Life within chronic care: is this a service or sentence?

P Govender, J Boyd, A Hassim, T Jordaan, N Mahomed, D Straeuli-Paul

Abstract

Background: Understanding the meaning of one’s lived experiences improves one’s understanding of what it means to be human, in association with the social, cultural and historical context in which being a human occurs. The authors in this study describe the lived experiences of residents within a chronic care facility including the practitioner and family perspectives.

Methods: A qualitative approach was employed with a single-site, descriptive, instrumental case study design. Purposive sampling was utilised to select the chronic facility. Multiple sources of evidence included narratives, semi-structured interviews with staff, residents and family members, and activity profiles of the residents augmented by an ergonomic evaluation of the facility. Content analysis using within-case analysis was implemented.

Results: The greatest impact on the quality of the resident’s lived experiences emanates from the physical, organisational and social environments in which they reside. Limited resources, poor staff attitudes and routines that are enforced both on the staff of the facility and the residents appear to reduce optimal functioning within the facility. Furthermore the residents’ intrinsic motivation, presence of enforced idleness, learned helplessness and institutionalisation is often intensified and becomes characteristic of the residents lived experiences.

Discussion: The lived experiences of the residents are described according to quality of life indicators that were identified during the study and supported by literature. These include the influence of the physical, social and organizational environments on the residents’ functional status, which comprises physical well-being and emotional well-being and engagement in meaningful occupations including social interaction and relationships with other individuals.

Conclusions: Findings of this study may be valuable in understanding and facilitating a positive change in service delivery within chronic care centres.

Keywords: chronic care, institutionalisation, lived experiences, residents, occupational deprivation