View/Open - ARAN - National University of Ireland, Galway

265
Chapter 7 Discussion
However, Nay (1998) argues there are impersonal factors in healthcare provision
that reduce the opportunities for care providers to communicate with residents
and their families and to subsequently develop successful interpersonal
relationships with them. These impersonal factors are time-poor, task-orientated
and socially isolating environments. Nay (1998) argues that it is these
impersonal factors that prevent the healthcare professional from addressing the
residents’ needs, interests and entitlements for decision-making.
7.2.4 Summary
Discussion of the findings at this point suggests that there are various promoting
and prohibiting factors for autonomy for older people in residential care. Sub-
theme 1a, The Person, identified promoting factors such as education and
gerontological specialism, resident independence, enablement of resident
decision-specific capacity and sharing of power. Prohibiting factors were
identified as a lack of education, resident dependence, prevention of resident
decision-specific capacity and not sharing power. Sub-theme 1b, The
Personality, identified promoting factors such as a desire to work with older
people, positive attitude toward older people and being open, motivated and
flexible. Prohibiting factors were identified as not choosing to work with older
people, negative attitude toward older people and being closed, demotivated and
inflexible. Sub-theme 1c, Person to Person, identified promoting factors such as
good interpersonal skills, good relationships (between residents, between staff
and residents, between staff, and between staff and family members), listening,
knowing the person (their past, present and future) and biological care planning.
Prohibiting factors were identified as poor interpersonal skills, poor relationships
(between residents, between staff and residents, between staff, and between staff
and family members), not listening, not knowing the person (their past, present
or future) and medicalised care planning.
7.3 Being Personal
The second theme, Being Personal, will now be discussed.