Autonomy in long‐term care: a need, a right or a luxury?

Boyle, Geraldine

doi:10.1080/09687590802038795

Cited by 52 publications

(69 citation statements)

References 29 publications

(32 reference statements)

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“…Key to this argument is that the focus on choice of service and resources is at best insufficient and potentially counter to the overall goals of independent living and increased autonomy and rights as expressed both by government (Department of Health, 2007) and the Independent Living Movement (Morris, 2006;Boyle, 2008). This can be seen as a problem, not with the abstract concept of choice, but in the specific emphasis given in public policy to the market model of individual agents making free purchasing choices.…”

Section: Discussionmentioning

confidence: 99%

“…Choice was also a key element of the campaign, led by the disability movement (although older people played little part in this) for an ethical approach to social care, which maximises the autonomy of people using services (Morris, 2006;Ellis, 2007;Boyle, 2008). Existing services were experienced as inflexible and unreliable, and felt to create dependency (Morris, 2006).…”

Section: A Brief History Of Choicementioning

confidence: 99%

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Assessing the Role of Increasing Choice in English Social Care Services

et al. 2011

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This article aims to explore the concept of choice in public service policy in England, illustrated through findings of the Individual Budgets (IB) evaluation. The evaluation tested the impact of IBs as a mechanism to increase choice of access to and commissioning of social care services around the individual through a randomised trial and explored the experiences and perspectives of key groups through a large set of interviews. The article presents a reexamination of these interview data, using three 'antagonisms of choice' proposed in the literature -choice and power relations, choice and equity, and choice and the public nature of decisions -as organising themes. The randomised trial found that IB holders perceived they had more control over their lives and appreciated the extra choice over use of services, albeit with variations by user group. However, problems of power relations, equity and the constraints implied by the public nature of decision-making were complicating and limiting factors in producing the benefits envisaged. The focus on choice in policy, especially as implemented by IBs, emphasises an individualistic approach. The findings suggest that addressing broader issues relating to power, equity and an understanding of the public nature of choice will be of value in realising more of the benefits of the policy.

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Section: Discussionmentioning

confidence: 99%

Section: A Brief History Of Choicementioning

confidence: 99%

Assessing the Role of Increasing Choice in English Social Care Services

et al. 2011

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“…As a result, it is difficult for many older adults to make themselves 'at home' in a nursing home (Granbom et al, 2014;Shin, 2014). Several studies have found that the core qualities of home are positively linked to the well-being of older people, including those in longterm care settings (Boyle, 2008;Cooney, 2012;Sixsmith et al, 2014). This suggests that feeling at home can enhance the wellbeing of older adults in long-term care (Cooney, 2012).…”

Section: Introductionmentioning

confidence: 96%

Experiences of home and institution in a secured nursing home ward in the Netherlands: A participatory intervention study

Klaassens

Meijering

2015

Journal of Aging Studies

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Nursing homes have been criticised for not providing a home for their residents. This article aims to provide insight into (1) the features of home and institution as experienced by residents and caregivers of a secured ward in a nursing home, and (2) how interventions implemented on the ward can contribute to a more home-like environment. For this purpose, a participatory intervention study, involving both caregivers and residents, was carried out. We collected data through qualitative research methods: observations, in-depth interviews and diaries to evaluate the interventions over time. We adopted an informed grounded theory approach, and used conceptualisations of total institutions and home as a theoretical lens. We found that the studied ward had strong characteristics of a total institution, such as batch living, block treatment and limited privacy. To increase the sense of home, interventions were formulated and implemented by the caregivers to increase the residents' autonomy, control and privacy. In this process, caregivers' perceptions and attitudes towards the provision of care shifted from task-oriented to person-centred care. We conclude that it is possible to increase the home-like character of a secured ward by introducing core values of home by means of interventions involving both caregivers and residents.

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“…More specifically, this framework makes explicit the need to move beyond technical competences and engage in the promotion of partnerships and collaborative practices with older adults (McCormack, 2004; McCormack & McCance, 2006). This relational perspective (Cardol, De Jong, & Ward, 2002; Nolan et al., 2004; Smebye & Kirkevold, 2013) also serves to counteract and problematize concepts such as autonomy, decision‐making, and self‐determination in person‐centered care, which assign a central value to individualism and cognitive competences (Boyle, 2008). …”

Section: Introductionmentioning

confidence: 99%

Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement

et al. 2017

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This study focuses on influence that older adults, living in nursing homes, have over everyday activities. Everyday activities are key to sustain a sense of stability, predictability, and enjoyment in the local world of people's everyday and therefore a critical dimension of the person‐centeredness framework applied within gerontology. This narrative ethnographic study aimed to shed light on how influence can be situated contextually, and how it can emerge through activities as well as how it is negotiated in everyday by frail older adults living in a nursing home. Residents, staff members, and significant others from one nursing home in an urban area of Sweden participated in this study. Data were gathered through fieldwork, including participant observation and formal and informal conversations during a period of 6 months. Data were analyzed through a narrative interpretative approach. The findings are presented in narrative form as exemplars. The exemplars—Craquelures as justification, Seeking a place for other life worlds and An almost perfect trip—reveal a gap between the client‐centeredness framework and lived experiences regarding older adults’ influence in everyday activities. The role of everyday activities in the context of frailty is discussed in terms of ethical and responsive engagement, and implications for health‐care practices are considered.

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Autonomy in long‐term care: a need, a right or a luxury?

Cited by 52 publications

References 29 publications

Assessing the Role of Increasing Choice in English Social Care Services

Assessing the Role of Increasing Choice in English Social Care Services

Experiences of home and institution in a secured nursing home ward in the Netherlands: A participatory intervention study

Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement

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