Understanding the factors that affect nursing home adjustment through the lived experiences of recently admitted older persons

Abstract

The world population is ageing. As people get older, their care needs increase. With the number of traditional informal carers decreasing, admission to a Nursing Home (NH) has become a common occurrence among older persons in Malta. International literature has shown that older persons experience a lot of different emotions during their transition from home to a NH, followed by a period of adjustment to their new surroundings. The aim of this study is to discover which factors influence the adjustment of Maltese older persons’ following their recent admission to a NH. This study adopted a qualitative descriptive phenomenological approach. Three NHs from different regions of Malta were selected. A purposive sample of seven participants who were 65 years or older and had resided in a NH for six months or less was obtained with the assistance of NH managers. Data collection was carried out via face to face, audio recorded in-depth interviews, and was later analysed using Colaizzi’s descriptive phenomenological analysis. Phenomenological data analysis revealed four main themes that were related to adjustment: The decision to enter the NH, The NH environment, Activities in the NH and Relationships inside the NH. All of the participants made reference to their deteriorating health as a reason for considering entering the NH. The degree of participation in the decision-making process affected the participants’ satisfaction with the relocation which had an impact on their adjustment. Shared rooms caused privacy concerns, and hindered personalisation due to the limited space available. Amenities such as open spaces and chapels were appreciated by participants as they could continue to practice their hobbies and religious traditions. The quality of NH food also affected some participants’ adjustment especially when comparisons were drawn to homemade cooking. Activities outside the NH were mostly enjoyed, while those organised inside the NH were described as lacking variety and inclined towards the female stereotype. The relationship with roommates and NH staff had a great impact on overall adjustment. Good relationships with roommates were defined as supportive and encouraging, while poor relationships caused anxiety and stress. Good relationships with NH staff were defined as welcoming and helped build trust, while bad relationships caused the participants to feel objectified and neglected.