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Chapter 7 Discussion
templates included prompts for positive statements and incorporated language
which promotes negotiation and agreement. Furthermore, the use of critical
companionship mentoring in phase two of this research supported the staff with
developing their negotiation and capacity building skills with the residents. Thus
it is recommended that residential care units seek out potential critical
companions in order to facilitate changes in practice which may enhance resident
autonomy.
The findings suggest that management structures can promote or prohibit
resident autonomy. Frustrations were expressed in relation to the management
structures and it was suggested that this in turn affects morale and motivation to
change. Flexible, open and supportive approaches to care were viewed to
positively impact upon resident autonomy. On the basis of these findings it is
recommended that all managers or leaders in residential care for older people
adopt this flexible, open and supportive approach to care. Transformational
leadership may help in achieving this.
This research found that some staff felt that their colleagues held negative
perceptions about working with older people. The concept analysis also revealed
that positive attitudes toward older people are important for resident autonomy. It
is therefore recommended from this research that nurses and other health care
professionals must engage in and promote activitieswhich may reduce negative
stereotypes about older people. In addition this research found that all staff of all
grades who work with older people should choose to work with older people and
hence employers in residential care should actively seek out potential staff
members who have a desire to work with older people.
In summary it is recommended in order to enhance resident autonomy that nurse
educators should focus on improving nursing knowledge and skills for
biographical care planning, negotiation and resident capacity building. In
practice, organisations should foster a flexible, open and supportive approach to
care which is managed by transformational leaders, supported by critical
companions and delivered by staff with positive attitudes about ageing and older
people.