Supporting older people living in care homes: A qualitative network approach

Abstract

In Scotland, older people living in care homes are becoming increasingly frail and in need of more specialised care and support. Additionally, demand for care home services will likely increase due to a growing ageing population. Care approaches being applied in care homes, such as person-centred care and relationship-centred care, emphasise the importance of relationships and community. Despite this, little research has explored how the support networks of older people living in care homes are structured or composed, and thus, where support may be lacking for residents. This study seeks to understand how residents utilise their support networks and how this support affects their experience in the care home, as well as their wellbeing. This thesis uses an egocentric network approach to construct the support networks of residents, and a critical realist approach to qualitative data analysis in order to identify mechanisms which may impact a resident’s network and wellbeing. Staff members and visitors were also interviewed in order to identify additional barriers to support in care homes. The findings describe the support networks of 36 older people living in care homes and residents revealed that there were a number of barriers to receiving support. Most notably, negative relationships with staff and an inability to make meaningful connections with fellow residents made making relationships in the care home difficult. Staff discussed organisational and administrative burdens that limited their ability to provide better support and highlighted resources which could result in better support. Additionally, patterns of support emerged through network and qualitative analysis, which formed the basis for developing a typology of support networks for residents. Residents who made connections with staff and allowed their families to integrate with staff members were more likely to have a better experience in the care home, as well as better wellbeing. Together, these findings inform care home practice, as well as approaches to care and support, by identifying gaps in resident support and factors that can contribute to better relationships within care homes.