Ideals Regarding a Good Life for Nursing Home Residents with Dementia: views of professional caregivers

Abstract

This study investigates what professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia. Ten caregivers were interviewed; special attention was paid to the way in which they deal with conflicting values. Transcripts of the interviews were analysed qualitatively according to the method of grounded theory. The results were compared with those from a similar, earlier study on ideals found in mission statements of nursing homes. The concepts that were mentioned by most interviewed participants as important for a good life were ‘peace and quiet’, ‘going along with subjective experience’ and ‘no enforcement: the way the resident wants it’. A considerable overlap was found between the interviews and the mission statements; however, when compared with the mission statements, the interviews put less emphasis on individuality and on giving meaning, and more on offering residents pleasant activities. When faced with conflicting values, caregivers tend to make pragmatic and more or less intuitive decisions. Although this has its merits, it may be desirable to stimulate conscious reflection regarding conflict between different values.

Keywords

dementia nursing home care quality of life

Get full access to this article

View all access options for this article.

References

Hark T. The three faces of flourishing . Soc Philos Policy 1999; 16: 44-71 .

Nussbaum MC. Human functioning and social justice: in defense of Aristotelian essentialism . Polit Theory 1992; 20: 202-246 .

Sandoe P. Quality of life - three competing views . Ethical Theory Moral Pract 1999; 2: 11-23 .

Wolf S. Happiness and meaning: two aspects of the good life . Soc Philos Policy 1997; 14: 207-225 .

Kane RA. Long-term care and a good quality of life: bringing them closer together . Gerontologist 2001; 41: 293-304 .

Phillips CD. Yali’s question and the study of nursing homes as organizations . Gerontologist 2002; 42: 154-156 .

Regnier V , Pynoos J. Environmental intervention for cognitively impaired older persons. In: Birren JE , Sloane RB , Cohen GD eds. Handbook of mental health and aging, second edition. San Diego, CA: Academic Press , 1992: 763-792.

Kalis A , van Delden JJM , Schermer MHN. The good life for demented persons living in nursing homes . Int Psychogeriatr 2004 (in press).

Strauss AL , Corbin JM. Basics of qualitative research: grounded theory, procedures, and techniques. Newbury Park, CA: SAGE , 1990.

10.

Pidgeon N , Henwood K. Using grounded theory in psychological research. In: Hayes N ed. Doing qualitative analysis in psychology. London: Psychology Press , 1997: 245-273.

11.

Miles MB , Huberman AM. Qualitative data analysis: an expanded sourcebook, second edition. Thousand Oaks, CA: SAGE , 1994.

12.

Fliess JL. Statistical methods for rates and proportions, second edition. New York: Wiley , 1981.

13.

Camberg L , Woods P , Ooi WL et al. Evaluation of simulated presence: a personalized approach to enhance well-being in persons with Alzheimer’s disease . J Am Geriatr Soc 1999; 47: 446-452 .

14.

Post SG. The moral challenge of Alzheimer disease. Baltimore, MD: Johns Hopkins University Press , 1995.

15.

Zingmark K , Sandman PO , Norberg A. Promoting a good life among people with Alzheimer’s disease . J Adv Nurs 2002; 38: 50-58 .

16.

Kitwood T. Toward a theory of dementia care: ethics and interaction . J Clin Ethics 1998; 9: 23-34 .

17.

Arneson RJ. Human flourishing versus desire satisfaction . Soc Philos Policy 1999; 16: 113-142 .

18.

Jennings B. A life greater than the sum of its sensations: ethics, dementia and the quality of life . J Ment Health Aging 1999; 5: 95-106 .