How do families construct positive caregiving experiences in long-term aged care? Hermeneutic interpretation in process.

Abstract

Most family caregivers feel that they are failing their relatives by admitting them to a nursing home. The decision to institutionalise a family member is often a final desperate step after previous efforts to maintain a relative at home have broken down. Being able to recreate a valued identity as a family caregiver following the placement of a relative is vital.

Reconstructing meaning through seizing possibilities for positive caring emerged as a significant aspect of a hermeneutic phenomenological study of family caregiving in nursing homes. Hermeneutic analysis of in-depth interview transcripts and observation field notes of 14 family caregivers experiences of caring uncovered 5 shared meanings: accommodating new and different ways of caring; feeling a part of the nursing home community; learning to care in stress-reducing ways; seeing the whole picture; and learning to seize possibilities for self.

This paper will demonstrate how Heideggerian philosophy provided direction to reveal how meaning in everyday caregiving was disclosed, and Gadamerian philosophy shaped the process of generating understanding of such meaning from an interpretation of the stories shared. Detailed parts of family caregivers stories, those parts defined as significant by the narrators, will be merged with the researcher's interpretation of the meanings embedded in the stories shared.

Findings will be discussed in terms of the empowering process family caregivers experience as they discover ways of setting up positive possibilities to continue caring within nursing homes. The implications of such findings provide a justification for the promotion of a shared ideology of care that recognises, and gives equal status to, pathphysiological, psychosocial and interactional ways of knowing. Ideological change will be examined in terms of the value of accessing family knowledge and expertise and articulating the need to develop caring partnerships which empower family caregivers to redevelop a sense of future which is viewed with hope, strength and positive anticipation.