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Chapter 2: Literature Review
literature was the organisation’s approach to residential care. It was suggested that if
residential care moves from task-based care to person-centred care then older
people’s autonomy will be enhanced. Policy documents recognise that autonomy is
an integral ingredient in person-centred care and subsequent quality of life. The role
of the nurse within the care environment was also reported to be important for
residents’ experiences of autonomy, and it was suggested that educational
programmes need to be delivered in a way that can equip nurses with the knowledge
and skills to promote resident autonomy. The role of the family was suggested to be
significant in terms of staff getting to know the resident and planning with them how
they would like to spend their day. This section also highlighted the importance of
negotiated care planning for the realisation of a resident’s autonomy. Finally, the
literature revealed that negative staff attitudes in relation to ageing may impact upon
the level of autonomy experienced by residents.
The literature review revealed that of the few studies undertaken, the majority had
adopted qualitative approaches. The most common data collection methods included
interviews and observations. The most informative study adopted a case study
approach (Forbes-Thompson and Gessert, 2005). It yielded succinct and richly
descriptive findings, suggesting that examination of this research phenomenon lends
itself well to a case study approach. The lack of operationalisation of the
phenomenon suggests that action- or practice-based research approaches are also
required in order to advance our understanding of autonomy for older people in
residential care.
To summarise it can be established at this point what is known and unknown about
resident autonomy:
What is known about resident autonomy:
It is known that autonomy is integral to person centred care and subsequent
quality of life for older people in residential care.
It is known that policy makers and older people themselves believe that
person centred care is related to quality of life in residential care. It is also