'Making it better': self-perceived roles of family caregivers of older people living in care homes: a qualitative study

BACKGROUND: With growing numbers of frail older people making the move to a care home, family carers are increasingly finding themselves in the position of assisting with this transition and establishing a new caring role within this context. However, the nature of the family caregiving role within the care home setting is poorly understood. AIMS AND OBJECTIVES: This paper draws on data from a study, which sought to better understand the experience of nursing home placement from the viewpoint of relatives. The focus here is on the self-perceived contribution of family carers to life within the home. METHODS: A constructivist methodology was used. Data were collected in 37 semi-structured interviews involving 48 people who had assisted a close relative to move into a care home. FINDINGS: Data analysis revealed three phases to the transition from the relatives' perspective. This paper reports on the findings which relate to the final phase: 'making it better', which documents experiences of establishing a new caregiving role within the care home. Relatives described three main aspects to their role: maintaining continuity, which involves helping the older person to maintain their sense of identity through the continuation of loving family relationships and through helping staff to get to know the resident as an individual; keeping an eye, by monitoring the care received, providing feedback to staff and filling any gaps, and contributing to community through interacting with other residents, relatives and staff, taking part in social events and generally providing a link with the outside world. RELEVANCE TO CLINICAL PRACTICE: Findings suggest that the potential contribution of relatives to promoting the well-being of both residents and staff is under-developed. Staff in care homes should seek to identify the role that relatives would like to perform and support them to achieve this.