Relationships between nurses and older people within the home: exploring the boundaries of care

To explore the nature of relationships between nurses and older people within the home and to illuminate the nature and quality of caring boundaries within this setting.

Older people are increasingly receiving nursing care in the home. There has been little exploration of the nature of the nurse-older patient relationship within this setting.

An ethnographic approach using semi-structured interviews with 16 community nurses and 13 older patients (aged 65 years and over), were undertaken to explore the nature of care relationships within the home setting.

The study has highlighted the centrality of the location of care and the concept of 'the home' in terms of geographical and metaphorical meanings. Moreover, the study has clearly illuminated the complex nature of relationships and boundary construction from a number of perspectives.

As the location of care for older people continues to move closer to home it is crucial that the implicit qualities that are valued within nurse-patient relationships within this context of care, and which contribute to the quality of care, are recognized and made more explicit at the organizational and policy level.

For nurses working within the home there is a clear impetus to clearly define and articulate the full breadth of their role, the nature of relationships and issues surrounding professional boundary construction within this environment. There is also a need for the core qualities that underpin the receipt of care within the home and the facets of the nurse-patient relationship valued by older people to be fully recognized and accounted for.