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Chapter 1: Introduction and Background
1.4 The Guiding Conceptual Framework for the Study
Due to the lack of consensus in the literature about what autonomy for older people
in residential care actually means, a concept analysis of resident autonomy was
undertaken at the outset and this was then used to guide this research (Welford et al.,
2010). The next chapter, the literature review, details this process.
The following attributes of resident autonomy were delineated from the concept
analysis:
Residents delegate care needs based on the right to self-determination and the
rights of older people.
Residents’ capacity is encouraged and maintained.
Negotiated care plans through open and respectful communication. Family or
significant others included when the resident is cognitively impaired.
Residential unit has culture and atmosphere of flexibility within an ethos of
maintaining resident dignity.
Residents involved in decision-making.
Antecedents for resident autonomy were also identified:
Staff attitudes are positive in relation to ageing and older people.
Values and beliefs of staff are person-centred and non-paternalistic.
Staff communicate effectively with each other, with residents and with
visitors.
Resident assessment is robust and involves gathering life histories.
An atmosphere of openness, motivation and flexibility.
Respect for dignity and for fellow human beings evident between staff, and
between staff and residents.