Coercion in nursing homes

2015 ◽  
Vol 23 (3) ◽  
pp. 253-264 ◽  
Author(s):  
Elisabeth Gjerberg ◽  
Lillian Lillemoen ◽  
Reidar Pedersen ◽  
Reidun Førde
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Next Of Kin ◽  
Best Interest ◽  
Focus Group Interviews ◽  
Ethical Considerations ◽  
Individual Interviews ◽  
Nursing Home Patients ◽  
Legal Challenges ◽  
Group Interviews

Background: Studies have demonstrated the extensive use of coercion in Norwegian nursing homes, which represents ethical, professional as well as legal challenges to the staff. We have, however, limited knowledge of the experiences and views of nursing home patients and their relatives. Objectives: The aim of this study is to explore the perspectives of nursing home patients and next of kin on the use of coercion; are there situations where the use of coercion can be defended, and if so, under which circumstances? Methods: The data are based on individual interviews with 35 patients living in six nursing homes and seven focus group interviews with 60 relatives. Ethical considerations: Participation was based on written informed consent, and the study was approved by the Regional Committees for Medical and Health Research Ethics. Results: More than half of the patients and the majority of the relatives accepted the use of coercion, trusting the staff to act in the patient’s best interest. However, the acceptance of coercion is strongly related to the patients’ lack of understanding, to prevent health risks and to preserve the patient’s dignity. Conclusion: The majority of nursing home patients and relatives accepted the use of coercion in specific situations, while at the same time they emphasised the need to try alternative strategies first. There is still a need for good qualitative research on the use of coercion in nursing homes, especially with a closer focus on the perspectives and experiences of nursing home patients.

Fostering dignity in the care of nursing home residents through slow caring

2016 ◽  
Vol 24 (7) ◽  
pp. 778-788 ◽  
Author(s):  
Vibeke Lohne ◽  
Bente Høy ◽  
Britt Lillestø ◽  
Berit Sæteren ◽  
Anne Kari Tolo Heggestad ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Healthcare Personnel ◽  
Focus Group Interviews ◽  
Ethical Considerations ◽  
Science Data ◽  
Data Services ◽  
The Social ◽  
Group Interviews

Background: Physical impairment and dependency on others may be a threat to dignity. Research questions: The purpose of this study was to explore dignity as a core concept in caring, and how healthcare personnel focus on and foster dignity in nursing home residents. Research design: This study has a hermeneutic design. Participants and research context: In all, 40 healthcare personnel from six nursing homes in Scandinavia participated in focus group interviews in this study. Ethical considerations: This study has been evaluated and approved by the Regional Ethical Committees and the Social Science Data Services in the respective Scandinavian countries. Findings: Two main themes emerged: dignity as distinction (I), and dignity as influence and participation (II). Discussion: A common understanding was that stress and business was a daily challenge. Conclusion: Therefore, and according to the health personnel, maintaining human dignity requires slow caring in nursing homes, as an essential approach.

How to avoid and prevent coercion in nursing homes

2013 ◽  
Vol 20 (6) ◽  
pp. 632-644 ◽  
Author(s):  
Elisabeth Gjerberg ◽  
Marit Helene Hem ◽  
Reidun Førde ◽  
Reidar Pedersen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Focus Group Interviews ◽  
Alternative Strategies ◽  
Nursing Home Staff ◽  
Alternative Interventions ◽  
Persuasive Strategies ◽  
Organization Of Care ◽  
Wide Range ◽  
Group Interviews

In many Western countries, studies have demonstrated extensive use of coercion in nursing homes, especially towards patients suffering from dementia. This article examines what kinds of strategies or alternative interventions nursing staff in Norway used when patients resist care and treatment and what conditions the staff considered as necessary to succeed in avoiding the use of coercion. The data are based on interdisciplinary focus group interviews with nursing home staff. The study revealed that the nursing home staff usually spent a lot of time trying a wide range of approaches to avoid the use of coercion. The most common strategies were deflecting and persuasive strategies, limiting choices by conscious use of language, different kinds of flexibility and one-to-one care. According to the staff, their opportunities to use alternative strategies effectively are greatly affected by the nursing home’s resources, by the organization of care and by the staff’s competence.

scholarly journals React and act: a qualitative study of how nursing home leaders follow up on staff-to-resident abuse

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Janne Myhre ◽  
Susan Saga ◽  
Wenche Malmedal ◽  
Joan Ostaszkiewicz ◽  
Sigrid Nakrem
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Elder Abuse ◽  
Comparative Method ◽  
Individual Level ◽  
Staff Members ◽  
Individual Interviews ◽  
Group Interviews ◽  
Different Levels

Abstract Background Elder abuse in nursing homes is a complex multifactorial problem and entails various associations across personal, social, and organisational factors. One way leaders can prevent abuse and promote quality and safety for residents is to follow up on any problems that may arise in clinical practice in a way that facilitates learning. How nursing home leaders follow up and what they follow up on might reflect their perceptions of abuse, its causal factors, and the prevention strategies used in the nursing home. The aim of this study was to explore how nursing home leaders follow up on reports and information regarding staff-to-resident abuse. Methods A qualitative explorative design was used. The sample comprised 43 participants from two levels of nursing home leadership representing six municipalities and 21 nursing homes in Norway. Focus group interviews were conducted with 28 care managers, and individual interviews took place with 15 nursing home directors. The constant comparative method was used for the analyses. Results Nursing home leaders followed up incidents of staff-to-resident abuse on three different levels as follows: 1) on an individual level, leaders performed investigations and meetings, guidance, supervision, and occasionally relocated staff members; 2) on a group level, feedback, openness, and reflection for shared understanding were strategies leaders used; and 3) on an organisational level, the main solutions were to adjust to available resources, training, and education. We found that leaders had difficulties defining harm and a perceived lack of power to follow up on all levels. In addition, they did not have adequate tools for evaluating the effect of the measures that were taken. Conclusions Nursing home leaders need to be clear about how they should follow up incidents of elder abuse on different levels in the organisation and about their role in preventing elder abuse. Evaluation tools that facilitate systematic organisational learning are needed. Nursing homes must operate as open, blame-free cultures that acknowledge that incidents of elder abuse in patient care arise not only from the actions of individuals but also from the complex everyday life of which they are a part and in which they operate.

The meaning of slow nursing in dementia care

Dementia ◽  
2015 ◽  
Vol 16 (7) ◽  
pp. 930-947 ◽  
Author(s):  
Daniela Lillekroken ◽  
Solveig Hauge ◽  
Åshild Slettebø
Keyword(s):  
Nursing Homes ◽  
Focus Group ◽  
Best Practices ◽  
Sense Of Coherence ◽  
Participant Observation ◽  
Research Literature ◽  
Focus Group Interviews ◽  
People With Dementia ◽  
Group Interviews ◽  
The Moment

Research literature in the dementia field lacks examples of ‘best-practices’ demonstrating concretely how it is possible to support the sense of coherence in people with dementia. The purpose of this study was to elucidate the nurses’ views concerning a caring approach that may support the sense of coherence in people with dementia. The data were collected through participant observation and focus group interviews during a four-month period in 2011. Sixteen registered nurses recruited from two Norwegian nursing homes participated in this study. The data were interpreted using a phenomenological-hermeneutical method. Three themes were identified: ‘being in the moment’, ‘doing one thing at a time’, and ‘creating joy and contentment’. An overall interpretation of these themes is described by the metaphor ‘slow nursing’, a caring approach that may lead to supporting the sense of coherence in people with dementia.

The Alchoholic Patient in the Nursing Home

1972 ◽  
Vol 3 (3) ◽  
pp. 273-277 ◽  
Author(s):  
Margaret W. Linn ◽  
Bernard S. Linn ◽  
Shayna R. Greenwald
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Workers ◽  
Diagnostic Data ◽  
Nursing Home Patients ◽  
Diabetes Outcome ◽  
Specific Illness

There are indications that more alcoholics are being placed in nursing homes than ever before. To determine in what ways these patients differ from others going to nursing homes, all alcoholics (72) placed from hospital to nursing homes were studied prior to placement and followed 6 months in 35 homes. Seventy-one nonalco-holics placed during the same period were randomly selected for comparison. Hospital disability ratings from physicians, evaluations from social workers, and diagnostic data from records indicated no significant differences in levels of disability or impairment. Alcoholics were less likely to be currently married and had less income. Although they were younger, they had a significantly higher number of diagnoses than other nursing home patients (P< .01); however, with the exception of cirrhosis and brain syndrome, they had fewer serious illnesses such as cancer and diabetes. Outcome after 6 months showed 28 percent left the nursing home, 45 percent were still in the home, 10 percent were hospitalized, and 16 percent had expired. These outcomes were not significantly different from other nursing home patients. Results indicate alcoholics are as much in need of nursing home services as other patients, even though they differ along social and specific illness patterns *

scholarly journals Grindagutar på sjukeheim: Tilsette sin erfaring med kulturprosjekt

2014 ◽  
Vol 9 (2) ◽  
pp. 42
Author(s):  
Aud Berit Fossøy ◽  
Solveig Hauge ◽  
Ellen Karine Grov
Keyword(s):  
Nursing Home ◽  
Focus Group ◽  
Nursing Home Residents ◽  
Holistic Care ◽  
Focus Group Interviews ◽  
Cultural Project ◽  
Group Interviews ◽  
Culture Activity

<p><strong>Grindagutar at nursing home: Employees experience with cultural project.</strong><em><br />Background: Culture activity contributes to holistic care for nursing home residents, and the employees are key personnel for success.<br />Aim: Explore the employees’ experience putting culture projects into life in a nursing home.<br />Methods: The material, based on four focus group interviews with employees in the nursing home, is categorized and analyzed through text condensation.<br />Results: The culture projects created activity and were sources for thriving. However, not participating directly in the activity, the employees let the artists in, were available for them, and watched the patients during the performances. Their function as “door-openers/-keepers” resulted in hosting responsibility, leading to a position of confusion regarding the role as protectors for the patients. Main challenges were how to give feedback regarding whether the patients liked/disliked the performance, and the feeling of being trapped in a position as bystander rather than making the culture activity a common happening for the patients and the employees. </em><strong></strong></p>

What's the Story?: Exploring Parent–Teacher Communication through ePortfolios

2017 ◽  
Vol 42 (4) ◽  
pp. 13-21 ◽  
Author(s):  
Amanda Higgins ◽  
Sue Cherrington
Keyword(s):  
Early Childhood ◽  
Document Analysis ◽  
Electronic Portfolios ◽  
Communication Tool ◽  
Focus Group Interviews ◽  
Teacher Communication ◽  
Childhood Education ◽  
Individual Interviews ◽  
Group Interviews ◽  
Reported Data

ELECTRONIC PORTFOLIOS (ePORTFOLIOS) ARE a relatively new phenomenon in early childhood education (ECE) with minimal existing research available on their use and effectiveness as a learning and communication tool in ECE. This article reports on a study examining the influence of ePortfolios on parent–teacher communication in one early childhood (EC) service. Reported data has been drawn from online surveys, document analysis of ePortfolios, individual interviews and focus group interviews with parents and teachers. Thematic analysis identified two main themes: the benefits and drawbacks of communicating via the ePortfolio, and the types of communication that were evident.

Choosing to live in a nursing home: a culturally and linguistically diverse perspective

2015 ◽  
Vol 21 (2) ◽  
pp. 239
Author(s):  
Cecilia A. Yeboah
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Cultural History ◽  
Nursing Home Residents ◽  
Linguistically Diverse ◽  
Culturally And Linguistically Diverse ◽  
Individual Interviews ◽  
Cultural Origins ◽  
Diverse Perspective

As part of the findings of a study on culturally and linguistically diverse older people relocating to a nursing home, this paper contributes to our understanding of how older people draw on their cultural history to explain their decisions to relocate. Family reciprocity was identified by most participants as central to their decisions, regardless of their specific cultural origins. Using the grounded theory methodology, data were collected through progressive, semi-structured, repeated, in-person, individual interviews with 20 residents of four nursing homes in the northern suburbs of Melbourne, Australia. Culturally and linguistically diverse (CALD) older people, regardless of specific cultural origin, make relocation decisions based on the importance and meaning of reciprocity within families. Understanding their decisions as reflecting a culturally valued reciprocity offered a sense of cultural continuity to the relocation and was comforting to the older adults involved in the study. This study also suggests that culturally and linguistically diverse older people are much more active participants in the decision to relocate to a nursing home than is commonly recognised. The four nursing homes in the northern suburbs of Melbourne and the 20 participants studied constitute only a small proportion of all culturally and linguistically diverse older nursing home residents in Australia. Therefore, the findings may not be pertinent to other culturally and linguistically diverse elderly. Nonetheless, this study makes an important contribution to future discussions regarding cultural diversity in the nursing home relocation of culturally and linguistically diverse older Australians. The study findings provide some insight into the conditions and contexts that impact nursing home relocation.

scholarly journals Co-afflicted but invisible: A qualitative study of perceptions among informal caregivers in cancer care

2019 ◽  
pp. 135910531989040 ◽  
Author(s):  
Mattias Tranberg ◽  
Magdalena Andersson ◽  
Mef Nilbert ◽  
Birgit H Rasmussen
Keyword(s):  
Lived Experience ◽  
Cancer Care ◽  
Informal Caregivers ◽  
Next Of Kin ◽  
Focus Group Interviews ◽  
Informal Group ◽  
Targeted Interventions ◽  
Perceived Burden ◽  
Group Interviews

This article explores the lived experience of informal caregivers in cancer care, focusing on the perceived burden and needs of individuals seeking support from an informal group for next of kin. A total of 28 individuals who were closely related to a patient with cancer participated in focus group interviews. Three themes were identified: setting aside one’s own needs, assuming the role of project manager, and losing one’s sense of identity. Together they form the framing theme: being co-afflicted. The characteristics of informal caregivers are shown to be similar to those of people with codependency, motivating development of targeted interventions from this perspective.

The existential cancer journey: Travelling through the intersubjective structure of homeworld/alienworld

2015 ◽  
Vol 21 (4) ◽  
pp. 375-391 ◽  
Author(s):  
Elisabeth Assing Hvidt
Keyword(s):  
Health Care Professionals ◽  
Qualitative Interviews ◽  
Research Literature ◽  
Focus Group Interviews ◽  
Rehabilitation Centre ◽  
Transformative Experiences ◽  
Individual Interviews ◽  
Patient Narratives ◽  
Illness Experiences ◽  
Group Interviews

In the past couple of decades, there has been significant interest in the research literature and patient narratives that focus on describing the cancer journey as involving existential and spiritual transformative experiences. The purpose of this article is to contribute with a new and deepened understanding of the existing literature by offering a philosophical informed analytic conceptualization that highlights the ‘liminal’, transformative and ‘generative’ dimension of the cancer journey. For that purpose, qualitative data drawn from a qualitative study investigating existential experiences of a group of Danish patients in rehabilitation were analysed employing the American phenomenologist Anthony J. Steinbock’s interpretation of the Husserlian concepts homeworld/alienworld ( Heimwelt/Fremdwelt). Data used in this article derived from qualitative interviews (11 individual interviews and 9 focus group interviews) with cancer patients participating in rehabilitation week courses at a Danish rehabilitation centre. The analysis led to the development of three themes: ‘The heavy break with the homeworld’, ‘Realizing a new homefellowship’ and ‘Transformation of the homeworld’. Findings suggest that journeying with cancer involves a ‘liminal’ experiencing of having to navigate in a borderless and unfamiliar territory between a homeworld and an alienworld before ultimately arriving at a sense of transformation in which meaning is derived from both lifeworlds. It is argued that such an understanding of the intersubjectivity between lifeworlds highlights the need for health care professionals communicating with patients throughout their cancer journey about whether and how the illness experiences have been integrated into their lifeworld and whether help is needed in order to achieve existential rehabilitation.

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