Beyond choices : trade-offs between residential care and family home

Abstract

The minute we are born, biological, psychological and sociological changes start and the ageing process begins. Upon reaching old age people become more susceptible to institutionalisation. Research shows that most older persons would prefer to continue living in the community (Kahana, 2006). However demand for long term care keeps increasing. This study investigates why relatively healthy older persons leave their family home and move into residential care, how such a move affects their well-being, and what sort of support would they have helped them to continue living in their community. Adopting a qualitative approach, this study takes a phenomenological research design and presents the subjective experience of seven older persons who went through the relocation from their family home to residential long term care. A number of key findings emerged. Some older persons become vulnerable due to external and/or internal factors. External factors include the increased risks and difficulties experienced in old age whilst internal factors are the decreased means to cope with external factors. Older persons in this study experienced difficulties such as spouse’s health problems, a controlling family and homelessness. The coping capacities were compromised due to apprehension, submission to family pressure, loss of control and self-perceived burden. The relocation provided the older persons with some benefits such as reassurance and companionship. However they also reported hardship due to a sense of loss attributed to one’s active life in the community resulting in emotional distress. This study also reviews social support which the older persons availed from whilst they were still living in the community. The findings revealed that informal support was present but limited, not enough to prevent institutionalisation, whilst formal support according to the participants was inadequate in terms of quality and quantity. This study then presents some recommendations related to the role of networks of relationships that could ensure older persons’ well-being, referred to as Circles of Support that can sustain older persons’ choices.