This study examined the effects of a group treatment of Self-Instructional Training (S.I.T.) with an institutionalized aged (65 or over) population. The purpose of the S.I.T. program was to increase the positive content of speech elicited in a structured social interaction. S.I.T., as developed for this study, followed Meichenbaum's three phase model. First was the educational phase, where the rationale and introduction were presented. Second was the rehearsal phase where therapeutic techniques were developed and modeled. Third was the application phase where newly acquired skills were practiced. Four groups (total N = 51) were randomly assigned to either the experimental group or the no-treatment control group at each of two residential care facilities. The S.I.T. program emphasized substitution of negative self-statements with positive self-statements aimed at developing a more successful repertoire of social interaction skills. Results were analyzed by comparing tabulated positive minus negative self-statements elicited during tape recorded standard interviews. Statistical analysis showed significantly more positive response sets for the experimental subjects on four of the ten hypotheses that reflected the ten standard interview questions. The analysis of the combined responses from the entire interview showed significant differences favorinq a positive response pattern for the experimental subjects. These findings were interpreted to demonstrate the effectiveness of S.I.T. for increasing positive speech content in an institutionalized aged population. A case was made for increased use of S.I.T. programs as a therapeutic means of ameliorating a range of problems faced by the aged. / Graduation date: 1983

Set within the context that the world’s population is ageing at an unprecedented rate, it is argued that care of the elderly, and their everyday lived experiences are poised to become prominent concerns. In the shadow of this, the ageing population poses a myriad of challenges not only for the elderly but also for policy makers who put in place systems for the provision of services within residential care homes. By virtue, given that communities of elderly consumers voices are often muted within many academic analyses of social policy and service provision this study illuminates and distils communities of elderly consumers understandings of residential care homes. Given the absence of suitable literature within the fields of marketing and interpretive consumer research, this study turns to the sociological and anthropological literature of Hall and Jefferson (1976) and Levi-Strauss (1966). In doing so, communities of elderly consumers within residential care homes can be theorised as a cultural community of ‘bricoleurs’ within a ‘cultural map of meaning’. Furthermore, viewed through this lens, such bricoleurs can be seen to understand their meaningful everyday lived experiences within, and through, the use of ‘bricolage’. Emanating from eight existential-phenomenological interviews, a rich picture emerges wherein bricoleurs understandings of residential care homes can be seen to be embedded not only within, but also through, such things as the body, leisure trips, noise disturbances, death, large items of furniture, small hand-sized objects, mobility aids, quality of care and social interaction. Moreover, in the light of the resultant interpretations common themes can be seen to emerge within communities of bricoleurs social and material understandings of residential care homes, namely the notion of cultures of dependency, trauma and comfort. This research contributes to marketing knowledge in that it argues that communities of ‘elderly bricoleurs’ within residential care homes can be seen to be held together by unique understandings of cultures of dependency, trauma and comfort. Furthermore, it is also argued that elderly bricoleurs address themselves to a relatively limited amount of bricolage that enables them to keep alive actual, desired, imagined and fictional community ties. Furthermore, the reality and efficacy of cultural communities of elderly bricoleurs seems to depend on their ability to address ‘whatever is to hand’ (Levi-Strauss, 1966) in order to construct and understand their cultural maps of meaning within residential care homes.

The intent of my project is to recognize the importance of the residential care home administrator by providing him or her with a training curriculum in order to have additional knowledge upon which to base program planning. Perhaps, someday, a unique type of care outside as well as inside California.

Bibliography: leaves 309-334. / xi, 369 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines the culture of two nursing homes using an ethnographic method which is underpinned by ethnomethodology as a philosophical approach. The study shows how older and disabled people are seen to deviate from social norms and how society responds to their situation. Future directions for aged care are suggested, and include evidence based practice, primary nursing and the evolution of a nurse practitioner focussed model of care, with adequate support for nurses. / Thesis (Ph.D.)--University of Adelaide, Dept. of Clinical Nursing, 2000

This thesis is an examination of the definition and implementation of ‘good practice’ in residential care for senior citizens. The central contention is that ‘good practice’ is a term that has been variously defined. Different groups define it in different ways, and their definitions have changed over time. This reflexive qualitative study explores ‘good practice’ in local authority, voluntary and private residential care homes in Scotland from the perspective of policy, practice and the experience of senior citizens who live in them. The study is based on analysis of policy documents, historical studies, and reanalysed interview and survey data from two earlier studies conducted by the author and colleagues. The thesis shows that the notion of ‘good practice’ that emerges in policy and practice documents is a confused and often conflicting set of ideas. Historically, the earliest were driven by concerns over cost. In more modern times, statements about ‘good practice’ have had a more benevolent intent but are frequently flawed by paternalistic and ageist assumptions. It is shown that staff in residential homes typically adopt a different set of attitudes: their preoccupation is with safety and the avoidance of risk. Although benevolent in intention, these interpretations of ‘good practice’ are also at variance with what residents themselves actually want. Two particular models or styles of care are examined in detail. One of these is the use of ‘keyworkers’, often implemented in ways that fail to realise its potential. The other is the ‘hotel’ model of care. The potential of this model as an alternative to the statutory model is explored. The thesis concludes that it is a model that can realise the goal of enabling residents to exercise independence, choice and privacy while meeting their needs in residential care.