Optimising social conditions to improve autonomy in communication and care for ethnic minority residents in nursing homes: A meta‐synthesis of qualitative research

Abstract

A large proportion of nursing home residents in developed countries come from ethnic minority groups. Unmet care needs and poor quality of care for this resident population have been widely reported. This systematic review aimed to explore social conditions affecting ethnic minority residents' ability to exercise their autonomy in communication and care while in nursing homes. In total, 19 studies were included in the review. Findings revealed that ethno-specific nursing homes create the ideal social condition for residents to express their care needs and preferences in a language of choice. In nonethno-specific nursing homes, staff cultural competence and nursing home commitment to culturally safe care are crucial social conditions that enable this group of residents to fulfil their autonomy in communicating and in participating in their care. In contrast, social conditions that undermine residents' ability to express their care needs and preferences include low levels of staff cultural awareness and cultural desire, negative attitudes towards residents and limited organisational support for staff to improve culturally responsive and culturally safe care. In conclusion, it is important to optimise the social conditions to support ethnic minority residents to communicate their care needs and preferences.

Comparisons on factors affecting residents fulfilling self-determination in ethno-specific and mainstream nursing homes: a qualitative study

“…Our ndings support two previous literature reviews which found creating cultural and linguistic congruent care is a social condition for residents to communicate their needs and preferences and ful l autonomy [5,15] . However, our study revealed that arranging bilingual staff to be available and accessible for residents during all shifts was not always possible in ethno-speci c nursing homes.…”

“…This nding supports studies on Finnish ethno-speci c nursing homes in Sweden where rich resources to support residents' social engagement were developed through connections and collaborations with community organisations [7,30] . This nding also supports the suggestion that arranging residents from the same ethnic group in a unit of a mainstream nursing home, may be logistically viable in terms of encouraging socialisation among residents while developing resources to support culturally and linguistically congruent care [5,7] .…”

“…Studies revealed that supporting residents ful lling selfdetermination is positively associated with their health, wellbeing and quality of life [3,4] . Residents from culturally and linguistically diverse (CALD) backgrounds in developed countries experience signi cant challenges in ful lling self-determination compared to non-CALD residents in a mainstream nursing home due to known cross-cultural communication challenges with staff [5] . Moreover, residents' preferences (i.e.…”

“…Studies found that residents with dementia were still capable of engaging in some own care activities and their preferences remained stable over time [16] . Recent literature reviews on CALD residents in nursing home in developed countries found that their pro ciency in mastering the dominant language of a particular country was a prerequisite for them to ful l self-determination in everyday care [5,15] . Studies showed that staff who did not share the same language and culture with residents in ethno-speci c nursing homes could demonstrate culturally congruent care and prevent changed behaviours in CALD residents when they adapted their practices to residents' culture, for example learning residents' native language and using it when communicating with them, and respecting residents' cultural values [12,13] .…”

Home‐ and community‐level predictors of social connection in nursing home residents: A scoping review

“…Second, there were also no studies that assessed the impact of culturally-77 or ethno-specific 78 nursing homes where care is tailored to a particular group, including through aspects such as staffing, offering specific foods and activities as well as building design. 79 Third, we found only five studies of community-level characteristics and most used census-derived measures of the population surrounding the home. A report of case studies from LTC homes in Canada, Norway, and Germany found that families and residents highlighted the importance of neighborhood amenities that allow residents to engage with the community and visitors.…”