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Chapter 7 Discussion
view as it was observed that there were long periods of inactivity for some
residents even though many of the staff participants in the interviews recognised
the importance of providing meaningful activity as part of their role. Langer
(1983) suggests residents’ passivity in their day may be due to the older person’s
perception that they lack ability to exercise control over their lives.
However,Scott et al. (2003) pointed out that not all older patients want to be
active. One of the antecedents from the concept analysis for resident autonomy
identifies the importance of robust resident assessment and it is suggested that
this level of assessment can inform the healthcare professional about what level
of activity the resident wishes to have or what recreational activities are
important and meaningful to them. Ostlund (2009) suggested that TV viewing
can be considered to be a meaningful activity for older people in residential care.
It was suggested that TV is useful for coping with disengagement, for adapting to
new technologies, as a reference to the rest of the world and can be a social and
private experience. However, in this study it was observed that few residents had
access to their own TV and that communal TV’s were often left on all day with
nobody really watching them. It has been suggested that assessment of past and
present life situations may shape residents’ current recreational wishes (Atkins,
2006; Quill and Brody, 2006; Tutton, 2005; Davis, Ellis and Laker, 2000;
Beauchamp and Childress, 1994; Lidz, Fischer and Arnold, 1992; Gillon, 1990;
Kant, 1989; Meyers, 1989; Feinberg, 1989; Collopy, 1988) and contribute to
personalised care which realises autonomy.
One resident in this study stated that “if I was at home I would be doing things
around the house….I was a tradesman”. He expressed frustration at the lack of
personalised care for him. Whitaker (2004) describes how older peoples’
tiredness is not always related to ageing but is influenced by the inactive care
culture in nursing homes. Similarly, one resident in this study commented “what
would you expect in a home” which suggests that older people have low
expectations of the type of activity they can experience in residential care.
Another resident commented that the day room was not her “scene” while one
resident stated that “it’s the same every day”. Staff participants described their
wishes to “get the residents out” but could not suggest ways to meet this resident
need. Phase two of this research introduced a care plan which had a “social