Improving Quality of Life for Older People in Long-Stay Care ...

choice regarding the gender of a care giver administering intimate care. Dignitycan also be upheld by respecting residents’ need for privacy through, for example,the provision of an adequate number of single rooms.Similarly, new regulatory structures must take account of the social world ofresidents. Personal and group identity can be sustained by maintaining anddeveloping contact with families and local communities. Residential care unitsshould be at the centre of communities, drawing in people from the outsidethrough family contacts and intergenerational programmes of activities. Contactswith active retirement associations, schools and voluntary groups should bedeveloped and maintained to foster relationships at all levels. Connectedness canbe improved by ensuring that the physical layout of the facility encourages visitingand social interaction. Tables that residents can sit around and chat or interactwould be an improvement on chairs lined around the walls facing the television.Residents should also be grouped together according to mental, not physical,capability. Flexible visiting hours and the provision of private space to entertainvisitors, including child friendly areas, will also contribute to greater socialinteraction and connectedness with family and friends.Any new regulatory structure must also ensure that the autonomy and capabilitiesof residents are recognised and understood. For example, with respect to activitiesit is essential that those on offer should be meaningful and provide the residentwith interest and stimulation. Therefore, residents should be consulted about whatactivities to offer in the care setting. Residents should also be given the choice ofparticipation in available activities. Residential care staff face a common dilemmaregarding the health and safety of residents and the degree of acceptable risk.Residents must be allowed to decide on the level of risk they are willing to take.Balancing risk with health and safety and allowing residents to take greater riskswould enable residents to have a greater involvement in the running of the nursinghome. Enabling those residents who wish to become more involved in the runningof the care facility and participate in activities lends a sense of empowerment toresidents and makes them feel useful, thereby contributing to their sense of self.It also makes the care establishment seem more of a home and less of aninstitution. On the other hand, many residents are happy to be freed of theseresponsibilities so they can relax and enjoy their retirement more fully. If that is thecase, then they should not be pressurised into doing things they do not want to do.227