Bonnix Kayabu
Country: Congo
Background: Medicine
Research Project: Older People's Participation in the Decision-making process before moving from hospital to a Nursing home in Dublin
Objectives: The aim of this thesis is to establish how older people participate in the decision to be admitted to a nursing home; to determine the circumstances surrounding the time of admission to a nursing home; and to identify the main causes influencing their decision to move to a nursing home.
Methods: Purposive sampling techniques were utilised to recruit participants who were residents in a nursing home in Dublin. Qualitative, in-depth interviews were conducted with eight older people who were living in a private nursing home for more than three months and less than 12 months. Narrative analysis was used to analyse their stories.
Results: Findings indicated that respondents had a variety of views, which were rooted in individual experiences of the process of planning their discharge from hospital to nursing home in the discharge planning. Some respondents were involved in the process and they negotiated or were consulted in the decision-making, meaning that they had a say in the process, whereas others felt they were compelled to move to the nursing home and felt excluded from the discussions. The lack of options was mentioned in many cases. It was rare for a respondent to have made independent choices but, on the other hand, interdependence in making decisions appeared to offer a way of being involved in the decision for those respondents who had a say in discussions. Reasons to move to the nursing home included a decision made by the family or by health staff, along with poor health, loneliness and financial constraints. Six major themes emerged from the analysis of the data: passivity/ lack of control, options/ choice, physical well-being, emotional well-being, financial resources/ difficulties, and ineffective communication.
Conclusion: As the number of Irish older people living in nursing homes is increasing rapidly and little is known about their participation in the decision-making process, they should be at the heart of discharge process to make sure that their voice is heard. The process of moving older people to residential care needs to be smooth in order to achieve better outcomes in nursing homes and to provide a setting where older people’s potential can be realised – rather than making them feel unimportant and unwanted.
Keywords:
Older people, decision-making process, participation, residential care, qualitative
Dissertation Word Count: 15,874