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Facilitating choice and control for older people in long-term care.

Boyle, Geraldine (2004). Facilitating choice and control for older people in long-term care. Health and Social Care in the Community, 12(3) pp. 212–220.

DOI (Digital Object Identifier) Link: https://doi.org/10.1111/j.1365-2524.2004.00490.x
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Abstract

The community care reforms enabled some older people with severe disabilities to remain at home with domiciliary care services, as an alternative to institutional admission. This paper explores the extent to which the reforms actually enabled older people receiving domiciliary care to have greater choice and control in their daily lives than older people living in institutions. Findings are reported from a comparative study carried out in Greater Belfast, Northern Ireland, that determined the extent to which the subjective quality of life of older people – particularly autonomy – varied according to the type of setting. The older people were interviewed using a structured interview schedule and subjective autonomy was assessed using a measure of perceived choice. The measure consisted of 33 activities relating to aspects of everyday life such as what time to get up, when to see visitors or friends, and how much privacy was available. Qualitative data were also recorded which informed on the older people’s perspectives on their own lives, particularly the extent to which they exercised choice on a daily basis. Two-hundred and fourteen residents in 45 residential and nursing homes were interviewed, as were 44 older people receiving domiciliary care in private households. The study found that older people living in institutions perceived themselves to have greater decisional autonomy in their everyday lives than did older people receiving domiciliary care. Indeed, it was clear that living at home did not ensure that one’s decisional autonomy would be supported. However, living alone may facilitate exercising a relatively higher degree of autonomy when living at home. Whilst the community care reforms have provided some older people who have severe disabilities with the option of receiving care at home, this has not necessarily enabled them to have greater choice and control in their everyday lives than older people admitted to institutions.

Item Type: Journal Item
Copyright Holders: 2004 Blackwell Publishing Ltd
ISSN: 1365-2524
Keywords: autonomy; domiciliary care; institutional care; older people
Academic Unit/School: Faculty of Wellbeing, Education and Language Studies (WELS) > Health, Wellbeing and Social Care > Nursing
Faculty of Wellbeing, Education and Language Studies (WELS) > Health, Wellbeing and Social Care
Faculty of Wellbeing, Education and Language Studies (WELS)
Item ID: 40999
Depositing User: Geraldine Boyle
Date Deposited: 01 Oct 2014 13:11
Last Modified: 07 Dec 2018 10:25
URI: http://oro.open.ac.uk/id/eprint/40999
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