Bound within the limits: Facing constraints to family caring in nursing homes.

Abstract

Facing constraints to meaningful caring emerged as a significance aspect of the experience of caring explored in a larger hermeneutic phenomenological study of family practices, before, during, and following the admission of an older relative into a nursing home. Hermeneutic analysis of in-depth interview transcripts and observation field notes of fourteen family carers' experiences disclosed six shared meanings: being out of control; not being heard; experiencing barriers to sharing care with staff; feeling adrift, excluded and disempowered; wanting to engage in caring partnership; and living in a constant state of anxiety. Concern is illuminated in the narrative of family carers' experiences of being misunderstood, and attempting to manage constraints imposed by institutional rules and care routines which threaten the quality of existence for themselves and their relatives. This paper challenges nurses to increase their awareness and acknowledgement of the importance of creating a context of care in which family carers may feel empowered to engage in meaningful caring activities and relationships.