Elements of assisted bodily care : Ethical aspects

• Background: Many frail older persons who die in Swedish nursing homes need assisted bodily care. They must surrender their bodies to the authority of assistant nurses, which may affect their autonomy, and dignity of identity. While assistant nurses claim to support older persons’ wishes, older persons claim having exposedness to assistant nurses’ routines. The provider-receiverin congruence revealed here warrants investigation.Aim: To describe the elements of assisted bodily care, as performed in a nursing home.Research design: Data were collected through thirty-nine observations of assisted bodily care, analyzed with qualitative content analysis.Participants and research context: Seventeen older persons and twenty-two assistant nurses from a Swedish nursing home.Ethical considerations: The research was conducted in line with the Declaration of Helsinki,further approved by the regional ethics committee.Findings: Findings show, that assisted bodily care consists of assistant nurses’ practical work, performed at a high tempo. Still, assistant nurses attempt to adapt this work to older persons’wishes for self-determination, taking into account their day-to-day state of health. In spite of time pressure and occasional interruptions, there is room for consideration and affection in assisted bodily care.Discussion: Assistant nurses try to promote older persons’ dignity of identity, but sometimes fail, possibly due to lack of time. On the contrary, they seem to know older persons well enough to adapt assisted bodily care according to their preferences and support self-determination. This indicates that openness to older persons’ life-worlds may be more important than the amount of time available.Conclusions: Nursing home contexts might benefit from adopting a person-centered palliative care perspective, highlighting the value of relationships and shared decision-making. If so, older persons and assisted nurses could prepare agreement on practices and goals in assisted bodily care beforehand. Such routines may be time-saving and beneficial to all.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Medicinsk etik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Medical Ethics (hsv//eng)

Nyckelord

Assistant nurses

Bodily care

Dignity

Ethics

Nursing home

Människan i välfärdssamhället, Palliativ vård

The Individual in the Welfare Society, Palliative Care

Omvårdnad

Publikations- och innehållstyp

ref (ämneskategori)

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