A meaningful daily life in nursing homes - a place of shelter and a space of freedom: a participatory appreciative action reflection study

Abstract

Background: Shortcomings in elderly care have been reported in many parts of the world, including Sweden. However, national guidelines for elderly care have been introduced in Sweden, which contain core values and local guarantees of dignity. These highlight the need for dignity and well-being, and organising the older person's daily life so that they perceive it as meaningful. Therefore, the aim of the present study was to describe older persons' experience and knowledge about obstacles, opportunities and solutions to developing a meaningful daily life for those living in nursing homes. Methods: This study combined the Participatory Appreciative Action Reflection (PAAR) and hermeneutic approaches. Twenty-five older persons participated and persons with dementia or cognitive impairments were included. Repeated interviews were carried out as reflective conversations, leaving 50 interviews in total, wherein the older persons provided their analyses and reflections on a meaningful daily life. Finally, an analysis of the data was completed based on a life-world hermeneutic approach. Results: We identified five tentative interpretations that describe obstacles, opportunities and solutions for a meaningful daily life. Themes 2 and 4 outline obstacles for a meaningful daily life, and Themes 1, 3 and 5 describe opportunities and solutions for a meaningful daily life: (1) Having space to be yourself; (2) No space to be yourself; (3) Belonging and security; (4) A feeling of insecurity; and (5) Longing for something to happen. In the main interpretation, we found that the five tentative interpretations are related to Tuan's concepts of space and place, where place can be described as security and stableness, and space as freedom and openness. Conclusions: The reciprocal relationship is a solution for a meaningful daily life and occurs in the interaction between staff and older persons in nursing homes. It is the balance of power, and constitutes a place of shelter and a space of freedom for a meaningful daily life. The older person must have balance between shelter and freedom to have a meaningful daily life.

Making Each Other’s Daily Life: Nurse Assistants’ Experiences and Knowledge on Developing a Meaningful Daily Life in Nursing Homes

“…This is consistent with a previous study with older persons in nursing homes, wherein they explained that they felt secure and at home due to the staff’s encounters with them and that this creates a meaningful daily life [28]. …”

“…This is in line with older persons’ preferences to keep their habits and routines in nursing homes to help ensure a meaningful daily life [28]. Their identity can be threatened when health deteriorates and they can no longer maintain habits and routines [33].…”

“…In interviews with older persons, it is precisely the community and the relationship with the staff that creates a meaningful daily life [28]. This sharing of something and the community can be seen as a “play”, something that happens by itself with no obligation [27].…”

Joy of life in nursing homes: A qualitative study of what constitutes the essence of Joy of life in elderly individuals living in Norwegian nursing homes

“…Along with a sense of belonging, positive relations are included in most professional understandings of the concept of well‐being . Having positive relations presume mutual love, care and considerations, all of which are regarded as principal requirements for well‐being . The present study showed the importance of being related to family, friends and the NH staff in order to experience JOL.…”

A Visual Analysis on How the Physical Environment Conditions Relatives’ Involvement in Nursing Homes

“…From a nursing geography perspective, it is not possible to separate people from places and vice versa (Andrews, 2003). This implies that people construct places and are at the same time constructed by them (James, Blomberg, & Kihlgren, 2014;Kim, 2010;Tuan, 1977). This means that the interactions and involvement of people in shared spaces is very much conditioned by the ways in which physical care environments are constructed (Andrews, 2002).…”