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“Every single morning I ask them if they want to get up.”
(S01)
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Chapter 5 Findings
“It would be nice to offer them the choice but sometimes there is
the practice of everybody has to get up or everybody has to stay in
bed.”
(S11)
“I get choice with clothes. But making other decisions it can be
difficult. Some are very obliging but once again it’s the time limit.”
(R07) (Barthel 8)
Choices available and unavailable seemed to centre around basic physical care:
“Well the main choice for them is whether they are going to get up
out of bed or not, that’s the main thing they have, or whether they
want a shower or a bath. Other than that they don’t have a choice.”
(S07)
“We went in and we gave him a bed bath and we sorted his bowels
out and he was very appreciative.”
(S11) (Barthel 11)
The following quote really summarises how and why compromises around the
choices available are made in residential care:
“But as I settled into the work and being involved in it physically
on a full-time hours a week basis, I can see sometimes unless there
is a compromise somewhere we can’t do everything. We can’t have
people in bed at a certain time and have the energy to put more
people in bed later and get all the work done if there isn’t
compromise somewhere, and sometimes that compromise is to
come with saying to the patient: ‘Really I need to put you back at 5
o’clock, I’d love to leave you up until half six but this is the
situation, we have two other gentlemen that have to go back as they
are heavy and the night staff need a certain amount of this work
done by 8pm’. So that is where the compromise is and
unfortunately it’s more for the patient giving up their choices than
for us.”
(H03)
The sub-theme “The Person”, whilst describing the independence and
dependence of the resident person and the staff person’s ability to encourage
their capacity to be involved in their care and in making decisions, also describes
the conflict between “doing for” residents and enabling “self-doing”, which is a
person’s basic human right. Being “self-governing, self-ruling, self-determining”