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Nudging in the nursing home: A qualitative interpretive study.

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Nudging in nursing homes guides resident choices and behaviors. Experienced caregivers effectively use nudging for efficient care and improved interactions, balancing influence with resident well-being.

Keywords:
AutonomyCare RoutinesDignityExperienced caregiversNudgingNursing homesSoft paternalism

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Area of Science:

  • Gerontology
  • Healthcare Ethics
  • Behavioral Science

Background:

  • Nudging, a method of influencing choices through environmental changes, is debated for its ethical implications in healthcare, particularly concerning autonomy and informed consent.
  • While some view nudging as manipulation, others argue it respects freedom and autonomy by aligning with personal values and preventing more intrusive paternalism.
  • The increasing use of soft paternalism via nudging necessitates an examination of its application within healthcare settings.

Purpose of the Study:

  • To explore the phenomenon of nudging within the specific context of nursing home environments.
  • To understand how nudging strategies are implemented and perceived by caregivers in long-term care settings.

Main Methods:

  • A qualitative interpretive research design guided by Gadamer's hermeneutics was utilized.
  • Observations lasting seven to eight weeks were conducted across three distinct Norwegian nursing home units (long-term, dementia, rehabilitation).
  • Interviews were held with caregivers, including nurses, auxiliary nurses, occupational therapists, and physiotherapists.

Main Results:

  • Nudging in nursing homes manifested through three primary themes: modification of physical surroundings, strategic use of information and interaction, and the implementation of ambiguous interventions.
  • Caregivers navigate a spectrum of influence, from subtle nudging to assertive persuasion, when guiding residents' choices and behaviors.
  • The study identified that experienced caregivers effectively employ nudging to streamline care routines, enhance efficiency, and foster better resident-caregiver interactions.

Conclusions:

  • Nudging is actively employed in nursing homes to guide residents toward choices and behaviors that promote well-being and align with social norms.
  • Caregivers face complex considerations when utilizing various influence strategies, including nudging, to support residents.
  • Effective nudging by experienced caregivers contributes to efficient care delivery and improved interpersonal dynamics within nursing homes.