Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T20:54:27.488Z Has data issue: false hasContentIssue false

From Institution to ‘Home’: Family Perspectives on a Unique Relocation Process*

Published online by Cambridge University Press:  23 May 2011

Darlene Hutchings*
Affiliation:
Western Regional Integrated Health Authority
Judith J.L. Wells
Affiliation:
Western Regional School of Nursing
Kelli O’Brien
Affiliation:
Western Regional Integrated Health Authority
Carla Wells
Affiliation:
Western Regional School of Nursing
Anna Marie Alteen
Affiliation:
Western Regional School of Nursing
Leslie J. Cake
Affiliation:
Grenfell Campus of Memorial University
*
Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Darlene Hutchings, MHS Western Regional Integrated Health Authority P.O. Box 2005 Corner Brook, NL. A2H 6J7 ([email protected])

Abstract

This hermeneutic phenomenological study provided insight into the experiences of family members of residents diagnosed with mild to moderate dementia who were relocated from institutional-based care to a unique assisted-living environment. Semi-structured interviews were conducted with 10 family members, and six themes emerged: (a) ongoing communication, (b) relief and contentment, (c) meaningful activities, (d) enhanced environment, (e) improved functioning, and (f) engaged staff. These findings have significant implications for care delivery and future program planning in caring for residents with special needs. Above all, we can conclude that client-centered care results in positive outcomes for residents and family members.

Résumé

Cette étude phénoménologique et herméneutique a donné un aperçu des expériences des membres des familles des résidents qui ont été diagnostiqués d’une démence légère à modérée et qui ont été déménagés de leur institution de soins dans une résidence medicalisée unique. Des entrevues semi-dirigées ont été realisées avec 10 membres de la famille, dont six thèmes ont émergé : (a) la communication en cours, (b) de secours et de contentement, (c) des activités significatives, (d) un environnement amélioré, (e) le fonctionnement amélioré, et (f) le personnel engagé. Ces résultats ont des implications importantes pour la prestation des soins et la planification des programmes futurs dans les soins aux résidents ayant des besoins spéciaux. Surtout, nous pouvons conclure que les résultats axés sur le client des soins produit des résultats positifs pour les résidents et les membres des familles.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The researchers thank the family members for sharing their stories and providing insight into their personal experiences of relocation. The researchers also acknowledge the financial assistance of Western Health and the in-kind support provided by the Western Regional School of Nursing and by the Grenfell Campus of Memorial University. Kelli O’Brien was a recipient of the Canadian Health Services Research Foundation’s Executive Training for Research Fellowship, and this research was completed in partial fulfilment of this program.

References

Aneshensel, C.S., Pearlin, L.I., Levy-Storms, L., & Schuler, L.H. (2000). The transition from home to nursing home mortality among people with dementia. Journal of Gerontology, 55B, S152S162.CrossRefGoogle Scholar
Annerstedt, L. (1997). Group-living care: An alternative for the demented elderly. Dementia Geriatric Cognitive Disorder, 8, 136142.CrossRefGoogle ScholarPubMed
Armer, J. (1996). An exploration of factors influencing adjustment among relocating rural elders. Journal of Nursing Scholarship, 28(1), 58.Google Scholar
Auer, S., & Reisberg, B. (1997). The GDS/FAST staging system. International Psychogeriatrics, 9, 167171.Google Scholar
Canadian Institute of Health Research (2005). Tri-council policy statement: Ethical conduct for research involving humans. Retrieved September 19, 2007, from http://www.pre.ethics.gc.ca/english/pdf/TCPS%20October%202005_E.pdfGoogle Scholar
Cheek, J., Ballantyne, A., Gillham, D., Mussared, J., Flett, P., Lewin, G., et al. . (2006). Improving care transitions of older people: Challenges for today and tomorrow. Quality in Aging-Policy, Practice, and Research, 7(4), 1826.Google Scholar
Crum, R.M., Anthony, J.C., Bassett, S.S., & Folstein, M.F. (1993). Population-based norms for the Mini Mental State Examination by age and educational level. Journal of the American Medical Association, 269, 23862391.CrossRefGoogle ScholarPubMed
Davies, S., & Nolan, M. (2004). Making the move: Relatives’ experiences of the transition to a care home. Health and Social Care in the Community, 12, 517526.CrossRefGoogle ScholarPubMed
Day, K., Carreon, D., & Stump, C. (2000). The therapeutic design of environments for people with dementia: A review of the empirical research. The Gerontologist, 40, 397416.Google Scholar
Ejaz, F.K., Noelker, L.S., Schur, D., Whitlatch, C.J., & Looman, W.J. (2002). Family satisfaction with nursing home care for relatives with dementia. Journal of Applied Gerontology, 21, 368384.CrossRefGoogle Scholar
Eliopoulos, C. (2010). Gerontological nursing (7th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.Google Scholar
Folstein, M., Robins, L.N., & Helzner, J.E. (1983). The Mini Mental Status Exam. Archives of General Psychiatry, 40, 812.CrossRefGoogle Scholar
Freidman, S., Williamson, J.D., Lee, B.H., Ankrom, M.A., Ryan, S.D., & Denman, S.J. (1995). Increased fall rates in nursing home resident after relocation to a new facility. Journals of American Geriatric Society, 43, 12371242.CrossRefGoogle Scholar
Gallagher, E., & Walker, G. (1990). Vulnerability of nursing home residents during relocations and renovations. Journal of Aging Studies, 4(1), 3146.CrossRefGoogle Scholar
Golafshani, N. (2003). Understanding reliability and validity in qualitative research. The Qualitative Report, 8, 597607.Google Scholar
Gruneir, A., Lapane, K.L., Miller, S.C., & Mor, V. (2008). Is dementia special care really special? A new look at an old question. Journal of American Geriatrics, 56, 199205.CrossRefGoogle Scholar
Hawes, C., Rose, M., & Phillips, C.D. (1999). A national study of assisted living for the frail elderly. In Mollica, R. (Ed.), State Assisted Living Policy, 1998. (Report HHS-100-94-0024; HHS 100-98-0013). Washington, DC: U.S. Department of Health and Human Services.Google Scholar
Hodgson, N., Freedman, V.A., Granger, D.A., & Erno, A. (2004). Biobehavioural correlates of relocation in the frail elderly: Salivary cortisol, affect and cognitive function. Journals of American Geriatric Society, 52, 18561862.CrossRefGoogle Scholar
Jackson, B., Swanson, C., Hicks, L.E., Prokop, L., & Laughlin, J. (2000). Bridge of continuity from hospital to nursing home-Part 1: A proactive approach to reduce relocation stress syndrome in the elderly. Continuum: An Interdisciplinary Journal of continuity of Care, 20(1), 38.Google ScholarPubMed
Kao, H.S., Travis, S.S., & Acton, G.J. (2004). Relocation to a long term care facility: Working with patients and families before, during, and after. Journal of Psychosocial Nursing, 42(3), 1016.Google ScholarPubMed
Kellett, U. (1999). Transition in care: Family carers’ experience of nursing home placement. Journal of Advanced Nursing, 29, 14741481.CrossRefGoogle ScholarPubMed
Maas, M.L., Reed, D., Park, M., Specht, J.P., Schutte, D., Kelley, L.S., et al. . (2004). Outcomes of family involvement in care intervention for caregivers of individuals with dementia. Nursing Research, 53, 7686.CrossRefGoogle ScholarPubMed
MacCourt, P. (2008). An evaluation of a licensed dementia housing model for older adults with dementia. Prepared for Beacon Community Services. Vancouver, BC: Author.Google Scholar
Mace, N.L. (1993). Observation of dementia specific care around the world. American Journal of Alzheimer’s Care and Related Disorder and Research, 1(3), 18.Google Scholar
Morgan, D.G., Stewart, N.J., D’Arcy, K.C., & Werezak, L.J. (2004). Evaluating rural nursing home environments: Dementia special care units versus integrated facilities. Aging and Mental Health, 8, 256265.CrossRefGoogle ScholarPubMed
Nay, R. (1995). Nursing home residents’ perceptions of relocation. Journal of Clinical Nursing, 4, 319325.Google Scholar
O’Reilly, D., Parfrey, P.S., Barrett, B., & McDonald, J. (1998). Efficiency of institutional long term care and annual demands for placement. Health Care Management Forum, 11, 2632.Google Scholar
Parfrey, P., & McDonald, J. (2005). LTC bed analysis and facility planning services, Corner Brook. Memorial University Clinical Epidemiology Unit. Prepared for Department of Health and Community Services. St. John’s, NL: Author.Google Scholar
Parker-Oliver, D., Aud, M., Bostick, J., Schwarz, B., & Tofle, R. (2005). Dementia special care units: A policy and family perspective. Journal of Housing for the Elderly, 19(1), 113125.CrossRefGoogle Scholar
Rader, J. (1995). Moving away from the hospital model to an individualized resident-centered model. In Tornquist, E.M. (Ed.), Individualized dementia care (pp. 310). New York: Springer.Google Scholar
Reimer, M.A., Slaughter, S., Donaldson, C., Currie, G., & Eliaszewicz, M. (2004). Special care facility compared to traditional environments for dementia care: A longitudinal study of quality of life. Journal of the American Geriatrics Society, 52, 10851092.Google Scholar
Strang, V., Dupuis-Blanchard, S., Nordstorm, M., & Thompson, B. (2006). Family caregivers and transition to long term care. Clinical Nursing Research, 15, 2745.Google Scholar
Swagerty, D.L., Lee, R.H., Smith, B., & Taunton, R.L. (2005). The context for nursing home resident care: The role of leaders in developing strategies. Journal of Gerontological Nursing, 31(2), 4048.Google Scholar
Swann, J. (2006). The journey into care. Nursing and Residential Care, 8, 410412.Google Scholar
Taft, L., Delaney, K., Seman, D., & Stansell, J. (1993). Dementia care. Creating a milieu. Journal of Gerontological Nursing, 19(10), 3039.Google Scholar
Thomasma, M., Yeaworth, R.C., & McCabe, B.W. (1990). Moving day: Relocation and anxiety in institutionalized elderly. Journal of Gerontological Nursing, 16(7), 1825.CrossRefGoogle ScholarPubMed
Tracy, J.P., & DeYoung, S. (2004). Moving to an assisted living facility: Exploring the transitional experience of elderly individuals. Journal of Gerontological Nursing, 30(10), 2633.CrossRefGoogle Scholar
Trochim, W.M.K., & Donnelly, J.P. (2006). The research methods knowledge base (3rd ed.)., Mason, OH: Thomson Publishing.Google Scholar
van Manen, M. (1997). Researching the lived experience. New York: State University of New York Press.Google Scholar
Volicer, L., Simard, J., Pupa, J., Medrek, R., & Riordan, M.E. (2006). Effects of continuous activity programming on behavioral symptoms of dementia. Journal of American Medical Directors Association, 7, 426431.Google Scholar
Werezak, L.J., & Morgan, D.G. (2003). Creating a therapeutic psychosocial environment in dementia care. A preliminary framework. Journal of Gerontological Nursing, 29(12), 1825.CrossRefGoogle Scholar