with ageing, with or without the diagnosis of a chronic condition, impacts on the ability to live independently, and for some, precipitates the need to move into long-term residential care. Often the decision to move into a residential or nursing home is driven by family members who feel that they cannot provide the support required for their elderly family member. With an increase in the ageing population, many nations have started to focus on building more residential home institutions to help meet the demand. Currently within the aged care sector, the drive for quality care and quality of life has shifted the focus from providing basic care needs to one of person-centred care. Person-centred care has been promoted internationally as a quality care model to enhance the life of the older people residing in residential homes, and it values the inclusion of all members involved in the care context as vital in supporting the wellbeing of older residents in the residential home setting. AIM: The purpose of this study was to explore the lived experience of person-centred care in residential homes from New Zealand and Singapore from the perspective of the residents, family members and frontline caregivers. The philosophical orientation of Van Manen’s lifeworld-hermeneutic phenomenology was adopted as the methodology to guide this study. METHOD: Interviews were conducted with thirty residents, ten family members and ten caregivers at two residential homes in New Zealand and Singapore. ANALYSIS: The audio-recorded interviews were transcribed and imported into NVIVO. The data were analysed using Van Manen’s six-step research process. RESULTS: The data from the three participant groups across the two countries were synthesised and three major themes emerged from the findings: ‘homelike’, ‘maintaining and developing connections’ and ‘workplace culture’. Each theme attempted to capture the unique and personal understanding of person-centred care as conceptualised by each participant. Relocation to a residential home caused distress and impacted on the resident’s experience of care. However, when there was continuity of their life themes and support from family and staff, this influenced their care experience positively. A care context that supported person-centred values at all levels was described as essential in fostering person-centred care. CONCLUSION: Some older residents have great difficulty in establishing a sense of home in the residential home settings. The transition into residential care requires further attention. Building collaborative relationships between residents, family members and frontline caregivers are vital in enhancing person-centred care, which fosters the alignment of expectations and preferences. At an organisational level, a supportive care context that provides the physical structure, human resources, and the promotion of holistic care underpins positive person-centred care outcomes.
Advisor: Whitehead, Lisa; Crowe, Marie; Trip, Henrietta
Degree Name: Doctor of Philosophy
Degree Discipline: Nursing Studies Christchurch
Publisher: University of Otago
Keywords: person-centred; care; residential; homes; perspectives; residents; family; members; frontline; caregivers; lived; phenomenology; experience; hermeneutics; Singapore; NewZealand
Research Type: Thesis