Exploring and enhancing autonomy for older people in residential care
Welford, Claire Lisa
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The purpose of this study was to explore autonomy for older people in residential care. A single exploratory embedded case study design was used. The case study was adopted for the purpose of gaining a better understanding of resident autonomy from multiple perspectives and multiple data sources. Prior to commencing the data collection phase of the research, a concept analysis of autonomy for older people in residential care was undertaken. This analysis was used to inform the development of the data collection tools. This first phase of the research included interviews, observations, documentary analysis and a staff attitude survey. Analysis of the findings from phase one revealed that there were problems with resident autonomy in the case study site. Two main themes emerged from the findings: The Personal and Being Personal. Findings from phase one resulted in a second phase of the research whereby staff participants enhanced one aspect of resident autonomy. Phase two was guided by action research principles in order to introduce a change in practice. Care plans with a focus on autonomy were designed and implemented in order to enhance the residents autonomy. Discussion of the findings from both phases of the research was summarised into promoting and prohibiting factors for resident autonomy. Recommendations are made in relation to the knowledge, skills and attitudes that health care professionals working with older people in residential care need to possess. Recommendations are also made for encouraging negotiation, biographical care planning and facilitation of resident decision making in residential care. Additional recommendations are made for further research which will extend the operationalisation of the concept of resident autonomy.