La régulation en institutions de long séjour. Un travail de soin et d’accompagnement auprès des personnes âgées

Mendelzweig, Marion Droz; Bedin, Maria Grazia; Chappuis, Marianne

doi:10.1684/sss.2011.0203

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“…It is a commitment to the ethics of care that leads caregivers to look for ways to adjust the rules. We consider this work as consisting of regulatory activities [29]. Between the requirements to systematize the collection of information on residents' wishes and the relational conditions of its feasibility, professional caregivers cannot do better than to look for ways to deal with the constraints.…”

Section: Regulation Theory and Its Utility In The Debate About Adsmentioning

confidence: 99%

Social regulation activities in end-of-life: a qualitative study on completion of advance directives in Swiss nursing homes

Mendelzweig

2020

BMC Palliat Care

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Background: In Switzerland as in many countries, steady trend is observed in nursing homes to promote writing of advanced directives (ADs). Implementation of ADs reflects the rise in public concern for the persons' right to selfdetermination and informed decision. The issue of end-of-life conditions is particularly acute in situations with dementia. This article investigates how ADs interventions in nursing homes strive simultaneously to behave in line with the principles of care ethics and with the intention to respond to legally binding instructions. Healthcare to dying residents with dementia in nursing homes is interpreted in light of the Regulation theory. Methods: Nursing home palliative care reference nurses were contacted through questionnaire. One hundred twenty-one addresses were reached, 69 responses were collected, giving a response rate of 57%. In order to deepen the understanding, 10 semi-directive interviews were conducted in 10 different nursing facilities with 12 palliative nurses.Results: Presently, Swiss nursing homes are lacking a model of AD suitable to people with dementia. The study sheds light on dissimilarities in the purpose assigned to ADs' procedure in the different facilities. Discrepancies in end-of-life care practices reveal more the influence of structural and organisational devices specific to each setting than conflicting views on end-of-life care principles. We analyse the interpretation of the Law and its implementation in the participating NHs as compromises that could be accounted for as a form of social regulation.Conclusion: Dementia accentuates the uncertainty inherent to end-of-life trajectories. The implementation of standardised procedures aimed at collecting the wishes of the person deprived of his or her discernment is source of dissonances with regard to the multiple interests involved in these care situations. In this context, the drafting of ADs during end-of-life care in NH correspond to new normative constraints requiring new collective regulation actions.

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Section: Regulation Theory and Its Utility In The Debate About Adsmentioning

confidence: 99%

Social regulation activities in end-of-life: a qualitative study on completion of advance directives in Swiss nursing homes

Mendelzweig

2020

BMC Palliat Care

View full text Add to dashboard Cite

show abstract

La régulation en institutions de long séjour. Un travail de soin et d’accompagnement auprès des personnes âgées

Cited by 1 publication

References 0 publications

Social regulation activities in end-of-life: a qualitative study on completion of advance directives in Swiss nursing homes

Social regulation activities in end-of-life: a qualitative study on completion of advance directives in Swiss nursing homes

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