A concept analysis of autonomy for older people in residential care

Abstract

To undertake a concept analysis (CA) of residential autonomy to identify its attributes. To reveal the antecedents and consequences of autonomy for older people in residential care and thus enable this concept to be operationalised. Background. Globally, there is an ageing population. This population and their families demand that services offer choice and recognise the older individual in care relationships. Concept analysis. Using the same search terms, findings from a literature search in 2007 and from a follow-up search in 2009 were used to conduct the CA. Rodgers (1989) framework was used to develop a model case of autonomy for older people in residential care. The attributes, antecedents, consequences and references were delineated. Six attributes of autonomy for older people in residential care were delineated. (1) Residents are involved in decision making while their capacity is encouraged and maintained. (2) Residents delegate their care needs based on the right to self-determination and this can be achieved through (3) negotiated care planning, which is encouraged through open and respectful communication and (4) including families or significant others when the resident is cognitively impaired. (5) The residential unit operates a culture and atmosphere of flexibility within an ethos of maintaining resident dignity. (6) Meaningful relationships are enabled by the presence of regular and motivated staff, and these relationships enhance the residents' opportunities to be autonomous. A CA framework is useful in trying to understand a term in its context and thus make it operational. This CA is the first step required for further research on this aspect of care. This is essential in informing this nursing specialty. The attributes, antecedents and consequences can now be used to operationalise the concept in practice.