title: Being perceived as a 'visitor' in the nursing staff's working arena--the involvement of relatives in daily caring activities in nursing homes in an urban community in Sweden.
abstract: BACKGROUND
  It is both complex and difficult for relatives when a loved one moves into a nursing home and many relatives are not prepared for the realities these new situations entail. Little attention has been paid to scrutinising the involvement of relatives in patient care, particularly in relation to the structures and routines of nursing homes or to the staff's reasoning concerning their involvement.
  
  
  OBJECTIVE
  To describe, from a gender perspective, how nursing staff's routines and reasoning act to condition the involvement of relatives in nursing homes.
  
  
  METHODS
  Focused ethnographic fieldwork was conducted in a medium-sized urban community in central Sweden in three different nursing homes.
  
  
  RESULTS
  The nursing staff assigns a certain code of conduct to all relatives they perceived as 'visitors' in their working arena. This code of conduct was related to the routines and subcultures existing among the nursing staff and stemmed from a division of labour; the underlying concept of 'visitor' predetermined the potential for relatives' involvement. This involvement is explicitly related to the general gendered characteristics that exist in the nursing staff's perception of the relatives.
  
  
  CONCLUSIONS
  The study's limitations are primarily concerned with shortcomings associated with a research presence during the fieldwork. The discussion focuses on the dimensions of power structures observed in the nursing home routines and the staff's reasoning based on their gendered assumptions. We argue that it is important to develop mechanisms that provide opportunities for nursing staff in elderly care to reflect on these structures without downplaying the excellent care they provide. We stress the importance of further exploring these issues concerning relatives and their involvement in nursing homes to facilitate the transition from informal caregiver to 'visitor'.
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. jessica.holmgren@ki.se
authors.forename: Jessica
authors.initials: J
authors.lastname: Holmgren
authors.forename: Azita
authors.initials: A
authors.lastname: Emami
authors.forename: Lars E
authors.initials: LE
authors.lastname: Eriksson
authors.forename: Henrik
authors.initials: H
authors.lastname: Eriksson
mesh_terms: D017028:Caregivers; D005190:Family; D009735:Nursing Homes / Q000458:organization & administration*; D009740:Nursing Staff; D013548:Sweden; D019037:Urban Health Services / Q000458:organization & administration*