Framing spaces in places: Creating “respite spaces” in dementia care settings

Abstract

Research on dementia care settings has primarily focused on routine aspects of life, including mealtimes, bathing procedures, etc. However, studies rarely explore how individuals with dementia interact in these settings during the intervals between routines. This study aimed to analyze how residents actively carved out spaces that provided temporary respite from institutional life, termed ''framing respite spaces.'' Ethnographic data was collected over five months in a dementia care setting in Sweden. Frame analysis was employed to investigate residents' shared understanding of non-task-orientated situations. The results showed that individuals with dementia adjusted to institutional order, but also actively created respite spaces through conversation. Interestingly, individuals with dementia interpreted conversational cues and often acted logically according to a shared definition of the specific situation. These findings showed that looking beyond task-orientated interactions between staff and residents can provide a more detailed picture of everyday life in dementia care settings.

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

“…While understanding that routines are necessary to provide care services in a secure way, other types of situations and practices as sources of meaning are less addressed. This reasoning is in line with findings of other studies in NH settings (Boelsma et al., 2014; Gubrium, 1975; Harnett, 2010, 2014; Öhlander, 1996; Persson & Wästerfors, 2009), where the coexistence of diverse life worlds might be concealed due to institutional routines. Furthermore, the exemplar Seeking for a place for other life worlds could be understood as threatening the resident's identity, due to limited influence and ownership over her everyday life.…”

“…Moreover, they emerge mostly from institutional needs and are not necessarily grounded on the residents' interests (Benjamin, Rankin, Edwards, Ploeg, & Legault, 2016;Boelsma, Baur, Woelders, & Abma, 2014), which puts person-centered practices at stake. Spontaneous, unplanned, and unprompted activities that emerge through a relational and person-centered understanding of care are less often addressed in this research field (Harnett, 2010(Harnett, , 2014. In this sense, a broader exploration of the role and meaning of activities embedded in practices in NH settings is needed (Harnett, 2014) to narrow the gap between policy, national guidelines, research advances, and everyday practices (Edvardsson, Varrailhon, et al, 2014).…”

“…Spontaneous, unplanned, and unprompted activities that emerge through a relational and person-centered understanding of care are less often addressed in this research field (Harnett, 2010(Harnett, , 2014. In this sense, a broader exploration of the role and meaning of activities embedded in practices in NH settings is needed (Harnett, 2014) to narrow the gap between policy, national guidelines, research advances, and everyday practices (Edvardsson, Varrailhon, et al, 2014).…”

“…There has been particular attention in research on the role and meaning that activities have for older adults living in NHs (Gustavsson, Liedberg, & Larsson Ranada, 2015; McCormack, Karlsson, et al., 2010, 2011; Van't Leven & Jonsson, 2002). Doing tasks, such as watering plants, doing laundry or setting the table, has been addressed as meaningful for older adults living in NHs (Edvardsson, Petersson, et al., 2014; Harnett, 2014). This knowledge about activities meaning for older adults is important, but limited because these tasks constitute just a small part of everyday activities in a NH.…”

Place memory and dementia: Findings from participatory film-making in long-term social care

“…A growing body of work has also started to focus on the ways in which people with dementia living in long-term care environments interact with spaces and places which are often not of their own choosing. Harnett (2013) notes, for example, how people with dementia 'carve out spaces' where they can obtain temporary respite from rule-governed and task-oriented institutional regimes, and identifies 'recollection talk' as one of two main tactics for framing such respite spaces.…”