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Supporting autonomy in long-term care: Lessons from nursing assistants
M Lindsey Jacobs1, A Lynn Snow2, Rebecca S Allen3
1Department of Psychology, The University of Alabama, USA.
Geriatric Nursing (New York, N.Y.)
|August 21, 2018
Summary
Nursing assistants (NAs) use ten autonomy-supportive tactics to maximize resident autonomy in nursing homes (NHs). These person-centered care (PCC) techniques promote independence, even with cognitive or physical limitations.
Area of Science:
- Gerontology
- Nursing
- Healthcare Management
Background:
- Maximizing autonomy is a core principle of person-centered care (PCC) in nursing home (NH) settings.
- Nursing assistants (NAs) play a crucial role in implementing PCC and supporting resident autonomy.
Purpose of the Study:
- To identify and describe specific autonomy-supportive techniques employed by NAs.
- To understand how NAs promote resident autonomy within NH environments.
Main Methods:
- Qualitative study involving 13 interviews with NAs.
- Approximately 80 hours of direct behavioral observation of NA-resident interactions across three NH neighborhoods.
- Thematic analysis of collected data.
Main Results:
- Ten distinct autonomy-supportive tactics were identified: assisting, monitoring, encouraging, bargaining, informing, providing instructions, persuading, asking, providing options, and redirecting.
- All identified tactics supported resident autonomy to varying degrees, with some being more restrictive than others.
- Specific NA actions were elucidated that can foster resident autonomy despite cognitive/physical limitations or safety concerns.
Conclusions:
- NAs utilize a range of techniques to support resident autonomy in NHs.
- Understanding these tactics can enhance the implementation of person-centered care best practices.
- These findings offer practical strategies for NAs to promote autonomy while ensuring resident safety.
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