Residential care for the elderly in eThekwini Metropolitan Municipality : a case study approach.

Abstract

Aim: This study explored and described residential care for the elderly in eThekwini Municipality in terms of the organizational structure, staff and residents, and determined how those factors influenced elder care. This was aimed to make recommendations for residential care in eThekwini Metropolitan Municipality. Methodology: A descriptive explorative case study design, using both quantitative and qualitative approaches was adopted for this study. The study participants included eight administrators, twenty elderly residents and thirty nursing staff from four residential care facilities (RCFs) in eThekwini Municipality, Durban. Data were collected through interviews, questionnaires, record review and observation based on the structure, process and outcome of the study's conceptual framework. Qualitative data were gathered from administrators and elderly residents. The data were transcribed and analyzed manually using Framework Analysis (Ritchi & Spencer, 1994). Quantitative data was obtained from nursing staff using questionnaires, and analyzed using SPSS. Findings: Administrative fmdings followed the structure, process and outcome of the study. The structural findings were focused on facility philosophy and human-material resources, as well as on emerging themes from the data. The emerging themes from facility philosophy were assisting vulnerable people across age groups, document review, quality indicators, admission criteria and reasons for admission to each facility. Emerging themes from human-material resources were fmancial sustainability, staff-resident ratio and material resources. The process findings were focused on care and service delivery to the elderly and the emerging themes were one big family, incidence of abuse, methods of elder care and service delivery, knowledge about elder care, relationship of control, being there, gentle restraint, setting boundaries with the residents, medication safety, common religious belief and resident satisfaction. Findings from the outcome were focused on success and challenges of elder care, experiences of the elderly and nursing staff care experiences. Thus, emerging themes from success and challenges were strong bond, retaining staff, maintenance of physical structure, location of care centre; success and its dependence and challenges of procuring basic medical equipment. Findings from experiences of the elderly were reasons for admission, relationship, experiences of the elderly, response shift, psychosocial support and satisfaction with care, cultural belief and well respected. Emerging themes from nursing staffs experiences of caring for the elderly was mainly focused on their professional knowledge about elder care. Details of these findings are written down in Chapters Four and discussed in relation to literature in Chapter Five. Conclusion: The study concluded by making recommendations for the care of the elderly in -RCFs in eThekwini Municipality in line with the findings of the study. The recommendations have implications for the government, policy makers, nursing education and nursing research. Moreover, those concerned are encouraged to adopt and use the recommendations where applicable to promote residential care quality for the elderly in eThekwini Metropolitan Municipality.