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Chapter 2: Literature Review
concept. The surrogate terms were identified in the literature as freedom and
participation. The literature also revealed the uses of autonomy as explained by
philosophers, social workers and other healthcare professionals. Step three requires
one to identify and select an appropriate realm for data collection. It was stated at the
outset that this research is focused on older people in residential care. Step four
requires one to identify the attributes for the concept. A concept, by definition, is a
cluster of attributes. The attributes of the concept constitute a real definition, as
opposed to a nominal or dictionary definition that merely substitutes one
synonymous expression for another (Rodgers, 1989). The attributes should be
present in all examples of the concept.
The attributes were delineated from the literature review (Table 2.2). Six key
attributes were deemed essential for autonomy for older people in residential care. 1)
Residents’ capacity encouraged and maintained. 2) Residents involved in decision-
making. 3) Residents’ delegate care needs based on the right to self-determination
and the rights of older people. 4) Negotiated care plans encouraged through open and
respectful communication. 5) Residential unit has a culture and atmosphere of
flexibility within an ethos of maintaining resident dignity. 6) Family or significant
others included when resident is cognitively impaired.