Autonomy for elderly people in long-term care

Area of Science:

• Gerontology and Long-Term Care
• Healthcare Quality Improvement
• Patient Autonomy Studies

Background:

• Autonomy is a critical aspect of quality of care in long-term settings.
• Assessing resident autonomy requires standardized evaluation methods.
• Previous assessments have not comprehensively evaluated autonomy across diverse long-term care facilities.

Purpose of the Study:

• To evaluate the extent of autonomy exercised by residents in long-term care facilities.
• To identify specific areas where resident autonomy is well-supported and where improvements are needed.
• To assess the utility of the CARE scheme for evaluating autonomy in long-term care.

Main Methods:

• A cross-sectional audit was conducted in 17 long-term care facilities.
• The Royal College of Physicians' CARE (Continuous Assessment Review and Evaluation) scheme was utilized.
• Data were collected from 298 residents to assess various indicators of autonomy.

Main Results:

• Most facilities offer choices regarding information, services, and complaints.
• Less than half of residents have a key worker, and care plans often lack detailed content.
• Indicators of choice scored higher in nursing homes than in hospitals; advocates are present for residents with competence issues.

Conclusions:

• While some autonomy is supported, significant gaps exist, particularly in resident involvement in policy and detailed care planning.
• Existing care plans provide a foundation for enhancing resident autonomy.
• Regular audits using schemes like CARE can inform a national quality system for long-term care.