Good care in group home living for people with dementia. Experiences of residents, family and nursing staff

Authors

  • Ezra van Zadelhoff,

    1. Authors:Ezra vanZadelhoff, LLM, MA, PhD Student, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University; Hilde Verbeek, PhD, Research Fellow, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Guy Widdershoven, PhD, Professor of Philosophy and Ethics of Medicine, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam; Erik van Rossum, PhD, Associate Professor, Centre of Research on Autonomy and Participation, Zuyd University of Applied Sciences, Heerlen and Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Tineke Abma, PhD, Professor of Client Participation in Elderly Care, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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  • Hilde Verbeek,

    1. Authors:Ezra vanZadelhoff, LLM, MA, PhD Student, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University; Hilde Verbeek, PhD, Research Fellow, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Guy Widdershoven, PhD, Professor of Philosophy and Ethics of Medicine, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam; Erik van Rossum, PhD, Associate Professor, Centre of Research on Autonomy and Participation, Zuyd University of Applied Sciences, Heerlen and Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Tineke Abma, PhD, Professor of Client Participation in Elderly Care, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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  • Guy Widdershoven,

    1. Authors:Ezra vanZadelhoff, LLM, MA, PhD Student, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University; Hilde Verbeek, PhD, Research Fellow, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Guy Widdershoven, PhD, Professor of Philosophy and Ethics of Medicine, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam; Erik van Rossum, PhD, Associate Professor, Centre of Research on Autonomy and Participation, Zuyd University of Applied Sciences, Heerlen and Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Tineke Abma, PhD, Professor of Client Participation in Elderly Care, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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  • Erik van Rossum,

    1. Authors:Ezra vanZadelhoff, LLM, MA, PhD Student, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University; Hilde Verbeek, PhD, Research Fellow, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Guy Widdershoven, PhD, Professor of Philosophy and Ethics of Medicine, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam; Erik van Rossum, PhD, Associate Professor, Centre of Research on Autonomy and Participation, Zuyd University of Applied Sciences, Heerlen and Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Tineke Abma, PhD, Professor of Client Participation in Elderly Care, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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  • Tineke Abma

    1. Authors:Ezra vanZadelhoff, LLM, MA, PhD Student, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University; Hilde Verbeek, PhD, Research Fellow, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Guy Widdershoven, PhD, Professor of Philosophy and Ethics of Medicine, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam; Erik van Rossum, PhD, Associate Professor, Centre of Research on Autonomy and Participation, Zuyd University of Applied Sciences, Heerlen and Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht; Tineke Abma, PhD, Professor of Client Participation in Elderly Care, Department of Medical Humanities, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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Ezra van Zadelhoff, PhD Student, Faculty of Health, Medicine and Life Sciences, Department of Health Services and Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht, The Netherlands. Telephone: +31 433883612.
E-mail:e.vanzadelhoff@maastrichtuniversity.nl

Abstract

Aims and objectives:  To investigate experiences of residents, their family caregivers and nursing staff in group living homes for older people with dementia and their perception of the care process.

Background:  Traditional nursing homes for people with dementia have several shortcomings related to depersonalisation, passivity, loss of skills and use of physical restraints. Group living homes are seen as an alternative to regular nursing homes, but experiences with this new care setting have rarely been investigated.

Design:  The study followed a naturalistic design. Qualitative data were collected over a period of 6 months in two group living homes located in the southern part of the Netherlands.

Methods:  Systematic participatory observations were carried out during daily life, care and activities in both homes. In addition, semi-structured interviews were held with residents, their family and nursing staff. These data were inductively analysed and related to Tronto’s care ethical framework.

Results:  According to all parties, group living homes create structural opportunities for individualised care and attention to the residents’ personal needs. The increased attentiveness and responsiveness for residents’ well-being was seen as a sign of good care and fits with the phases of caring about and receiving care of Tronto’s care ethical model. However, tensions occurred relating to the phases of taking responsibility and carrying out care. Not all residents and family members want or are able to take responsibility and perform self-care.

Conclusions:  Group living homes create conditions for good care and stimulate attentiveness and responsiveness. Tensions in these homes may relate to the new division of responsibilities and tasks.

Relevance to clinical practice:  Values of attention to needs and responsiveness are of high importance for nursing staff to provide good care for people with dementia in a nursing home setting.

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