Exploring nursing home resident and their care partner priorities for care using the Action-Project Method

Abstract

Background Nursing home (NH) residents’ experiences are embedded within their relationships to others. Our objectives were to describe how residents and care partners (family or staff members) jointly construct, discuss, and act on care priorities. Methods We used Action-Project Method, a qualitative method focused on action within social context. We recruited 15 residents and 12 care partners (5 family and 7 staff members) from 3 urban NHs in Alberta, Canada. Residents and care partners participated in a video-recorded conversation about their experiences in the NH, then individually reviewed the video-recording to add context to the conversation. Following transcription, preliminary narrative construction, and participant feedback, the research team conducted in-depth analysis to identify participant actions, goals, and projects, including those jointly shared by dyad members. Results All participants’ intentions could be broadly described as “making time in the NH as good as possible” and projects were grouped into five categories: resident identity, relationships (both presence and absence), advocacy, positivity, and respectful care. Participants often raised issues of short-staffing as a significant barrier to respectful care. Care partners, especially staff, used positivity to redirect residents from difficult topics. Joint projects could be identified in some, but not all, cases. Conclusions We found that maintaining a sense of identity, fostering relationships, and receiving respectful care were important to residents but that short-staffing created barriers. Methods to capture these aspects of the resident experience are needed but should not be influenced by care partners’ tendency towards positivity in resident interactions.

Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes

“…Relation-centered care views the relationship between the care provider and care recipient as the primary determinant of quality. For NH residents, relationships with staff greatly affect their experience within the facility ( Bowers et al, 2001 ; Coughlan & Ward, 2007 ; Gruneir et al, 2023 ; Vaismoradi et al, 2016 ). We posit that when care aides experience symptoms of burnout, they subsequently redirect their resources, specifically time and emotional resources, and they shift their approach to care from a relation-centered approach to task-oriented care.…”