The Development of Relationships Between Families and Staff in Long-term Care Facilities: Nurses' Perspectives

Gladstone, James W.; Wexler, Evelyn

doi:10.1017/s0714980800001483

Cited by 20 publications

(45 citation statements)

References 27 publications

(45 reference statements)

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“…LTC research indicates relationships are at the core of care, and improving outcomes for care recipients and formal and informal caregivers often is about building relationships and improving social relations (Holstein et al, 2011). Home care (Bourgeault, Atanackovic, Rashid, & Parpia, 2010; Dyck & England, 2012; Parks, 2003) and nursing home (e.g., Abrahamson, Suitor, & Pillemer, 2009; Bern-Klug & Forbes-Thompson, 2008; Gladstone & Wexler, 2002a, 2002b; Shield, 2003; Utley-Smith et al, 2009; Wilson, Davies, & Nolan, 2009) research bears this out. Across settings, it is essential to take a longer, evolutionary view of care and care arrangements.…”

Section: Discussionmentioning

confidence: 99%

“…Researchers have investigated formal–informal care intersections in home care (e.g., Ayalon, 2009; Ball & Whittington, 1995; Martin-Matthews, 2007; Neysmith & Aronson, 1997; Parks, 2003; Ward-Griffin & Marshall, 2003), nursing homes (e.g., Gladstone & Wexler, 2002a, 2002b; Shield, 2003), and, to a lesser extent, AL settings (Ball et al, 2005). Yet existing work does not offer a comprehensive understanding of the intersection of formal and informal care, including the factors that influence its interface and ensuing outcomes for care recipients and their caregivers.…”

Section: Introductionmentioning

confidence: 99%

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Convoys of care: Theorizing intersections of formal and informal care

Kemp

Ball

Perkins

2013

Journal of Aging Studies

113

127

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Although most care to frail elders is provided informally, much of this care is paired with formal care services. Yet, common approaches to conceptualizing the formal–informal intersection often are static, do not consider self-care, and typically do not account for multi-level influences. In response, we introduce the “convoy of care” model as an alternative way to conceptualize the intersection and to theorize connections between care convoy properties and caregiver and recipient outcomes. The model draws on Kahn and Antonucci's (1980) convoy model of social relations, expanding it to include both formal and informal care providers and also incorporates theoretical and conceptual threads from life course, feminist gerontology, social ecology, and symbolic interactionist perspectives. This article synthesizes theoretical and empirical knowledge and demonstrates the convoy of care model in an increasingly popular long-term care setting, assisted living. We conceptualize care convoys as dynamic, evolving, person- and family-specific, and influenced by a host of multi-level factors. Care convoys have implications for older adults’ quality of care and ability to age in place, for job satisfaction and retention among formal caregivers, and for informal caregiver burden. The model moves beyond existing conceptual work to provide a comprehensive, multi-level, multi-factor framework that can be used to inform future research, including research in other care settings, and to spark further theoretical development.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Convoys of care: Theorizing intersections of formal and informal care

Kemp

Ball

Perkins

2013

Journal of Aging Studies

113

127

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“…Staff-family interactions can produce tension and even conflict between health providers and family members of residents (Iecovich, 2000; Gladstone & Wexler, 2002; Hertzberg, Ekman, & Axelsson, 2003; Pillemer et al, 1998). In the state of North Carolina, for example, the state long-term care ombudsman’s office reports that the largest percentage (approximately 56%) of nursing home complaints are raised by residents’ relatives/friends/legal representatives rather than by the residents themselves, external facility representatives (i.e.…”

Section: Introductionmentioning

confidence: 99%

Staff perceptions of staff-family interactions in nursing homes

Utley-Smith

Colón‐Emeric

Lekan‐Rutledge

et al. 2009

Journal of Aging Studies

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Each year thousands of older adults are admitted to nursing homes. Following admission, nursing home staff and family members must interact and communicate with each other. This study examined relationship and communication patterns between nursing home staff members and family members of nursing home residents, as part of a larger multi-method comparative case study. Here, we report on 6-month case studies of two nursing homes where in-depth interviews, shadowing experiences, and direct observations were completed. Staff members from both nursing homes described stafffamily interactions as difficult, problematic and time consuming, yet identified strategies that when implemented consistently, influenced the staff-family interaction positively. Findings suggest explanatory processes in staff-family interactions, while pointing toward promising interventions.Keywords staff-family encounters; demanding families; relationship patterns; qualitative study; communication IntroductionFollowing nursing home admission, family members of the new resident and the health care staff must interact with each other. Some staff mistakenly think that family members abandon their relatives once they are admitted to the nursing home (Naleppa, 1996;Port et al., 2001;Rowles & High, 2003), but the reality is that most family and friends remain involved in the care of their relative through visits or phone calls (Naleppa, 1996;Stull et al., 1997;Nolan & Dellasega, 1999;Port et al., 2001). Staff members discover that the new resident brings family Correspondence to: Queen Utley-Smith, utley005@mc.duke.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript members who both expect continued involvement in care, and need information and attention (Hertzberg, Ekman, & Axelsson, 2001). Research has shown that family members value effective relationships with nursing home staff, whom they see as a source of information and a means of remaining involved in care decisions (Bowers, 1988;Duncan & Morgan, 1994). Also, family members who possess information about residents' preferences, habits and goals of care can assist staff to establish an optimal plan of care that contributes to resident wellbeing (Rowles & High, 2003). However, staff-family relationships evolve in a social and physical environment that while familiar to staff, is often foreign to family members, who find themselves in a strange place with new roles to play and complex rules to interpret. In a nursing home setting, where because of resource constraints there is little time to accomplish competing tasks and staff turnover is frequent, establishing and maintaining an effective staff-family relationship can be taxing for both parties (Hertzberg & Ekman, 2000;Bowers, Lauring, & Jacobson, 2001 (2006) found that some nursing home staff fostered family partnerships, while other nursing home staff maintained adversarial relationships with family members, preferring control. Research on staff-family interactions in other healthcare set...

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“…In a similar study in‐depth interviews were conducted with 17 RN participants selected through purposive sampling 57 . This research focused on staff perspectives of relationship development with families 57 .…”

Section: Resultsmentioning

confidence: 99%

Factors associated with constructive staff?family relationships in the care of older adults in the institutional setting

Haesler

Bauer

Nay

2006

Int J EB Healthcare

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Background Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff-family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff-family relationships. Search strategy A literature search was performed using the following databases for the years 1990-2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language. Selection criteria The review was limited to studies involving residents and patients within acute, subacute, rehabilitation and residential settings, aged over 65 years, their family and healthcare staff. Papers addressing family members and healthcare staff perceptions of their relationships with each other were considered for this review. Studies in this review also included those relating to interventions to promote constructive staff-family relationships including organisational strategies, staff-family meetings, case conferencing, environmental approaches, etc. The review considered both quantitative and qualitative research and opinion papers for inclusion. Data collection and analysis All retrieved papers were critically appraised for eligibility for inclusion and methodological quality independently by two reviewers, and the same reviewers collected details of eligible...

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The Development of Relationships Between Families and Staff in Long-term Care Facilities: Nurses' Perspectives

Cited by 20 publications

References 27 publications

Convoys of care: Theorizing intersections of formal and informal care

Convoys of care: Theorizing intersections of formal and informal care

Staff perceptions of staff-family interactions in nursing homes

Factors associated with constructive staff?family relationships in the care of older adults in the institutional setting

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