While nursing homes have begun to transform themselves—including their physical spaces, relationships between staff and residents, and technology—for both a better resident experience and improved healthcare outcomes, the reality is that the ideal place in which seniors would live out there final chapter is at home. InformationWeek outlined the top eight home health and IoT technologies that are emerging:.
While these technologies may seemingly be the panacea for senior living, obvious simplifications usually involve some hidden complications as well. We must carefully plan and orchestrate all interactions for seniors—from making these devices easy for seniors to use to ensuring that all healthcare stakeholders can interact remotely with seniors. Our role as experience designers is key to the successful use of home healthcare technologies. Department of Health and Human Services. Connecting Families to Senior Living. Senior Care Types Explained.
Retrieved March 9, Retrieved March 11, State Operations Provider Certification. Retrieved March 20, Retrieved March 16, Based on these standards: Buildings are organized into nursing units of approximately 40 residents, each in a shared room. A large nursing station is situated for easy eye contact in all directions.
Residents share communal bathing and shower areas. There is often a day room at the far end of the complex. There are large dining and activity spaces. Commercial kitchens, laundries, and other areas are off-limits to residents. Transforming the Nursing-Home Model To transform the nursing-home model that the government instituted decades ago, several forces have needed to unite: Thus, they do not need to comply with antiquated guidelines that are still mandatory for facilities that want government funding.
Moreover, seniors often prefer them to nursing homes By giving nursing homes some competition, they also ensure that seniors have more options. If we reflect on the transformation efforts organizations are pursuing relative to leveraging digital or being more customer focused, the following insights surface: They understand the importance of people to their transformation efforts. Whether focusing on employees or customers, the human side of a service is key.
They emphasize experience-based outcomes. As designers, we appreciate how people feel about an experience, but this is new territory for many organizations. Sleeping in a peaceful place transforms a physiological need into a pleasure. For example, provide a discreet bedroom—not a studio—that is large enough for a bed and wardrobe and has sufficient space for navigating around the room in a wheelchair. Feeling autonomous and safe while taking care of oneself increases self-esteem. Here are some examples: Use toilet-flushing buttons that residents can activate with the whole hand and require little force.
Install mirrors at a height that allows a seated person to see himself or herself. Provide a single large work area that is accessible to wheelchairs, has rounded corners, is strong enough to lean on, and can be lowered. Allow sufficient space for a table and chairs, ideally with a clear view of the TV and other spaces. A cozy, hospitable space stimulates socializing. For example, provide areas in the home for guests—such as a sofa bed.
Design Trends in Person-to-Person Interactions As I mentioned earlier, private senior-living options—which are often preferred—have caused the publicly funded nursing homes to take a hard look at themselves and make improvements. Provide hour access to approved visitors—not only family members. Moreover, nursing homes have to prove that visitors are aware of this policy—that is, it is encouraged rather than kept hidden. Encourage residents to dress in their own clothes and assist them in dressing rather than requiring hospital gowns.
Maybe all people need is to know they are cared for, even by a simple stranger. Moreover, I was stunned by the optimism they had for their future, even at old age. They were so youthful in spirit, regardless of their frail bodies. They were selfless enough to tell me to take care of myself , even if they were the ones in wheelchairs. It taught me that happiness can exist, even at old age, regardless of discouraging circumstances or diminishing health.
I learned that the rewards of volunteering is a two-way street. Just wanted to say a big "you're welcome! I think though, that we also owe you a big thank-you for all of your fantastic Thank you for your My Experience Volunteering at the Nursing Home. It truly is a beauty. First, a systematic review of the researchers' pre-understanding of the phenomenon was performed in order to become aware of and set aside pre-conceptions.
This phenomenological reduction began with a suspension of beliefs, assumptions, and biases about the phenomenon under investigation SHA versus what was already known about the SHA. Furthermore, it also involved some reflection on the perspective and the knowledge about a SHA from all sides including, from the professional, researchers, and the institutional perspective.
The researchers' pre-understanding has been acquired through many years of working in senior care, as heads of department and assistance assessment officer, and as a researcher. The transcribed interviews were read thoroughly several times to obtain an overall representation of the material. The materials components were then identified on an intuitive level followed by an interpretive reading to identify meaning in supporting units within the different components.
These units were carefully read and re-read to note changes or nuances in the meaning. A close dialogue with the text was held Gadamer, concerning questions of relevance to the research aim: This part of the analysis is described by Dahlberg b as being distant and then coming closer. Therefore, the researchers focus must be on how they choose their viewpoints, outlooks, distances, and perspectives when they try to understand something and how they make phenomena and their meanings explicit.
This is about moving between figures and backgrounds. The hermeneutical analysis continued with the interpretation of the oral accounts of the senior's experiences applied with sensible understanding of what the text was about and vice versa, thereby engaging the hermeneutic circle of having the meaning of the whole of the text inform the meaning of the parts of the text and vice versa Schwandt, The relevant statements were separated and recorded.
The statements of meaning were then collected into constituents and are also considered relevant to the phenomenon, here ambiguity in existence was found in the interviews. In the following, the results of the analysis are shown with an illustration of the data material. The phenomenon of lived experience in a SHA seems to be a state of ambiguity of existence. This phenomenon is manifested in the data material in the shape of varying constituents. In the proceeding sections, we describe this structure in the subjective orientation of the phenomenological meaning of a SHA.
This is also to show the temptation to be subjective and involved in the particularities and at the same time to show the temptation to be abstract and general in the descriptions. In other words, the repeated phrase shows the general patterns of ambiguity of existence the phenomena in the whole data material. In the following extract, the constituent of embodied experience of residential living is specified to show a state of ambiguity of existence.
The embodied experience means that the senior is bound by their body to the experience of waiting. An ordinary day in a SHA is experienced as a borderland between waiting, loneliness, and the joy of receiving help and care. This ambiguousness encompasses both joy as well as the dissatisfaction of waiting. On the other hand, the experiences of not being satisfied are considered justified because the staff is overworked and unable to satisfy all the wishes of the seniors, as they have actually experienced.
First impressions of the living experience are very positive, but further reflection shows that living at a SHA means learning to wait. The question then becomes: What is one waiting for? An example of this is waiting for one's own turn. This is a recurring topic in the data material. If the senior requires assistance to go to the bathroom, then they must be prepared to wait, thereby holding in their need to urinate. This is shown in the following extract:. Life in the SHA is also seen as slow moving and uneventful. The seniors adjust to the slow lifestyle and defend the staff when asked why nothing is done to break this slow moving existence.
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A woman states that:. The situation is the opposite for the personnel. There never seems to be enough time. They have many other tasks than just assisting the residents.
Keeping Life Meaningful: Designing the Senior Residence Experience
Despite this, a senior states that in retrospect she is satisfied with her living experience at the SHA, and that she tries to solve this problem through help from family instead of staff. In the following extract, the constituent of managing everyday experiences in the SHA living is specified to show a state of ambiguity of existence.
The ambiguousness relates to minimizing the demands of living and full living.
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This means that the seniors adapt to the lowered expectations. Everyday life continues with occasional entertainment and other activities during the afternoons. Food, accommodation, care, and assistance are all generally available. On the contrary, the seniors are grateful for everything they receive. The manner of expression displays ambivalence between expectations of life and limitation to fulfill them.
One woman states the following:. The constituent of adapting life to the SHA as an institution shows a state of ambiguity of existence. The ambiguousness relates to minimizing the self-regulating existence and adapting to the institution-regulating existence. The rules and regulations of the institution control life in the SHA.
Being-in-the-world entails an adaptation to a life in which the seniors are no longer able to choose when they can go outside, to whom they will sit next to when dinning. At the same time, being-in-the-world of the SHA means that the seniors can always have someone to talk to in the dayroom, can feel secure in their surroundings, and can receive the assistance they require.
When the seniors require assistance, they accept the fact that one must comply with the institution's routines as to when and how assistance is provided. This is decided by the representatives of the institution, in accordance with the established routines, current economy, and the prevailing laws. Under such conditions, it is difficult to be able to maintain control over one's own situation. The fact that someone else decides when and how often one is allowed to shower becomes part of everyday life in the SHA. This is revealed in the following extract. In the excerpt above, the woman states that she wishes she could shower more often, at least in the summer when it is warm, however, the staffs do not have the time to assist her.
It is interesting to note that neither she nor the other residents have discussed this limitation; however, they state that there is nothing they can do, that is, routines must be followed. Nevertheless, there are residents who have reflected upon this situation when life in a SHA is described in the newspapers and they have found discrepancies between what is written and their actual experiences. Despite this, the seniors defend the routines that deny a self-regulating existence, pointing out that if all the residents did as they wished, the staff would not be able to cope.
This is indicated in the following extract. The constituent of relationships to other residents shows a state of ambiguity of existence. The ambiguousness relates to being accepted or rejected as a fellow resident, due to one's health situation. Seniors move into a SHA for different reasons. Some live there for security and state of mind, others due to their care requirements. It is quite common that the seniors compare themselves with other residents and are affected by how other residents feel. It is easy for one to imagine that one might soon be in the same situation as another resident, who is in a worse condition.
This means that it may be difficult to sit together with others in the common rooms; therefore, it is not uncommon for residents to retire to their own apartments. Even though the living experience sometimes has a negative effect on the residents, there is also an understanding and acceptance of the situation of others, even an amount of altruism for their fellowman.
This is shown in the following excerpt. Despite the fact that living in a SHA offers social contact with other people in similar situations and in a similar age group, other residents are not seen as beneficial to other residents. The reason for this may be due to a difficulty in communication with several of the residents, depending on their type of ailment.
One may be unable to talk to them. Instead, the residents often turn to the staff for social contact. Thus, the senior residents have the possibility to choose not to interact with other residents for social contact.
My Experience Volunteering at the Nursing Home
This decision may initially seem positive, but can actually be detrimental for both parties in the long run, as indicated in the following extract. The constituent of adapting to the physical limitations shows a state of ambiguity of existence. The ambiguousness pertains to their life as it used to be when their body was healthy, and their life as it has now become due to an unhealthy body and the limitations it causes in their everyday lives.
The loss of physical ability can lessen one's expectations and desires in life. Consequently, desires in life are connected to the experiences of the body. In sickness, the body changes and with that, independence in life also changes. This also influences the manner of being-in-the-world through adaptation to daily life. Existence becomes as fragile as the subjective body.
As the body changes and one's physical capabilities become limited, one is forced to rely on others, which negatively affects one's self-esteem and identity. The body must be reinterpreted into something that no longer holds a given place in existence. In retrospect, life as it used to be is seen as a kind of utopia, as expressed herein. The constituent of adapting identity to SHA-living shows a state of ambiguity of existence.
The ambiguousness pertains to their identity in the past and their identity in the present. When the seniors talk about themselves, their identities of being independent and healthy in the past is shown. When the need for assistance becomes obvious and a move to a SHA is required, another identity must be created. The earlier identity, when the older adult did not require assistance and was independent, is viewed as very important. The feelings of being unable to perform certain tasks and the loss of independence become very apparent when moving into the SHA. These feelings affect identity.
When the move to the SHA occurs due to an inability to manage themselves and one's home, both a change in one's self-image and the image that others have of the senior occurs. The study shows that the seniors have difficulty identifying themselves as living in a SHA. They do not want to be seen as a person needing help and assistance in their daily lives.
It is important for them to discuss their experiences and feelings prior to the move. This shows ambiguous feelings regarding their own sense of identity between their prior and their current existence. However, the inauthentic self has to exist as presence-at-hand, which is thing-like in the world of the others. The constituent of acceptance of one's life and living without the feeling of being at home shows a state of ambiguity of existence.
This affects the manner in which the seniors are positioned in the world. This is evident from remarks such as: When the question regarding what it means to feel at home was asked, the individuals made references to their earlier home; however, they also accepted the SHA as their current home because they realize that they have no choice. The remainder of this paper, the analysis section will be discussed in relation to theoretical, methodological, substantive, and practical considerations.
Theoretically , this article, with its hermeneutical phenomenological approach, furthers the understanding of lived experiences and the lifeworld perspectives of seniors as having many ambiguities. The ambiguity of existence is a synthesis of the embedded meaning and the characteristics of the phenomenon of lived experience of a SHA, that is, being-in-the-world Heidegger, , a manner of being-there.
Seniors' experiences of living in special housing accommodation
The facts things as they appear surrounding lived experience, in this case the experience of living at a SHA, present in the seniors' lifeworld has been captured in their narratives and then analysed through an interpretation process. The underlying outcome of the synthesis is organized into constituents. These constituents provide the topics of the meaning of the phenomenon. The phenomenon represents commonalities across the participants' narratives but also accommodates for the variations within the data.
This balances the phenomenological descriptions with insightful interpretation, which anchors these interpretations in the narratives of the seniors. This theoretical approach has been an appropriate strategy to fulfill the aim of this study, which was to analyse the phenomenon of living in a SHA. The approach allows for an account of space, time, and the world from the seniors' perspective. This constructivist persuasion blends the phenomenological interpretive perspective with critical hermeneutics to give voice to peoples lived reality.
The weakness in the chosen approach is that there is a risk of uncertainty about the credibility and the transferability. According to Speziale and Carpenter , the credibility refers to the activities that increase the credible findings. In this study, we have illustrated as clearly as possible the evidence and thought processes that led to the conclusions.
However, we believe that the findings from this study are transferable to others in the sense that the findings provide support for the importance of person-centered care in health and social care settings as in the SHA. Phenomenological inquiry, however, brings to light perceptions of human experience of the phenomena, here the SHA. According to Hallberg, Dahlberg, and Ashworth , this tension between the subject positions and the abstract general descriptions must be present in good qualitative research. On the whole, the essential knowledge from this article is to obtain an insight about the complexity of the meaning and to describe the universal structure in the subjective orientation.
Because professional elder care practice is embedded in people's life experiences, the theoretical approach in this study is well suited and important to caring, professional care, and to qualitative approaches in elder care practice. Methodologically this paper reflects the special contribution of new knowledge that can be made by using a qualitative analysis to understand lived experience and lifeworld perspective in elder care.
The accounts in the narratives about the experiences of living in the SHA the phenomena are viewed as aspects of an abstract context of discourse that comes to life through these accounts.
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These accounts illuminate the variations and the contextual nuances in the personal experiences. These kinds of individual oriented descriptions are of moral concern for the person Hallberg et al.
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However, the descriptions provide the foundation for the meaning structure of the phenomena of living in a SHA. From these descriptions, we have moved our orientation in the analysis to grasp the very phenomena and distinguish it from descriptions of living in regular housing. In order to enlighten and describe the person oriented experience, as well as clarify the theoretical abstractions of the phenomena and their embedded meanings, we have presented detailed extracts to help readers to understand and follow the interpretive process and the validity in that very process.
Seven, meaning structural, constituents have been presented with supporting verbatim, descriptive expressions from the seniors. This adds to the authenticity and trustworthiness of the findings. Concerning the interpretive process, we remain aware and critical as to how well we have been able to be faithful witnesses to the accounts in the data. We have tried to remain receptive and flexible in understanding the interviewees' accounts.
The value of the data material is confirmed in the analysis. To further secure authenticity, the interviews were transcribed soon after being held. Being three researchers also helped in obtaining as detailed descriptions of the experience of the seniors' lifeworld as possible. This is also in line with Dahlberg a , who states that: Substantively, this analysis contributes to understanding how the SHA is accepted as a necessity due to failing health, but it is never considered to be a real home by the seniors in this study.