Larsen Lill Sverresdatter, Blix Bodil Hansen, Hamran Torunn
Faculty of Health Sciences, Department of Health and Care Sciences and Centre for Care Research North, UiT The Arctic University of Norway, Tromso, Norway.
Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromso, Norway.
Dementia (London). 2020 Aug;19(6):2038-2055. doi: 10.1177/1471301218814641. Epub 2018 Nov 23.
The current Western health policy of ageing in place relies on a triad collaboration among patients, healthcare service providers and family caregivers. Such collaborations presuppose involvement in a vague juridical landscape. This article explores family caregivers' experiences with involvement in and influence on nursing home decision-making processes for persons with dementia. The data consist of 12 in-depth interviews with family caregivers. Using positioning theory, we demonstrate how family caregivers strive to balance their assumed duty to care for the person with their needs to care for themselves. Their involvement (or non-involvement) in the complex decision-making process is demonstrated through the following seven positions: (1) self-condemning determiner, (2) dominant, (3) proponent, (4) saluting, (5) pending, (6) prisoner, and (7) stooge. Furthermore, we discuss why expedient positions are more available for some individuals and the consequences of family caregivers' various positions on the healthcare policy aims of collaboration and equal healthcare services.
当前西方就地养老的健康政策依赖于患者、医疗服务提供者和家庭护理人员之间的三方合作。这种合作预先假定了要置身于一个模糊的法律环境之中。本文探讨了家庭护理人员参与痴呆症患者养老院决策过程并对其产生影响的经历。数据包括对12名家庭护理人员的深入访谈。运用定位理论，我们展示了家庭护理人员如何努力在照顾患者的假定责任与照顾自身需求之间取得平衡。他们在复杂决策过程中的参与（或不参与）通过以下七个定位得以体现：（1）自我谴责的决定者，（2）主导者，（3）支持者，（4）致敬者，（5）待定者，（6）囚徒，以及（7）傀儡。此外，我们还讨论了为什么某些人更容易采取权宜性的定位，以及家庭护理人员的不同定位对合作医疗政策目标和平等医疗服务的影响。
