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

Abstract

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.

Elderly peoples’ experiences of nursing homes in Bam city: A qualitative study

“…Most of the elderly had a negative attitude towards the rest of the people, and considered them as irrational and inconsistent people, perhaps due to mental health problems and physical or cultural differences and sense of distrust. Though similar research performed in the Netherlands and Ireland nursing homes is indicative of the fact that sometimes, the elderly sit with each other and talk ( 37 , 38 ), drink coffee and read journals ( 37 ) and share their daily hours in this way ( 12 , 39 ). Perhaps the main reason for the difference between the relevant research and the research presented, is that the people with physical and mental problems in Iran, whether they are young or old, are maintained along with the elderly.…”

The Factors Influencing the Sense of Home in Nursing Homes: A Systematic Review from the Perspective of Residents

“…Feeling respected and feeling known by the people in a facility make it a home [ 26 , p. 751]. In addition, the style of working of care professionals has an influence [ 25 , p. 96]. What the caregivers did change was their style of working.…”

“…In addition, Robinson et al [ 29 , p. 500] found that there were competing demands for staff who were charged with creating a “homely atmosphere” in nursing home cottages, in which they had to choose between carrying out household activities and addressing serious health care needs. Through respecting the residents' wishes, the caregivers provide room for residents' self-determination [ 25 , p. 97]. Continuity in activities from one's previous home-life is important too [ 25 ].…”

“…Through respecting the residents' wishes, the caregivers provide room for residents' self-determination [ 25 , p. 97]. Continuity in activities from one's previous home-life is important too [ 25 ]. Items related to practicing a hobby are important even though many of the hobby activities were too complicated to carry out in the nursing home, because of impairments and limitations [ 16 ].…”

“…Whether participants' move to long-term care was voluntary or involuntary was a determining factor in whether they found a home or not [ 12 , 15 ]. Klaassens and Meijering [ 25 ] found that residents should be allowed to do as they wished, and there should be a shift away from risk avoidance to risk management. Being able to lock one's own door improves the sense of control and not “being locked up.” In the study by van Dijck-Heinen et al [ 2 ], the rules of nursing homes and the practices of care professionals were considered to be too steering.…”