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Chapter 2: Literature Review
Table 2.2: List of attributes of autonomy for older people in residential care
Attributes
Residents’ capacity encouraged and maintained.
(Boyle, 2008; Harnett and Greaney, 2008; Faulkner and Davies, 2006; Beauchamp
and Childress, 1994; Hofland, 1994; Agich, 1990; Gillon, 1990; Feinberg, 1989;
Collopy, 1988; Abramson, 1985;Mill, 1975).
Residents involved in decision-making.
(Boyle, 2008; Faulkner and Davies, 2006; Dooley and McCarthy, 2004;Beauchamp
and Childress, 1994; Hofland, 1994).
Residents’ delegate care needs based on the right to self-determination and the
rights of older people.
(Agich, 2004; Hofland, 1994; Horowitz. Silverstone and Reinhardt, 1991; Kant,
1989; Collopy, 1988;Mill, 1975).
Negotiated care plans encouraged through open and respectful communication.
(McCormack et al., 2008; Atkins, 2006; Quill and Brody, 2006; Tutton, 2005;
Agich, 2004, 1990; Davis, Ellis and Laker, 2000;Beauchamp and Childress, 1994;
Lidz, Fischer and Arnold, 1992; Gillon, 1990; Feinberg, 1989; Kant, 1989; Meyers,
1989; Collopy, 1988).
Residential unit has a culture and atmosphere of flexibility within an ethos of
maintaining resident dignity.
(McCormack et al., 2008; Faulkner and Davies, 2006; Agich, 1990; Collopy, 1988).
Family or significant others included when resident is cognitively impaired.
(Boyle, 2008; Harnett and Greaney, 2008; Hertzberg and Ekman, 2000; Ryan and
Scullion, 2000; Beauchamp and Childress, 1994; Duncan and Morgan,
1994;Hofland, 1994; Robinson, 1994; Doyal and Gough, 1991; Ekman and
Norberg, 1988).
Several authors acknowledged the importance of one’s capacity in order to exercise
ones autonomy (Mill, 1975; Abramson, 1985; Collopy, 1988; Feinberg, 1989; Agich,
1990; Gillon, 1990; Beauchamp and Childress, 1994; Hofland, 1994; Boyle,
2008).Gillon (1995) explained that this capacity is about being able to think, to
decide and to act freely and independently and without hindrance. Feinberg (1989)
advised that capacity must be encouraged and maintained. Cognitive impairment
should not be assumed to reduce ones capacity (Doyal and Gough,1991; Hofland,
1994; Boyle, 2008; Harnett and Greaney, 2008). Many explained that in addition to
capacity, older people have fundamental rights which include self-determination and
that they delegate care needs based on these rights (Mill, 1975; Collopy, 1988; Kant,
1989; Horrowitz, Silverstone and Reinhard, 1991; Hofland, 1994; Agich, 2004).
There was a lot of discussion in the literature about the importance of recognising the
subjective element of autonomy which recognises older peoples’ needs, values, goals