Abstract
Over the previous years, the residential care sector has gone through a transition from a rather paternalistic approach towards a more democratic way of caregiving. Nevertheless, many care organizations still find it challenging to engage their residents in the process of care. In this study, we investigated the challenges regarding the engagement of older adults in residential care. As recent studies indicated the increasing opportunities of ICTs, we paid particular attention to this in the process of engagement. We followed a participatory action research approach among caregivers and older adults at a somatic care department in a care residence in the Netherlands. Methods used included 15 participants in two homogeneous group sessions, reflections on action in practice, and one mixed focus group. Our findings show that both caregivers and older adults acknowledge the importance of engagement in daily care. However, their different perspectives on how this should take place, made the actual engagement of older adults a challenge. We determined three dilemmas complicating this engagement in care, and labeled these (1) autonomy versus dependence; (2) personal experiences versus privacy; and (3) happiness versus honesty. We found different ways of how caregivers and older adults deal with these dilemma’s in practice and defined these in terms of pitfalls and potentials. ICTs were shown to reinforce both the pitfalls and potentials. Paying attention to these challenges in residential care, including how caregivers and older adults deal with these challenges, will encourage a mutual understanding and actual engagement in decisions on daily care. Further research is recommended on the role of organizations’ management, older adults’ relatives, or older adults with cognitive impairments.
Highlights
In recent years, the residential care sector has experienced a transition from a traditional, rather paternalistic approach focused on physical health, protocols, and standards towards a more democratic way of care, emphasizing relationships and person-centered care [1]
We proposed to the older adults that they could take their own pictures to share their experiences with daily care
The older adults found it difficult to reflect on the process, the captured experiences showed their contribution: they consciously posed for the picture and their experiences were captured with their literal quotes
Summary
The residential care sector has experienced a transition from a traditional, rather paternalistic approach focused on physical health, protocols, and standards towards a more democratic way of care, emphasizing relationships and person-centered care [1]. Dutch care organizations have the legal obligation to establish a client council, based on the idea that decisions of the board should take into account the experiences with daily care as expressed by clients [4] This is an encouraging trend, as several studies show a positive impact on older adults’ physical, social, and mental wellbeing from being engaged in the care they. In line with earlier studies on this topic, we defined ICTs as all types of information and communication technologies used in order to gain or share information or to communicate with others, either face-to-face or at a distance [15] This may include software or hardware, and could include both structured methodologies or daily use of own means. Studying this may deliver us handles for facilitating older adults’ engagement in a futureproof way
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