The emotional context facing nursing home residents' families: a call for role reinforcement strategies from nursing homes and the community.
OBJECTIVE
Identify useful concepts related to the emotional context facing family members of nursing home residents. These concepts can be used in future studies to design and test interventions that benefit family caregivers.


METHODS
Secondary data analyses of qualitative ethnographic data.


METHODS
Two nursing homes in a large Midwestern city; 8 months of data collection in each.


METHODS
44 family members of nursing home residents whose health was considered, "declining."


METHODS
Role theory was used to design and help interpret the findings. Data included transcripts of conversations between family members and researchers and were analyzed using a coding scheme developed for the secondary analysis.


RESULTS
Comments about emotions related to the social role of family member were grouped into three categories: relief related to admission, stress, and decision making support/stress. Subcategories of stress include the role strain associated with "competing concerns" and the psychological pressures of 1) witnessing the decline of a loved one in a nursing home, and 2) guilt about placement. Decision-making was discussed as a challenge which family members did not want to face alone; support from the resident, health care professionals, and other family members was appreciated.


CONCLUSIONS
Family members may benefit from role reinforcement activities provided by nursing home staff and community members. All nursing home staff members (in particular social workers) and physicians are called upon to provide educationa and support regarding nursing home admissions, during the decline of the resident, and especially regarding medical decision-making. Community groups are asked to support the family member by offering assistance with concrete tasks (driving, visiting, etc.) and social support.
Bern-Klug
Mercedes
M
University of Iowa School of Social Work & The Aging Studies Program, Iowa City, IA 52242, USA. mercedes-bern-klug@uiowa.edu
D000328:Adult; D000368:Aged; D003159:Community-Institutional Relations; D003657:Decision Making; D004644:Emotions; D005190:Family / Q000523:psychology*; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D009735:Nursing Homes; D010343:Patient Admission; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology