Participation of older people in nursing homes:
An ethnographic exploration and analysis
Background
According to estimates, the demand for nursing homes in Switzerland will increase by 69% by 2040. Nursing homes are mainly used in the last two years of life, when older people need more care due to physical and/or cognitive impairments. As many older people fear losing their autonomy and self-determination in a nursing home, they are reluctant to take the decision to move into a nursing home. The negative perception of nursing homes has increased since the measures taken to protect the older population during the COVID-19 pandemic. This makes it all the more important to involve older people more closely in decisions that affect them individually and as a group of nursing home residents. Both governmental and non-governmental organizations consider the participation of nursing home residents to be important, but little research has been conducted on how participation is actually understood by residents, relatives, staff and nursing home managers. Little is also known about how older people in nursing homes, especially older people with physical and/or cognitive impairments, can not only (passively) participate, but also (actively) take part and help shape their everyday lives.
Objectives
This research on nursing homes aims to 1) describe how and by whom the participation of older people in nursing homes is understood, discussed and practiced by residents, relatives and staff. The project aims to 2) define possible inequalities related to the participation of older people in nursing homes that are unjust and unfair. Furthermore, it aims to 3) develop approaches to promote equitable participation of older people living in a nursing home.
Methods
This sub-project will conduct ethnographic field research in three nursing homes in the cantons of Basel-Stadt and Basel-Land over a period of one year.
Within the scope of objectives 1 and 2, we will produce a narrative review on the participation of older people in nursing homes. In addition, we will conduct semi-structured interviews and informal conversations with residents, relatives, staff and the nursing home management. Observations and document analyses broaden our insights into the everyday lives of residents and enable us to include the perspective of people with cognitive impairments. We analyze the data in an iterative process and present the case studies in a thick description.
For Objective 3, we organize at least eight workshops with a transdisciplinary advisory group across all projects, which build on the results of Objectives 1 and 2. This participatory approach enables us to include further perspectives and make the dissemination of the study results accessible to practitioners and German-speaking interested parties.
