Purpose
The purpose of this paper is to explore the indicators of quality in care for people working and living in aged residential care (ARC) settings.
Design/methodology/approach
This research was conducted using an ethnographic design in two distinct ARC facilities in a New Zealand city, a large facility with residential, dementia and hospital level care, and a small family owned facility providing residential care only. In total, 50 hours of observational data were collected, and semi-structured interviews were conducted with 21 people, including managers, careworkers, nurses, family members and residents. These data were thematically analysed using the constant comparative method.
Findings
The main indicators of quality for staff, family and residents included: a home-like, friendly and safe environment; good medical and personal care; respect for the residents; and good staff. Participants also acknowledged the need for adjustments by residents to living in aged care; and the challenges of caring for increasingly frail residents.
Originality/value
Findings support the growing recognition of a need for resident-centred approaches to ARC that are reflected in government policy and regulatory apparatus. Managers in ARC facilities must balance adherence with health and safety standards, and providing an environment where their residents can enjoy a meaningful life that has purpose and value.
Whether one has a "good death" or not is determined not only by the progression and management of the disease process by health professionals, but also by the way in which one is perceived, by self and others. There are no guidelines for the dying role; everybody dies differently and individually.
Introduction:
This paper discusses the application of the anthropological concept of liminality to narratives of New Zealanders living in the community with life threatening conditions, both malignant and non-malignant.
Method:
This qualitative research aimed to explore the ways in which people diagnosed with life-threatening conditions managed their life world. Using a narrative approach, 13 participants, eight spousal caregivers, three adult children, three specialists, one general practitioner and one psychotherapist were interviewed. Analysis was thematic and interpretive within a phenomenological framework.
Conclusion:
Receiving a diagnosis with a poor prognosis heralded significant life changes for patients and their families and precipitated a transition from an identity as a productive member of society and community participant to that of patient living with an uncertain future. Conceptualising end of life care in terms of liminality offers a powerful framework for understanding the experiences and challenges faced by people with life threatening conditions and their families.
Whether one has a "good death" or not is determined not only by the progression and management of the disease process by health professionals, but also by the way in which one is perceived, by self and others. There are no guidelines for the dying role; everybody dies differently and individually.
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