Living well in care systems publications

Temporalities of Aged Care: Time Scarcity, Care Time and Well-Being in Danish Nursing Homes

Abstract

Aged care staff in Danish nursing homes feel the pressures of time scarcity acutely. But what does this mean for the well-being of residents? Using the concept “care time” we consider subjective experiences of time to make sense of the multiplicity of temporal experiences in nursing home care. We will show how the temporal structures of a neoliberal institutional care logic is at odds with what residents expect from care time. Finally, drawing on a phenomenological understanding of well-being, we explore how residents’ temporal orientation to the present and the past can be drawn on to enhance well-being.

A Sense of Control and Wellbeing in Older People Living with Frailty: A Scoping Review

Abstract

A sense of control is important for supporting older people living with frailty to develop adaptive functioning to optimize wellbeing. This scoping review examined the literature on the sense of control and wellbeing in older people living with frailty within their everyday life and care service use. Nine databases were searched using the timeframe 2000 to 2021 to identify key ideas regarding control and wellbeing in older people with frailty. The review highlighted three major themes: a) Control as conveyed in bodily expressions and daily activities, b) Sense of control and influence of place of residence, and c) Control within health and social care relationships. Maintaining a sense of control is not only an internal feeling but is impacted by physical and social environments. Greater focus is needed on the nature of relationships between older people living with frailty and those who work alongside them, which support control and wellbeing.

Accessing a “bounded space”: An ethnographic map of a residential care home for old persons during COVID-19

  • Author(s): Jayme Tauzer
  • Published: Aging and Health Research, Vol.3 Issue 2, June 2023

Abstract

Taking place in a residential care setting in England during COVID-19, this ethnographic study offers a closer look at residents’ experiences of residential care, with particular focus on dignity and wellbeing. Viewing experiences of well-being as embedded within interpersonal negotiations, the study turns to experience and stories to reveal complexities and contradictions in this taken-for-granted space. However, the timeline and design for this project has been greatly impacted by COVID-19. In exploring the design of this study and its ‘journey’ toward the field, the following article takes a critical view in order to view the impacts that ‘bounded’ and protected care settings may have on the agency and rights of older adult research participants. In this article, I also consider some of the complex ethical issues of conducting qualitative research during a time when older adults are being denied personal visitors, which can further ‘bound’ the care home space. The article offers timely insight on issues of agency and voice when working with a ‘protected population’ during a time which highlights the vulnerability of old adults.

You can read the whole article at the link below:

https://www.sciencedirect.com/science/article/pii/S2667032123000252?via%3Dihub

INNOVATEDIGNITY ESR Emma Jelstrup Balkin, based at Aalborg University, Denmark published: Existential well-being for the oldest old in nursing homes: a meta-ethnography with Co-authors: Mette Grøkjaer, Denmark; Bente Martinsen, Denmark; Ingjerd Gåre Kymre, Norway; Mette Geil Kollerup, Denmark

You can read the whole article at the link below:

https://www.cambridge.org/core/journals/ageing-and-society/article/existential-wellbeing-for-the-oldest-old-in-nursing-homes-a-metaethnography

Abstract

Ideas of well-being in old age are often anchored in the successful ageing paradigm, foregrounding independence, activeness and autonomy. However, for those oldest old living in nursing homes, these goals are largely out of reach. In this article, we use the metaethnographic method to explore and reinterpret existing findings on the ways in which well-being is experienced (or not) by the oldest old in institutional care settings. We frame our findings in existential well-being theory, which understands wellbeing as a sense of ‘dwelling-mobility’. Our analysis resulted in the following themes: (a) institutionalisation as both restrictive and liberating; (b) reciprocity and mattering: the importance of being seen; (c) the need for kinship and the problem of ruptured sociality; (d) rethinking agency: situated, delegated and supported; and (e) lowered expectations: receiving care is not a passive act. We conclude that while institutional care environments are not always conducive to well-being, this does not have to be so. By shifting our focus from successful ageing ideals onto relationally situated care practices, a possibility for existential well-being opens up, even in situations of decline and care dependency.

INNOVATEDIGNITY ESR Emma Jelstrup Balkin, based at Aalborg University, Denmark published: Ethics and the impossibility of the consent form: Ethnography in a Danish nursing home with Co-authors: Mette Geil Kollerup, Denmark; Ingjerd Gåre Kymre, Norway; Bente Martinsen, Denmark; Mette Grøkjaer, Denmark

You can read the whole article at the link below:

https://www.sciencedirect.com/science/article/pii/S0890406523000117

Abstract

 Based on ethnographic fieldwork in a nursing home in northern Denmark, this article addresses challenges experienced in putting formal ethics requirements into practice. We consider how to unite procedural ethics with actual, lived ethics, when researching with vulnerable participants who live with a cognitively impairing condition. The article centers on the story of one resident, who wanted to share her experiences with what she had perceived as inadequate care, but who baulked once the wordy consent form was produced. The resident panicked that her words could now be used against her, that talking with the researcher would (further) compromise her care. She was caught in a bind, on the one hand she had a deep desire to tell her story, on the other the piece of paper in her hand threatened to trigger her anxiety and depression. In this article we therefore approach the consent form as an agent. By mapping out these unintended consequences of the consent form, we wish to draw attention to the complexities of ethical research conduct in practice, ultimately arguing that the concept of appropriate informed consent should be broadened so that it is sensitive to the lifeworld of participants. 

INNOVATEDIGNITY ESR Panagiota Lafiatoglou published: A systematic review of the qualitative literature on older individuals’ experiences of care and well-being during physical rehabilitation for acquired brain injury with Co-authors: Caroline Ellis-Hill, UK; Mary Gouva, Greece; Avraam Ploumis, Greece; Stefanos Mantzoukas, Greece

You can read the whole article at the link below: https://onlinelibrary.wiley.com/doi/full/10.1111/jan.15016

Abstract

Aims

To acquire an in-depth understanding of how older individuals diagnosed with acquired brain injury (ABI) experience their well-being and care when undergoing physical rehabilitation.

Design

Systematic literature review.

Data sources

The electronic databases of PubMed, CINAHL, APA PsycInfo, ASSIA and SCOPUS were searched from 2005 to 2020. Extensive reference checking was also conducted.

Review methods

A systematic review was conducted following PRISMA guidelines, including predominantly qualitative studies. Studies’ quality was appraised using the critical apraisal skills programme (CASP) tool.

Results

Seventeen studies met the inclusion criteria. Following methods of thematic synthesis, four overarching interpretive themes were identified: (a) Rehabilitation processes and their impact on older individuals’ well-being; (b) Identity and embodiment concerns of older individuals during rehabilitation; (c) Institutional factors affecting older individuals’ care and well-being experiences; and (d) Older individuals’ participation in creative activities as part of rehabilitation.

Conclusion

Organizational and structural care deficiencies as well as health disparities can adversely impact older individuals’ autonomous decision-making and goal-setting potentials. The discrepancy between older individuals’ expectations and the reality of returning home along with the illusionary wish to return to a perceived normality, can further negatively affect older individuals’ sense of well-being. Constructive communication, emotional support, family involvement in rehabilitation and creating a stimulating, enriching social environment can humanize and facilitate older individuals’ adjustment to their new reality following ABI.

Impact

There is a lack of qualitative research on older individuals’ ABI rehabilitation experiences, especially traumatic brain injury incidents. Further study should consider patients’ concerns over their involvement in decision-making and goal setting about their care. Overall, this review reveals the need to examine further the significance of humanizing care and the factors that affect older individuals’ sense of well-being.

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