A qualitative study of family members’ perspectives regarding decision-making for nursing home residents’ care
Peer reviewed, Journal article
Published version
Date
2024Metadata
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Original version
10.1080/17482631.2024.2370545Abstract
Purpose: We explored how family caregivers perceive decision-making regarding the care of
nursing home residents.
Methods: This qualitative study used Flemming’s Gadamerian-based research method. In
person semi-structured interviews about decision-making concerning residents’ care were
conducted with 13 family members (nine women, four men) of residents of three Norwegian
nursing homes.
Findings: The following themes emerged: Excessive focus on autonomy threatens resident
wellbeing and safety. Resident wellbeing is the caregiver’s responsibility. Resident wellbeing
serves as a guiding principle.
Conclusions: The family members of residents and the nursing home caregivers disagreed
about the significance of upholding resident autonomy to respect residents’ dignity. The
family members held that not all instances where residents refused care reflect autonomy
situations as care refusal often does not reflect the resident's true values and standards but
rather, stems from barriers that render necessary care actions difficult. In situations where
residents refuse essential care or when the refusal does not align with the residents second-
order values, the family members suggested that caregivers strive to understand the causes
of refusal and seek non-coercive ways to navigate it. Hence, the family members seemed to
endorse the use of soft paternalism in nursing homes to safeguard residents’ wellbeing and
dignity.