On sources of powerlessness in nursing home life

As feelings of identity and integrity are important for old people's efforts to maintain a healthy life, experiences of powerlessness ought to be prevented. This paper describes sources of powerlessness in nursing home life. Participant observations regarding lucid, elderly patients were undertaken in two Swedish nursing home wards. The observations focused on interactions on the wards, observed patient reactions and structural/functional conditions of life on the wards. The constant, comparative analysis searched for events or conditions which seemed to result in reactions signifying positive or negative experiences. Tender, loving care, strong cohesion and affection between patients and personnel were typical of the observations, yet patients complained of imprisonment, powerlessness and hopelessness. Observations are reported as related to legitimate, reward, expert, informational and reference power, self-confidence/respect and socialization. Also existential sources of powerlessness were identified. It is concluded that many factors co-operate to create feelings of powerlessness in the patients. Empowerment measures are suggested on organizational, interactional and personal levels.