Exploring Communicative Participation in Care Homes

Older people living in care homes are at risk of reduced communicative participation. Various approaches have been developed to promote communicative participation, which are largely initiated by researchers. However, to the best of our knowledge, no research to date has directly involved care home residents regarding the support they wish for in order to facilitate their communication. When it comes to research prioritisation, it is important to consider not only what should be researched, but also the way in which information is gathered. Involvement of the respective target group in research has increased considerably in recent years. Nevertheless, little research has been conducted on the perspectives of care home residents on the process by which they may be involved in research.

To investigate from the perspective of care home residents which support needs related to communicative participation should be prioritized in future research, and how residents wish to be involved in the research process.

The study is a qualitative consensus study using the Nominal Group Technique. Transcripts were analysed using reflexive thematic analysis.

A total of 10 older people from two care homes participated. Themes included research priorities at three levels: individual, social and organisational. According to the participants, future research should investigate the way in which they can be supported in their communication initiatives (individual level) and in which they are networking with like-minded individuals in the care home (social level). At an organisational level, designing care homes to promote communication is a research priority. In general, participants wanted to be involved in research that stimulates them, for example, by increasing their knowledge. They also wished for the process to be flexible and transparent, offering opportunities for genuine influence.

This study adds to the existing evidence regarding the relevance of communicative participation in care homes. It contributes insights into the way residents would like to be involved in research aiming at improving communicative participation. The study's findings provide possibilities for other disciplines involved in a care home setting to develop their own lines of (participative) research.

What is already known on this subject Care home residents are at high risk of reduced communicative participation, negatively affecting their quality of life. While research offers strategies to address this, residents' perspectives are crucial. Their involvement can enhance research relevance, allowing them to influence studies that impact them while fostering socialisation, knowledge, confidence and empowerment. Despite these positive effects, residents rarely are actively involved which is typically attributed to the highly structured nature of care homes and residents' specific health needs. Furthermore, it is unclear to what extent and in which way residents want to be involved in research examining communicative participation. What this study adds to the existing knowledge This study explores care home residents' perspectives on research regarding their communicative participation. Participants shared research needs at the individual, social and organisational levels. According to them, their communicative participation can be supported, for example, by networking assistance (individual), supportive strategies in communicating with persons with cognitive changes (social) and creating a communication-friendly environment (organisational). Participants were motivated to participate in research they find stimulating and that offers new knowledge. Due to individual preferences and the structured nature of the environment, the involvement process should be flexible. Transparency about the research process and its potential impact also encourages participation. What are the potential or actual clinical implications of this study? The results of this study demonstrate that a resident-centred approach to research priorities has revealed new insights. For instance, the results highlight the importance of fostering communication among residents, whereas existing research tends to focus on communication between residents and staff. These findings provide a basis for enhancing the communicative participation of nursing home residents and for planning their involvement in research in a setting-specific manner.