An exploration of the quality of life in nursing homes: the use of single case and organisational observation in a research project

Abstract

The present article provides a brief introduction to the research project, ‘Quality of Life in Nursing Homes’ funded by the University of Vienna. Within the scope of this project, single case observation and organisational observation techniques based on the Tavistock/Bick approach were employed as research methods in an effort to explore the subjective wellbeing experienced by residents of nursing homes suffering from dementia. Further subjects of the investigation were aspects of the organisational dynamics which influence the evocation of such feelings of wellbeing. The main emphasis of the article is on the presentation and discussion of excerpts from the observation accounts which were carried out in one particular nursing home. The article outlines just how intensely inmates of nursing homes themselves, but also caregivers and members of other professional groups involved with them, are continually confronted with the experience of cognitive and physical decline, loss and loneliness, helplessness and dependency, and also with the theme of the unrelenting approach of death. The article also describes the ways in which these experiences evoked strong and overwhelming emotions in staff members and residents as well as in members of the research team. In addition, the article outlines the psychosocial processes within the organisation, which might possibly help members of the organisation better tolerate and allay such feelings, and the influence that these processes have on the dynamics of everyday relationships within the home, and, as a further consequence, upon the wellbeing of the residents. One particular aspect highlighted is the fact that there is no mental or social space at the nursing home specifically set aside to enable the residents and the staff to exchange thoughts about these experiences and to understand their emotional impact. The article concludes with remarks on the difficulties involved in observing in nursing homes where people suffering from dementia live.