Continuing the commitment-to-care : family members' experience of being visitors in a long-term care facility : a thesis presented in fulfillment of the requirements for the degree of Master of Arts at Massey University
The purpose of this phenomenological study is to describe and interpret the phenomenon of being a visitor to an older relative in a long-term care facility as experienced by eight family members. These family members were previously their relatives' primary carers in the community. Each family member was interviewed about two months after their relative entered a care facility, and seven of the family members again three months later. Their narratives gave rich descriptions which showed how being a visitor was an integral part of each family member's life. The study shows that most family members are very committed to continuing the caregiving relationship when they visit their relatives. Emotional commitment is especially high. Family members perceive their visits as benefiting both their relatives and themselves. Their attempts to continue to participate in caregiving, though mostly respected, are sometimes discouraged and, on occasions, seem to be resented by some staff. For this and other reasons family members perceive some lack of control in their interaction with staff and with their relatives. Thus being a visitor is a stressful and yet also a valuable experience to which they learnt to adjust themselves. Family members sought support and guidance from nurses especially in setting their visiting goals and in communicating with them and their relatives. This was particularly the case with cognitively impaired relatives. Even after routine patterns of interaction had been established, further assistance was needed as the health of a relative declined or their own circumstances changed. A better understanding of family perspectives is important if family roles are not to be determined only by organisational and resident perspectives. Health providers, including nurses, need to appropriately balance responsibilities toward family members and residents to make visits meaningful for both. In turn, family members have knowledge and skills which have accumulated usually over a long time of caregiving from which nurses can learn. The main theme of this study is continuing-the-commitment-to-care. This is supported by four essential themes: perceiving-visiting, learning-to-live-with-visiting, continuing-with-visiting, valuing-commitment-to-visiling.