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Intersectional perspectives on family involvement in nursing home care: rethinking relatives' position as a betweenship
Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge.ORCID iD: 0000-0002-8551-3264
Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge.
Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge.
Red Cross University College of Nursing.ORCID iD: 0000-0002-0335-3472
2014 (English)In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 21, no 3, 227-237 p.Article in journal (Refereed) Published
Abstract [en]

This study seeks to understand, in the context of intersectional theory, the roles of family members in nursing home care. The unique social locus at which each person sits is the result of the intersection of gender, status, ethnicity and class; it is situational, shifting with the context of every encounter. A content analysis of 15 qualitative interviews with relatives of nursing home residents in Sweden was used to gain a perspective on the relationships between relatives and residents, relatives and the nursing home as an institution, and relatives and the nursing home staff. We sought to understand these relationships in terms of gendered notions of the family and the residents, which are handed down from generation to generation and thus condition who and how relatives should be involved in care, and the ways in which relationships change as care moves from home to nursing home. It requires knowledge and awareness that the nursing home culture is based on intersectional power structures in order for relatives to be involved in nursing home care in alternative and individual ways.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014. Vol. 21, no 3, 227-237 p.
Keyword [en]
elder care, institutional care, intersectional perspective, involvement, nursing homes, nursing staff, power structure, relatives
National Category
Nursing
Identifiers
URN: urn:nbn:se:rkh:diva-704DOI: 10.1111/nin.12046PubMedID: 23875545OAI: oai:DiVA.org:rkh-704DiVA: diva2:642073
Available from: 2013-08-20 Created: 2013-08-20 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Conditions for relatives' involvement in nursing homes
Open this publication in new window or tab >>Conditions for relatives' involvement in nursing homes
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe and analyse how the involvement of relatives is conditioned in nursing homes from different critical perspectives. Gender perspectives, discourse analysis and intersectional theory are applied, based on social constructionist ontology. The thesis comprises three qualitative papers and data are based on ethnographically-focused fieldwork in three municipal nursing homes in the form of formal/informal interviews, participating observations and the analysis of documents.

Based on gender perspectives, the routines and reasonings among nursing staff were studied and thematically analysed in relation to how these conditioned the involvement of relatives in the daily caring activities (I). In the second study (II), the nursing staff were interviewed in groups to describe, discursively analyse and identify the biopolitical meaning in the "involvement discourse" that was collectively constructed in the speech of the nursing staff concerning the involvement of relatives. In the last study (III), interviews with relatives were thematically analysed in the context of intersectional theory about their involvement in the nursing homes.

The findings show that the conditions for relatives’ involvement were dynamic and constantly in re-negotiation, but also conservative and inflexible. This placed relatives in both privileged and unprivileged social positions in the nursing homes, which were relevant for their involvement. The relatives were considered to be "visitors", which conditioned the characteristics and levels of involvement in the care of the residents and was linked to gendered notions of the division of labor, both within the groups of relatives and between nursing staff and relatives (I). The involvement of relatives was conditioned by the biopolitics of an "involvement discourse" that prevailed in the nursing homes. This built upon family-oriented rhetorics and metaphors that upheld and legitimised notions about relatives. The relatives were considered to be members of the "old" family in relation to the "new" family represented by the nursing staff (II). The relatives described how they were positioned in a betweenship, squeezed between different competing social musts from the older family members, the nursing homes as institutions and the nursing staff (III).

Inverting the prevailing picture of the involvement of relatives would make it possible to consider the nursing staff as pedagogical, professional and caring "visitors" in the nursing homes for the benefit of the residents and their relatives. This could be achieved through a constructive change management which emphasises the learning of nursing staff, their responsibility and the emotions of relatives, along with a focus on alternative notions of involvement, where relatives are included in the development of quality of care in Swedish nursing homes.

Place, publisher, year, edition, pages
Karolinska Institutet, 2015. 62 p.
Keyword
discourse analysis, focused ethnography, focus group interviews, gender perspectives, intersectionality, involvement, nursing homes, nursing staff, participant observations, qualitative interviews, relatives, social constructionism and thematic analysis
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-1858 (URN)978-91-7549-872-0 (ISBN)
Public defence
2015-05-26, H3 Blå, Alfred Nobels Allé 23, Huddinge, 13:00
Opponent
Supervisors
Available from: 2015-05-26 Created: 2015-05-25 Last updated: 2015-08-04Bibliographically approved

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Holmgren, JessicaEriksson, Henrik

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