An attempt to give nursing home residents a voice in the quality improvement process: the challenge of frailty.

Advanced frailty and confusion of many nursing home residents present a particular conundrum to researchers committed to resident participation. While the research is set in Australia, the challenge of frailty is common to researchers working with compromised older persons. This study was conducted in an Australian 32 bed nursing home. As researchers we took on the roles of facilitators and negotiators within a quality improvement process using the approach of fourth generation evaluation. The overall aim of the project was to provide all stakeholders, including residents and their significant others, with a voice in the negotiations and decisions that impact on their lives. The focus of this paper is our attempt to gain the perspective of residents and significant others.