The long goodbye : a study of the experience of placing and visiting a long term partner in residential care

Abstract

Spouses who place a long term partner in residential care have thus far had a limited voice in the research and policy agenda associated with the reform of Australian aged care policy. However they are in an important position to throw light on the impact of some o f the changes associated with the reform - resident centred regulation and funding and the integration of family, community and residential care. This thesis explores the experiences of spouses who place a long term partner in residential care, examines the residential context in which they visit their partners, and links these understandings to an analysis of how current policy frames family participation in residential care.The research is founded on a contextual approach to ageing. It seeks to locate phenomenological understandings within an appreciation of the broader social context. The research is inductive and exploratory and the qualitative methodology incorporates several research methods: in-depth interviews with 18 spouses who had placed a long term partner in care, observation exploring provision for - and the treatment of - families within the units where the partners had been placed, semistructured interviews with front line staff and managers, and an analysis o f the implicit and explicit expectations of families contained in the documentation produced by the facilities. The research findings are linked to an analysis of the roles constructed for families in current residential care policy and the capacity of families and front line staff to influence the nature of those relations.The research concludes that prevailing residential care policy and practice have a limited capacity to respond to the diverse needs and interests of the long term spouses and that the primary sources of this limitation are the conceptualisation and implementation of resident centred residential care policy, the level of the resources available, and the attitudes and priorities of front line staff. The argument is that the centrality of human relationships and meaning in aged care can be lost sight of in a policy environment shaped by a focus on residents, their rights, and the rationalisation of care. The thesis ends with an exploration of models for incorporating families in residential care and some recommendations that would enhance the sensitivity of policy and practice to the needs and interests of long term spouses.