Older people's experiences of care in nursing homes: a meta-synthesis

Abstract

Aim: To integrate the current international knowledge and enhance our understanding of the experiences of older people of being cared for in nursing homes.

Background: There is a lack of integrated knowledge to help face the challenge of providing care to older people in nursing homes. Understanding the experiences of older people regarding their own care leads to interventions for reducing older people's suffering, while living in nursing homes.

Methods: Keywords describing the experiences of being cared for in nursing homes were used to systematically search electronic databases for qualitative research articles. A meta-synthesis study employing the interpretative meta-ethnography approach devised by Noblit and Hare was carried out to analyse seven qualitative articles identified during the search process.

Findings: Seven studies included in this meta-synthesis were published between 2007 and 2015. The experiences of older people of being cared for in nursing homes were expressed by the metaphor 'retaining the meaning of being alive'. Older people wished for a homelike place where they would be delivered care with the consideration of all its humanistic aspects. While conflict between their expectations and organizational demands damaged this sought ideal, adjustment to life conditions and taking an active role led to a feeling of being alive.

Discussion: This meta-synthesis integrates our knowledge on organizational and administrative demands, and personal factors influencing the provision of individualized care in nursing homes.

Limitations: The mental functionality of older people that suffer from dementia might impact on their ability to be involved in research and have a 'voice' in terms of their experience of being cared for in nursing homes.

Conclusion and implications for nursing: The institutional character of the nursing home restricts older people's decision-making. The challenge in nursing home care is to balance the tensions between the individual needs and the collective dimensions of care.

Implications for nursing policy: Nurse policymakers need to consider the ambience in nursing homes, develop a caring culture for the provision of a holistic care to older people and make the nursing home as close to a home as possible.

Keywords: Meta-Ethnography; Meta-Synthesis; Nurses; Nursing; Nursing Care; Nursing Home; Older People; Qualitative Research.