Barriers and facilitators to promoting functional independence in a long-term care residence

Abstract

It is evident in nursing literature that there are several factors that impede or facilitate the promotion of functional independence amongst the segment of elderly people residing in long-term entities. These factors need to be identified if the population of elderly people needing long-term care is predicted to increase in the near future (WHO, 2011). This study investigates the perception of Maltese nurses with respect to barriers and facilitators that are encountered at a local long-term care residence. The objectives were aimed also at exploring the nurses' opinion of any benefits promoting functional independence amongst the residents has for the nurses and the elderly. A total of 35 nurses, their nursing experience ranging from less than 5 years to more than 20 years, participated in the study. Data collection was obtained through the use of a self-structured questionnaire using a quantitative approach, giving a response rate of 66%. Data analysis of the results was performed using Microsoft Excel and Microsoft Word. Results showed that the majority of the nurses had more than 20 years experience (n=17) and 86% were state-registered nurses. Demographic data also showed that the majority of the residents on the wards were dependent on all activities of daily living. Findings in the study revealed that the major barriers to promoting functional independence were the result of insufficiencies that exist within the residence (such as lack of staff), effects of institutionalisation and routine work, and increased number of residents. Whilst facilitators were connected to the general environment of the residence, the activities of daily living studied and staff characteristics. This research assignment may encourage the need for more research on other long term care institutions to compare the level of encouragement being given. Furthermore this study recommends further research, awareness, education and introduction of interventions and legislations regarding this matter, perhaps this could serve as an impetus to the newly appointed commissioner of old people. It was concluded that as long as barriers such as lack of staff persist, functional independence interventions can never achieve their full potential due to the increasing number of the elderly population and dependency amongst frail elderly people.