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Being a spectator in ambiguity: Family members' perceptions of assisted bodily care in a nursing home
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.ORCID iD: 0000-0002-8912-8101
Ersta Sköndal University College, Enheten för forskning i palliativ vård. Linköpings universitet.ORCID iD: 0000-0001-8007-1770
Ersta Sköndal Bräcke University College, Department of Health Care Sciences.ORCID iD: 0000-0001-9559-1939
2019 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 15, no 1, p. 1-10Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to explore family members' perceptions of assisted bodily care in a nursing home.

BACKGROUND: Many older people living in nursing homes need assisted bodily care, provided by assistant nurses. This means exposedness, as the assistance is often provided under stress, but also brings pleasure. Family members, who may wish to and often benefit from continuing to provide assisted bodily care, are perceived as visitors and are expected to relinquish the assisted bodily care to the assistant nurses.

DESIGN: This study has a qualitative design with a phenomenographic approach.

METHODS: Data were collected through semi-structured interviews (n = 13) with family members of older people who were aged > 80, permanently living in a nursing home, suffering from multimorbidity, and in daily need of assisted bodily care. The data were analysed using a phenomenographic method.

RESULTS: Three categories of description presenting an increasing complexity were identified. The family members perceived that assisted bodily care is built upon a respect for the older person's self-determination, practically supported by assistant nurses, and complemented by family members.

CONCLUSIONS: In the family members' perceptions, assisted bodily care signifies ambiguity, as they find themselves balancing between the older persons' need for self-determination and need for help, and, further, between their trust in the assistant nurses' skills and their own perceived inadequacies in intimate assisted bodily care.

IMPLICATIONS FOR PRACTICE: Policies that address the family members' role in nursing homes are needed. Furthermore, time for collaboration is needed for assistant nurses to inform and explain care decisions, become aware of the family members' perceptions of their situation and learn from them.

Place, publisher, year, edition, pages
2019. Vol. 15, no 1, p. 1-10
Keywords [en]
Assisted bodily care, Ethics, Family, Nursing home care, Phenomenography, Qualitative methods, Self-determination
National Category
Nursing
Research subject
The Individual in the Welfare Society, Palliative Care
Identifiers
URN: urn:nbn:se:esh:diva-8054DOI: 10.1111/opn.12289PubMedID: 31763780OAI: oai:DiVA.org:esh-8054DiVA, id: diva2:1423585
Available from: 2020-04-15 Created: 2020-04-15 Last updated: 2023-01-03Bibliographically approved
In thesis
1. När kroppen inte räcker till: Assisterad kroppslig omvårdnad i livets slut på vård- och omsorgsboende
Open this publication in new window or tab >>När kroppen inte räcker till: Assisterad kroppslig omvårdnad i livets slut på vård- och omsorgsboende
2020 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Det övergripande syftet med denna avhandling var att belysa vård i livets slut på vård- och omsorgsboende, med inriktning mot den kroppsliga omvårdnaden, utifrån äldre personers, undersköterskors och anhörigas perspektiv. Avhandlingen bygger på fyra delstudier. Tre analysmetoder användes;innehållsanalys (I & III), fenomenologisk hermeneutik (II) och fenomenografi(IV). Datainsamlingen omfattade individuella intervjuer (I, II & IV) och observation (III). Fynden visar att; (I) undersköterskor känner de äldre personerna och värnar deras självbestämmande, välbefinnande och värdighet. I sitt arbete fokuserar de främst på kroppslig omvårdnad. Äldre personer (II) upplever kroppslig omvårdnad som en assistans, växelvis i form av ett fängelse eller som en njutning. De värnar sitt självbestämmande, men anpassar sig efter de omständigheter som bestäms av andra. Det är främst undersköterskor som utför assisterad kroppslig omvårdnad (III), medan äldre tar del i det de kan, trots nedsatt kroppslig förmåga. Anhöriga räknar med att äldre personer utövar fullt självbestämmande gällande assisterad kroppslig omvårdnad (IV). Själva bidrar de med en assisterad kroppslig omvårdnad som inte innefattar intimhygien, medan de förblir observanta på undersköterskors arbete. Avhandlingen belyser att assisterad kroppslig omvårdnad kan överbrygga äldres kroppsliga begränsningar och leda till välbefinnande när självbestämmandet främjas. Sådan assisterad kroppslig omvårdnad kan utgöra en väsentlig del av en palliativ omvårdnad för äldre personer på vård- och omsorgsboende i livets slut.

Place, publisher, year, edition, pages
Stockholm: Ersta Sköndal Bräcke högskola, 2020. p. 135
Series
Avhandlingsserie inom området Människan i välfärdssamhället, ISSN 2003-3699 ; 4
Keywords
Anhöriga, Autonomi, Äldre personer, Kroppslig omvårdnad, Palliativ vård, Undersköterskor, Vård- och omsorgsboende, Välfärd, Värdighet
National Category
Nursing
Research subject
The Individual in the Welfare Society, Palliative Care
Identifiers
urn:nbn:se:esh:diva-8055 (URN)978-91-985808-4-6 (ISBN)
Public defence
2020-05-15, 09:00
Opponent
Supervisors
Available from: 2020-04-15 Created: 2020-04-15 Last updated: 2023-09-22Bibliographically approved

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Holmberg, BodilHellström, IngridÖsterlind, Jane

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