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Family care-giving and decisions about entry to care: a rural perspective

Published online by Cambridge University Press:  11 February 2011

ASSUMPTA RYAN ,
HUGH MCKENNA  and
OLIVER SLEVIN
ASSUMPTA RYAN*
Affiliation:
School of Nursing, University of Ulster, Northern Ireland, UK.
HUGH MCKENNA
Affiliation:
School of Nursing, University of Ulster, Northern Ireland, UK.
OLIVER SLEVIN
Affiliation:
School of Nursing, University of Ulster, Northern Ireland, UK.
*
Address for correspondence: Assumpta Ryan, School of Nursing, University of Ulster, Cromore Road, Coleraine, Northern Ireland, UK. E-mail: [email protected]
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Abstract

The aim of this qualitative study was to explore rural family carers' experiences of the nursing home placement of an older relative. The study was undertaken in a large Health and Social Care Trust in Northern Ireland using a grounded theory approach. Purposive sampling was used to initiate data collection and thereafter theoretical sampling was employed. Semi-structured interviews were conducted with 29 relatives of nursing home residents and the resultant data were recorded, transcribed and analysed using constant comparisons. The software package, QSR NVivo, was used to facilitate data management and retrieval. Older people had deep attachments to their homes and entry to care was a last resort. Rural family carers had close relationships with health- and social-care practitioners and felt supported in the decision-making process. The choice of home was a foregone conclusion for carers who had a strong sense of familiarity with the nursing homes in their area. This familiarity was influenced by the relatively rural communities in which respondents resided and by an efficient ‘grapevine’, which seemed to thrive in these small communities. This familiarity, in turn, influenced the choice of nursing home, timing of the placement and responses of family carers. The findings indicate that issues such as rurality and familiarity warrant a more detailed exploration in future research on entry to care.

Keywords

familycarersruralnursing homeoldercare-giving
Type
Articles
Information
Ageing & Society , Volume 32 , Issue 1 , January 2012 , pp. 1 - 18
Copyright
Copyright © Cambridge University Press 2011

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References

Andrews, G. J., Holmes, D., Poland, B., Lehoux, P., Miller, K. L., Pringle, D. and McGilton, K. S. 2005. ‘Airplanes are flying nursing homes’: geographies in the concepts and locales of gerontological nursing practice. International Journal of Older People Nursing, 14, 8b, 109–20.Google ScholarPubMed
Barbour, R. S. 2001. Checklists for improving rigor in qualitative research: a case of the tail wagging the dog. British Medical Journal, 322, 1115–7.CrossRefGoogle Scholar
Beshiri, R., Bollman, R., Clemenson, H., Morgan, A. and McDermott, A. 2000. Defining rural. Unpublished draft paper prepared for Statistics Canada, Ottawa.Google Scholar
Coburn, A. and Bolda, E. J. 1999. The rural elderly and long-term care. In Ricketts, T. C. (ed.), Rural Health in the United States. New York: Oxford University Press, 170–89.Google Scholar
Cohen, D. and Prusak, L. 2001. In Good Company. How Social Capital Makes Organizations Work. Harvard Business School Press, Boston, Massachusetts.Google Scholar
Congdon, J. G. and Magilvy, J. K. 2001. Themes of rural health and ageing from a program of research. Geriatric Nursing, 22, 5, 234–8.CrossRefGoogle ScholarPubMed
Davies, S. 2001. Wanting what's best for them. Relatives' experience of nursing home entry: a constructivist inquiry. Unpublished PhD thesis, Faculty of Medicine, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK.Google Scholar
Dellasega, C. and Mastrian, K. 1995. The process and consequences of institutionalizing an elder. Western Journal of Nursing Research, 17, 123–40.CrossRefGoogle ScholarPubMed
Efraimsson, E., Hoglund, I. and Sandman, P. 2001. ‘The everlasting trial of strength and patience’: transitions in home care nursing as narrated by patients and family members. Journal of Clinical Nursing, 10, 813–19.Google ScholarPubMed
Evason, E. 1998. Aspects of informal care in Northern Ireland. In Baldwin, S. (ed.), Needs Assessment and Community Care: Clinical Practice and Policy Making. Butterworth Heinemann, Oxford, 113–21.Google Scholar
Evason, E., Whittington, D. and Knowles, I. 1993. The Cost of Caring. Equal Opportunities Commission for Northern Ireland, Belfast.Google Scholar
Glaser, B. 1998. Doing Grounded Theory: Issues and Discussions. Sociology Press, Mill Valley, California.Google Scholar
Glaser, B. and Strauss, A. 1967. The Discovery of Grounded Theory. Aldine, Chicago.Google Scholar
Glover, J. J. 2001. Rural bioethical issues of the elderly: how do they differ from urban ones. The Journal of Rural Health, 17, 4, 332–5.CrossRefGoogle ScholarPubMed
Gold, R., Kennedy, B., Connell, F. and Kawachi, I. 2002. Teen births, income inequality and social capital: developing an understanding of the causal pathway. Health and Place, 8, 2, 77–83.CrossRefGoogle ScholarPubMed
Gurney, C. and Means, R. 1993. The meaning of home in later life. In Arber, S. and Evandrou, M. (eds), Ageing, Independence and the Life Course. Jessica Kingsley, London, 119–31.Google Scholar
Halpern, D. 2008. Social Capital. Polity Press, Cambridge.Google Scholar
Heenan, D. 2000. Expectations and attitudes affecting patterns of informal care in farming families in Northern Ireland. Ageing and Society, 20, 203–16.CrossRefGoogle Scholar
Kawachi, I., Subramanian, S. V. and Kim, D. 2008. Social Capital and Health. Springer, New York.CrossRefGoogle Scholar
Kearns, R. A. 1993. Place and health: towards a reformed medical geography. The Professional Geographer, 46, 67–72.Google Scholar
Keefe, J. and Fancey, P. 2000. The care continues: responsibility for elderly relatives before and after admission to a long-term care facility. Family Relations, 49, 3, 235–44.CrossRefGoogle Scholar
Kellett, U. M. 1999. Transition in care: family carers' experience of nursing home placement. Journal of Advanced Nursing, 29, 6, 1474–81.CrossRefGoogle ScholarPubMed
Lowe, P. and Speakman, L. 2006. The Ageing Countryside. The Growing Older Population of Rural England. Age Concern, London.Google Scholar
McCann, S., Ryan, A. A. and McKenna, H. P. 2005. The challenges associated with providing community care for people with complex needs in rural areas: a qualitative investigation. Health and Social Care in the Community, 13, 5, 462–9.CrossRefGoogle Scholar
McGibbon, M. 1995. The Dromore Carers Survey. Age Concern Northern Ireland, Belfast.Google Scholar
Munhall, P. L. and Boyd, C. O. 1993. Nursing Research: A Qualitative Perspective. Second edition, National League for Nursing Press, New York.Google Scholar
Nay, R. 1995. Nursing home residents' perceptions of relocation. Journal of Clinical Nursing, 4, 5, 319–25.CrossRefGoogle ScholarPubMed
Nolan, M. and Dellasega, C. 2000. ‘I really feel I've let him down’: supporting family carers during long-term care placement for elders. Journal of Advanced Nursing, 31, 4, 759–67.CrossRefGoogle ScholarPubMed
Office for National Statistics 2004. Rural and Urban Area Classification 2004: An Introductory Guide. The Countryside Agency, Department for Environment, Food and Rural Affairs, Welsh Assembly Government, Office of the Deputy Prime Minister, UK.Google Scholar
Organisation of Economic Co-operation and Development (OECD) 1994. Creating Rural Indicators for Shaping Territorial Policies. OECD, Paris.Google Scholar
Penrod, J. D. 2001. Functional disability at nursing home admission: a comparison of urban and rural admission cohorts. Journal of Rural Health, 17, 3, 229–38.CrossRefGoogle Scholar
Poland, B., Lehoux, P., Holmes, D. and Andrews, G. 2005. How place matters: unpacking technology and power in health and social care. Health and Social Care in the Community, 13, 2, 170–80.CrossRefGoogle ScholarPubMed
Putnam, R. D. 2000. Bowing Alone. The Collapse and Revival of American Community. Simon and Schuster, New York.Google Scholar
Reed, J., Cook, G., Sullivan, A. and Burridge, C. 2003. Making a move: care-home residents' experience of relocation. Ageing & Society, 23, 2, 225–41.CrossRefGoogle Scholar
Reed, J. and Payton, V. R. 1996. Constructing familiarity and managing the self: ways of adapting to life in nursing and residential homes for older people. Ageing & Society, 16, 5, 543–60.CrossRefGoogle Scholar
Reed, J., Payton, V. R. and Bond, S. 1998. The importance of place for older people moving into care homes. Social Science and Medicine, 46, 7, 859–67.CrossRefGoogle ScholarPubMed
Richards, L. 1999. Using NVivo in Qualitative Research. Sage, London.Google Scholar
Roberts, L. W., Battaglia, J., Smithpeter, M. and Epstein, R. S. 1999. An office on main street: health care dilemmas in small communities. Hastings Centre Report, 29, 28–37.CrossRefGoogle ScholarPubMed
Rosenthal, K. 2005. Rural nursing: flowing like a river. In Lee, H. and Winters, C. (eds), Conceptual Basis for Rural Nursing. Springer Publishing Company, New York, 187–95.Google Scholar
Rowles, G. D. 1981. The surveillance zone as meaningful space for the aged. Gerontologist, 21, 3, 304–11.CrossRefGoogle ScholarPubMed
Rowles, G. D. and High, D. M. 1996. Individualizing care: family roles in nursing home decision making. Journal of Gerontological Nursing, 22, 3, 20–5.CrossRefGoogle ScholarPubMed
Ryan, A. A. and Scullion, H. 2000. Nursing home placement: an exploration of the experiences of family carers. Journal of Advanced Nursing, 32, 5, 1187–95.CrossRefGoogle ScholarPubMed
Schutz, S. E. 1994. Exploring the benefits of a subjective approach in qualitative nursing research. Journal of Advanced Nursing, 20, 412–7.CrossRefGoogle ScholarPubMed
Shucksmith, M. 1999. Rural housing. In Shucksmith, M. and Murphy, C. (eds), Rural Audits: A Health Check on Rural Britain. Commissioned by The Rural Group of Labour MPs, Arkleton Centre for Rural Development Research, Aberdeen, UK, 21–5.Google Scholar
Stoller, E. P. and Lee, G. R. 1994. Informal care of rural elders. In Coward, R. T., Bull, C. N., Kukulka, G. and Galliher, J. M. (eds), Health Services for Rural Elders. Springer, New York, 33–64.Google Scholar
Strauss, A. and Corbin, J. 1990. Basics of Qualitative Research. Sage, Thousand Oaks, California.Google Scholar
Strauss, A. and Corbin, J. 1998. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Second edition, Sage, Thousand Oaks, California.Google Scholar
Wahl, H. 2001. Environmental influences on aging and behaviour. In Birren, J. E. and Schaie, K. W. (eds), Handbook of the Psychology of Ageing. Fifth edition, Academic, New York, 215–32.Google Scholar
Weinert, C. and Burman, M. 1994. Rural health and health seeking behaviors. Annual Review of Nursing Research, 12, 65–92.CrossRefGoogle ScholarPubMed
Wenger, G. C. 1990. The special role of friends and neighbors. Journal of Ageing Studies, 4, 2, 149–69.CrossRefGoogle Scholar
Wenger, G. C. 1999. Choosing and paying for care. Health and Social Care in the Community, 7, 3, 187–97.CrossRefGoogle Scholar
Wenger, C. G. 2001. Myths and realities of ageing in rural Britain. Ageing & Society, 21, 1, 117–30.CrossRefGoogle Scholar
Wiles, J. 2005. Conceptualizing place in the care of older people: the contribution of geographical gerontology. International Journal of Older People Nursing, 14, 8b, 100–8.Google ScholarPubMed
Williams, A. M. and Cutchin, M. P. 2002. The rural context of health care provision. Journal of Interprofessional Care, 16, 2, 107–15.CrossRefGoogle ScholarPubMed