Nursing support of the lived experience of health in lucid elderly nursing home patients.
Anne E.M. Nyström
Abstract
The lived experience of health is not entirely dependent on somatic status or ambitious nursing. The purpose of this study was to clarify how registered nurses can facilitate a lived experience of health in elderly, lucid nursing home patients.
A qualitative approach has been applied. Data have been gathered by interviews and participant observations in nursing homes in a city area. The analysis has used ethnographic principles. Salient patterns, themes and concepts have been discussed connecting to relevant, existing knowledge from psychology, sociology, philosophy and nursing. A concept analysis has also been performed.
Nursing home patients described the experience of health as based on daily life worthy of human beings; self esteem: identity and integrity; and peace of mind, which, once attained, could also compensate for shortcomings on lower levels. Patients and nurses saw the striving for peace of mind as a personal responsibility, yet affected by outer conditions. Patients expected elderly to be able to handle difficult experiences. Using cogitation was seen as appropriate for this.
Living in a nursing home had multifacetted characteristics. The powerlessness and family life perspectives elucidated many of these. Increasing deterioration and dependence in the elderly were expected, but not ongoing maturation and personal growth.
Nursing support comprised: assistance and help in daily life, prevention of unnecessary suffering, practical environmental arrangements, leadership functions, and facilitation of supportive interactions in the ward. Messages communicated to the patients by the actions were important. Special emphasis was laid on empowerment of the patients by provision of appropriate information and emotional support in accepting realities, dealing with problems and accomplishing decisions.
A human being is a unity of body, mind and interaction with environment, and acceptable function of all three intertwined aspects makes the prerequisite for peace of mind and a lived experience of health. Nursing support of the elderly patient is discussed, and special measures are suggested. Consequences for society's goal setting and informational obligation are formulated, and changes in nursing education are proposed.
Key words: cogitation, elderly, empowerment, frail elderly, health, maturation, nursing, nursing homes, nursing support, peace of mind.
ISBN 91-628-1695-0
Department of Primary Health Care, Göteborg University, Vasa Hospital, S-411 33 Göteborg, Sweden.