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The Development of Relationships Between Families and Staff in Long-term Care Facilities: Nurses' Perspectives

Published online by Cambridge University Press:  31 March 2010

James Gladstone  and
Evelyn Wexler
James Gladstone*
Affiliation:
McMaster University
Evelyn Wexler
Affiliation:
University of Toronto
*
Requests, etc., James Gladstone, Ph.D., Associate Professor, School of Social Work – KTH319, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M4. e-mail: [email protected]
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Abstract

The objective of this study was to explore the way in which relationships develop between family members and staff working in long-term care facilities. In-depth, qualitative interviews were conducted with 17 registered nurses. Data were analysed inductively using the constant comparative method. Findings showed that RNs perceive their relationships with families to develop in four stages: the “initial greeting,” sizing up,” “making a tentative decision,” and “reaching a final decision”. Several contextual factors were associated with the way in which relationships developed, including structural factors, family recognition of staff efforts, open communication, and professional identity. Findings suggest that relationships can best be understood from an interpretive perspective and that an analysis of family-staff relationships should consider the influence of social power.

Résumé

Cette étude visait l'exploration du développement des relations entre les membres d'une famille et le personnel des établissements de soins de longue durée. Des entrevues en profondeurs ont été menées auprès de 17 infirmières autorisées. On a effectué des analyses inductives des données au moyen de la méthode de comparaison constante. Les résultats démontrent que les infirmières autorisées perçoivent leur relation avec la famille selon un modèle en quatre étapes: la rencontre initiale, l'évaluation, la tentative de décision, la décision finale. Plusieurs facteurs contextuels ont été associés à la façon dont les relations se développent, notamment les facteurs structuraux, la reconnaissance par la famille des efforts du personnel, la communication ouverte et l'identité professionnelle. Les résultats semblent indiquer que les relations sont plus facilement comprises par le biais de l'interprétation et qu'une analyse des relations famille-personnel devrait tenir compte de l'influence du pouvoir social.

Keywords

StagesMeaningsSocial PowerFamilyNursingStadessignificationspouvoir socialfamillesoins infirmiers
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 21 , Issue 2 , Summer/Été 2002 , pp. 217 - 228
Copyright
Copyright © Canadian Association on Gerontology 2002

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Footnotes

*James Gladstone gratefully acknowledges the financial support of the Alzheimer Society of Canada research grant #95-01

References

Aneshensel, C.S., Pearlin, L.I., Mullan, J.T., Zarit, S.H., & Whitlatch, C.J. (1995). Profiles in caregiving. The unexpected career. San Diego: Academic Press.Google Scholar
Baars, J. (1991). The challenge of critical gerontology: The problem of social constitution. Journal of Aging Studies, 5, 219–243.CrossRefGoogle Scholar
Béland, F., & Arweiler, D. (1996). Conceptual framework for development of long-term care. Policy 1. Constitutive elements. Canadian Journal on Aging, 15, 649–681.CrossRefGoogle Scholar
Bengtson, V.L., Burgess, E.O., & Parrott, T.M. (1997). Theory, explanation and a third generation of theoretical development in social gerontology. Journal of Gerontology: Social Sciences, 52B, S72–S88.CrossRefGoogle Scholar
Bowers, B.J. (1988). Family perceptions of care in a nursing home. The Gerontologist, 28, 361–368.CrossRefGoogle ScholarPubMed
Brody, E.M., Dempsey, N.P., & Pruchno, R.A. (1990). Mental health of sons and daughters of the institutionalized aged. The Gerontologist, 30, 212–219.CrossRefGoogle ScholarPubMed
Bury, M. (1995). Aging, gender and sociological theory. In Arber, S. & Ginn, J. (Eds.) Connecting gender and aging. A sociological approach (pp. 15–29). Buckingham, UK: Open University Press.Google Scholar
Clark, P.G. (1994). Social, professional, and educational values on the interdisciplinary team: Implications for gerontological and geriatric education. Educational Gerontology, 20, 35–51.CrossRefGoogle Scholar
Diamond, T. (1992). Making gray gold. Narratives of nursing home care. Chicago: The University of Chicago Press.CrossRefGoogle Scholar
Duncan, M.T., & Morgan, D.L. (1994). Sharing the caring: Family caregivers' views of their relationships with nursing home staff. The Gerontologist, 34, 235–244.CrossRefGoogle ScholarPubMed
Dupuis, S.L., & Norris, J.E. (1997). A multidimensional and contextual framework for understanding diverse family members' roles in long-term care facilities. Journal of Aging Studies, 11, 297–325.CrossRefGoogle Scholar
Edelson, J.S., & Lyons, W.T. (1985). Institutional care of the mentally impaired elderly. New York: Van Nostrand Rhei-nhold.Google Scholar
Fagermoen, M.S. (1997). Professional identity: Values embedded in meaningful nursing practice. Journal of Advanced Nursing, 25, 434–441.CrossRefGoogle ScholarPubMed
Foner, N. (1994). The caregiving dilemma. Work in an American nursing home. Berkeley: University of California Press.Google Scholar
Gilchrist, V.J. (1992). Key informant interviews. In Crabtree, B.F. & Miller, W.L. (Eds.), Doing qualitative research (pp. 70–89). Newbury Park: Sage.Google Scholar
Gladstone, J., & Wexler, E. (2000). A family perspective of family/staff interaction in long-term care facilities. Geriatric Nursing, 21, 16–19.CrossRefGoogle ScholarPubMed
Gladstone, J.W. (1995). The marital perceptions of elderly persons living or having a spouse living in a long-term care institution in Canada. The Gerontologist, 35, 52–60.CrossRefGoogle ScholarPubMed
Glaser, B.G., & Strauss, A.L. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine.Google Scholar
Gubrium, J.F. (1995). Voice, context, and narrative in aging research. Canadian Journal on Aging, 14 (supplement), 68–81.CrossRefGoogle Scholar
Gubrium, J.F., & Holstein, J.A. (1997). The new language of qualitative method. New York: Oxford University Press.Google Scholar
Kaufman, S.R. (1994). In-depth interviewing. In Gubrium, J.F. & Sankar, A. (Eds.) Qualitative methods in aging research (pp. 123–136). Thousand Oaks, CA: Sage.Google Scholar
Ketefian, S. (1985). Professional and bureaucratic role conceptions and moral behavior among nurses. Nursing Research, 34, 248–253.CrossRefGoogle ScholarPubMed
Kramer, C.H., & Kramer, J.R. (1976). Basic principles of long-term patient care. Springfield, IL.: Charles C. Thomas.Google Scholar
Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Beverly Hills: Sage.CrossRefGoogle Scholar
Luborsky, M.R. (1994). The identification and analysis of themes and patterns. In Gubrium, J.F. & Sankar, A. (Eds.) Qualitative methods in aging research (pp. 189–210). Thousand Oaks, CA: Sage.Google Scholar
Luborsky, M.R., & Rubinstein, R.L. (1995). Sampling in qualitative research. Research On Aging, 17, 89–113.CrossRefGoogle ScholarPubMed
Maas, M.L., Swanson, E.A., Specht, J., & Reed., D. (1997). Family-staff partnerships in long-term care. Paper presented at the 50th Annual Scientific Meeting of the Ger-ontological Society of America, Cincinnati, Ohio.Google Scholar
Marshall, V.W. (1995). Social models of aging. Canadian Journal on Aging, 14, 12–34.CrossRefGoogle Scholar
Montgomery, R.J.V. (1983). Staff-family relations and institutional care policies. Journal of Gerontological Social Work, 6, 25–37.CrossRefGoogle Scholar
Neidhardt, E.R., & Allen, J.A. (1993). Family therapy with the elderly. Newbury Park: Sage.Google Scholar
Ohlen, J., & Segesten, K. (1998). The professional identity of the nurse: Concept analysis and development. Journal of Advanced Nursing, 28, 720–729.CrossRefGoogle ScholarPubMed
Parenti, M. (1978). Power and the powerless. New York: St. Martin's Press.Google Scholar
Pillemer, K., Hegeman, C.R., Albright, B., & Henderson, C. (1998). Building bridges between families and nursing home staff: The partners in caregiving program. The Gerontologist, 38, 499–503.CrossRefGoogle ScholarPubMed
Riddick, C.C., Cohen-Mansfield, J., Fleshner, E., & Kraft, G. (1992). Caregiver adaptations to having a relative with dementia admitted to a nursing home. Journal of Geron-tological Social Work, 19, 51–75.CrossRefGoogle Scholar
Ross, M.M., Rosenthal, C.J., & Dawson, P.G. (1997). Spousal caregiving in the institutional setting: Task performance. Canadian Journal on Aging, 16, 51–69.CrossRefGoogle Scholar
Rubin, A., & Shuttlesworth, G.E. (1983). Engaging families as support resources in nursing home care: Ambiguity in the subdivision of tasks. The Gerontologist, 23, 632–636.CrossRefGoogle ScholarPubMed
Schmidt, M.G. (1987). The patient's partner: The spouse in residential care. Health & Social Work, 206–212.CrossRefGoogle ScholarPubMed
Schwartz, A.N., & Vogel, M.E. (1990). Nursing home staff and residents' families role expectations. The Gerontologist, 30, 49–53.CrossRefGoogle ScholarPubMed
Shuttlesworth, G.E., Rubin, A., & Duffy, M. (1982). Families versus institutions: Incongruent role expectations in the nursing home. The Gerontologist, 22, 200–208.CrossRefGoogle ScholarPubMed
Stewart, M., Banks, S., Crossman, D., & Poel, D. (1994). Partnerships between health professionals and self-help groups: Meanings and mechanisms. In Lavoie, F., Borkman, T. & Gadron, B. (Eds.) Self help and mutual aid groups (pp. 199–240). New York: Haworth.Google Scholar
Strauss, A., & Corbin, J. (1998). Basics of qualitative research. Newbury Park: Sage.Google Scholar