Abstract
AbstractAutonomy is important in every stage of life. However, little is known about how autonomy is enhanced for older adults living in residential care facilities (RCFs). This leads to the research question: which facilitators and barriers to autonomy of older adults with physical impairments due to ageing and chronic health conditions living in RCFs are known? The results will be organised according to the framework of person-centred practice, because this is related to autonomy enhancement. To answer the research question, a systematic literature search and review was performed in the electronic databases CINAHL, PsycINFO, PubMed, Social Services Abstracts and Sociological Abstracts. Inclusion and exclusion criteria were derived from the research question. Selected articles were analysed and assessed on quality using the Mixed Methods Appraisal Tool. Facilitators and barriers for autonomy were found and arranged in four themes: characteristics of residents, prerequisites of professional care-givers, care processes between resident and care-giver, and environment of care. The established facilitators and barriers are relational and dynamic. For a better understanding of the facilitators and barriers to autonomy for older adults with physical impairments living in RCFs, a description is based on the 35 included articles. Autonomy is a capacity to influence the environment and make decisions irrespective of having executional autonomy, to live the kind of life someone desires to live in the face of diminishing social, physical and/or cognitive resources and dependency, and it develops in relationships. The results provide an actual overview and lead to a better understanding of barriers and facilitators for the autonomy of older adults with physical impairments in RCFs. For both residents and care-givers, results offer possibilities to sustain and reinforce autonomy. Scientifically, the study creates new knowledge on factors that influence autonomy, which can be used to enhance autonomy.
Highlights
In many Western countries, governments see active citizenship as an important theme
The worldwide trend in health care is that older adults with chronic conditions and physical impairments continue to live at home (Cartier, 2003; Bjornsdottir, 2009; Jacobs, 2019)
A systematic literature review will be executed with the research question: which facilitators and barriers to autonomy of older adults with physical impairments due to ageing and chronic health conditions living in residential care facilities (RCFs) are known?
Summary
In many Western countries, governments see active citizenship as an important theme. A neoliberal philosophy has influenced and changed health-care systems during the last decade. Policies are directed towards self-management and informal care from family and friends
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