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Chapter 7 Discussion
7.4 Summary, Recommendations, Limitations and Conclusions
It was established at the outset that there was no consensus on the meaning of
autonomy for older people in residential care. A subsequent problem identified
was whether or not older people in residential care actually experience
autonomy. Thus the central aim of this research was to explore autonomy for
older people in residential care. Firstly, a concept analysis of resident autonomy
was undertaken in order to clarify its meaning. Secondly, the concept analysis
was used to inform the development of research data collection tools. Research
suggests that autonomy can be viewed from many perspectives and hence both
objective and subjective data was collected in one case study site from interview,
observation and documentary sources. Two core themes emerged: The Personal
and Being Personal. This then generated a secondary aim for the research which
was to enhance one aspect of resident autonomy in the case study site. An action
research approach was adopted in order to meet this aim.
The findings provide information for practitioners, educators and researchers
about resident autonomy. For practitioners, the research describes resident
autonomy from many perspectives in the real world setting. For educators, it
describes the knowledge, skills and attitudes that health care professionals
working with older people in residential care need to possess in order to enhance
resident autonomy. For researchers, it demonstrates one way in which the
concept of autonomy for older people in residential care may be operationalised
and paves the way for further research. Therefore the final recommendations are
made on the basis of these collective findings.
7.4.1 The Personal
As early as the nineteen seventies Mill (1975) suggested that autonomy was
about “one’s own conception of the good life” and yet this research found that
nurses today still struggle with understanding, negotiating and documenting what
this conception is for each resident for whom they care for. This research found
that the residents autonomy was affected by the lack of the nurse participants
care planning skills. It was found that the nurses did not always focus on what
matters to the resident, did not try to get to know the resident as a person and