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Chapter 2: Literature Review
whether or not an act is autonomous requires the act to be assessed within the
context of the person’s life. It is suggested that when a person has dementia then
their life history can be used to assist caregivers with offering them options for
everyday decisions that are consistent with their life history.
Tutton (2005) and Cook (2010) stated that understanding patients’ personal histories
and biographies creates opportunities for knowing what is important to them. It also
provides an insight into how they are experiencing their present situations. Tutton
(2005) reported that knowing the (authentic) person and how they would like to live
their daily life provides the basis for participation in daily care. Thus compilation of
life plans may impact upon whether or not an older person in residential care
experiences autonomy. Furthermore, the importance or value that staff place on
getting to know the resident in order to compile these life plans may be determined
by their own attitudes about older people.
2.3.7 Staff Attitudes
Randers and Mattiasson (2004) state that research has shown healthcare
professionals’ values, beliefs and attitudes towards older patients affect how they
view and approach the patients in their care, and this ultimately affects the level of
autonomy and quality of care they experience. Rodgers and Neville (2007) supported
this by stating that negative or ageist attitudes towards older people are a direct threat
to their autonomy. Katz (1960) defined an attitude as an individual predisposition to
evaluate a symbol, object or aspect of the individual’s world as positive or negative.
Wesley (2005) stated that attitudes shape individuals’ ability to understand, organise
and clarify the world around them and influence the individual’s behaviour and
knowledge acquisition. More recently, Mandy, Lucas and Hodgson (2007) explained
that attitudes may be considered to be a combination of positive and negative
evaluations by which we interpret events, situations and relationships. They are
based on our own experience of what others have told us, or what others have
patterned for us. Several researchers have connected healthcare professionals’ level
of knowledge about ageing with positive attitudes (Mandy, Lucas and Hodgson,
2007; Wells et al., 2004; Wade, 1999), while others have suggested that negative
attitudes arise out of the type of work often associated with caring for older people
(Wells et al., 2004; Pursey and Luker, 1995; Hope, 1994). In contrast, Salmon