Coming to Terms: African-Americans' Complex Ways of Coping with Life in a Nursing Home

Abstract

Based on qualitative interviews with 14 nursing home residents and 13 caregivers, this article explores how elders adapted to life in a nursing home, and how their caregivers came to embrace nursing home placement as the optimal way to meet their elders' need for care. These processes were mediated by two mechanisms: the function the institution fulfilled for residents and their caregivers, and the coping strategies residents used to adapt to institutional living. The wide variety of elders' psycho-emotional coping strategies can best be summarized as accommodation, resignation, and resistance which translate into a number of behaviors. However, there was no typical or neat movement from resistance to resignation followed by accommodation. Instead, residents pulled from their repertoire of coping strategies the ones that served them best in a given situation and in a way that allowed them to express simultaneously satisfaction and discontent, compromise and adjustment. Clark and Anderson's (1967) model of adaptation proved useful for understanding participants' struggle to come to terms with life in the nursing home.

Resident strategies for making a life in a nursing home: a qualitative study

“…The strategies used in day‐to‐day life were ways the participants coped with the challenges of institutional living and these strategies are consistent with previous studies (Porter & Clinton , Kahn , Groger ). When participants spoke of the difficulties they faced living in the nursing home; they often recalled how they dealt with other difficult situations in the past.…”

“…More recently researchers have focused on the influence of culture on resident adjustment to nursing home life (Kahn , Groger , Lee et al . ).…”

Caring to achieve the maximum independence possible: a synthesis of qualitative evidence on older adults’ adaptation to dependency

“…These include psycho emotional strategies which I tentatively summarize as accommodation, resignation, and resistance, and which translate into a number of coping behaviours [...] Initially most residents dislike the nursing home, but eventually they accepted it and conceded that ‐under the circumstances‐ […] Accommodation connotes efforts on the part of the residents to adopt a positive attitude about their new home […] resignation include such things as not complaining, not fussing, accepting the inevitable, making do or doing without, relinquishing control, […] resistance connotes a refusal to admit that one might find satisfaction […]. (Groger 2002, p. 195)…”

“Can You Give Me Respect?” Experiences of the Urban Poor on a Dedicated AIDS Nursing Home Unit

“…Their acts of resistance were similar to the coping strategies of some African American elders living in a nursing home (Groger, 2002). Knowing their place, based on racist ideology, meant being subservient, being less than human-unseen, unheard, and unrecognized as an African American (Bolton, Giger, & Georges, 2004).…”