published_or_final_version / Public Administration / Master / Master of Public Administration

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / abstract / Dentistry / Doctoral / Doctor of Philosophy

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

M.A. (Social Work) / Relevant literature clearly indicates a steady increase in not only the number of aged persons but also the demented population. Consequently it has become imperative that the nursing staff responsible for the day - and night care of demented patients in a residential setting, acquire appropriate knowledge of dementation as such, and clarity on their roles in an endeavour to decelerate the dementation process. They, furthermore, need to be aware of the special needs of demented aged persons --needs which call for particular professional skills. In this study the emphasis is on the development and evaluation of a group work programme for nurses in two homes for demented aged persons. The programme is based upon knowledge on dementation, and its contents are directed at a repertoire of skills which, when effectively practised, will serve as a support system to nurses. Researcher made use of an indirect measuring method: an experimental - and control group were established at two homes where direct observation was done in respect of the behaviour of the residents and the nature of nursing. A questionnaire was completed by the experimental - and control group, prior to and following on the provision of a group work programme. The target universe consisted of fifteen nurses at two homes for demented aged persons. Nine and six members of the nursing staff were respectively connected to the experimental - and control groups. The experimental group attended nine sessions which incorporated the mediating - goal model designed by Papell and Rothman (in du Preez 1979:73)...

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Text in Afrikaans / Verpleegktmdiges het 'n etiese en professionele verantwoordelikheid om elke bej aarde se reg op selfbeskikking te erken, bulle in die uitvoering daarvan te ondersteun en op volgehoue basis te ontwikkel met die oog op die bereiking van die hoogste moontlike vlak van onafhanklikheid in die daaglikse lewe. Die doel van hierdie studie was om die mate te bepaal waarin professionele verpleegkundiges werksaam in geregistreerde, gesubsidieerde tehuise vrr bejaardes in die Pretoria-omgewing hierdie verantwoordelikl1eid uitleef Ontleding van die data, wat deur 'n vraelys ingewin is, dui daarop dat verpleegktmdiges sonder twyfel die bejaarde se reg op selfaktualisering erken. V erpleegkundiges ervaar egter onsekerheid oor die praktiese wyse van selfsorgondersteuning sowel as die wenslik11eid van gesondheidsbevordering by die gelnstitusionaliseerde bejaarde. Ten einde die sinvoll1eid van die gelnstitusionaliseerde bejaarde se bestaan te verseker, sentreer die belangrikste aanbevelings in hierdie studie rondom die voorsiening van opleidingsprogramme aan gerontologiese verpleegktmdiges asook gesondheidsvoorligting aan die bejaarde self / Nurses have an ethical and a professional responsibility to acknowledge the elderly's right to self-determination, to support them in this regard and to ensure ongoing development so that they may attain the highest possible level of independence in their daily life. The purpose of tllis study was to determine to what extent nurses working in registered, subsidized homes for the aged in the Pretoria area live up to tllis responsibility. Analysis of tl1e data, obtained by questimmaire, has clearly shown that nurses acknowledge the right of the elderly to self-actualization, but they feel uncertain about the practical ilnplementation of self-care support and tl1e desirability of promotil1g health amongst the il1stitutionalized aged. In order to ensure that tl1e institutionalized aged person leads a meanil1gfullife, the mail1 recommendations of tllis study centre on providil1g educational progrmes for gerontological nurses as well as health education for the elderly. / Health Studies / M.A. (Nursing)

Thesis (MA)--Stellenbosch University, 2003 / ENGLISH ABSTRACT: Ageing is a fact of life. It often gives rise to unfortunate consequences. Physical infirmities; senile dementia; emotional disturbance. Indeed, the effects of the ageing process can be such as to render a person incapable of performing the ordinary and normal functions of life. In such a case, institutionalisation presents itself as a prospect to enable an aged person to cope with the ordinary day-to-day activities of living. The purpose of institutionalisation is to improve the quality of life of the elderly. In considering the process, a number of important facets need to be borne in mind. Firstly, the process must be seen in relation to the condition of the person being institutionalised. Secondly, the process must be seen as a matter of extraordinary change in the life of the aged person. This implies a detailed explanation and full disclosure of the process envisaged, and, if needs be, appropriate counselling of the person concerned. Thirdly, there must be sympathetic and sensitive assistance given to the aged person in adapting to a new situation. Fourthly, a continuing and intimate interest in, and concern for, the aged person on the part of the family must be accentuated and impressed. This gives rise to the importance of visitation on the part of the family. Its meaning and purpose must be understood. The need for meaningful visitation must be stressed, and the status of a respected member of the family must be emphasised. The aged person must never be cut-off, separated or neglected. Visits must not be a coincidental, haphazard and aimless occurrence. Visitation must always be directed at improving the quality of life of the aged person. The aged person, despite her advanced years and debilitated condition, remains a person with thoughts, feelings, emotions, difficulties and problems. She needs time and attention. The normal or regular pattern of visitation does not, by and large, accomplish these ends. Something more is required. Specialised visitation. This is something different from ordinary, normal, social visitation. It is more intense, more concentrated and more regular. It embodies consistent and continuous contract. It is directed at effectiveness. It is never haphazard or aimless and always has as its objective an improved quality of life for the aged. The specialised visitor and the resident come to know each other well; they come to trust each other, and they come to realise that the object of the visit is more than an exchange of frivolities. Specialised visitation manifests a concern for the aged; it offers them support, stability, certainty and security. This is so because the specialised visitor responds to an inner conviction, an infinite calling, and an earnest urging. It is not a task but a vocation. Many factors contribute to the enhancement of the quality of life of the elderly : three may be mentioned. Institutionalisation, visitation and the role undertaken by the specialised visitor. / AFRIKAANSE OPSOMMING: Veroudering is 'n gegewe feit wat dikwels tot ongelukkige toestande soos fisiese swakhede, seniliteit en emosionele versteuring lei. Die gevolge van veroudering kan inderdaad 'n persoon verhinder om die alledaagse en normale funksies van lewe uit te voer. In sulke gevalle bied institusionalisering die moontlikheid dat 'n bejaarde persoon wel kan handel met die gewone dag-tot-dag aktiwiteite van die lewe. Die doel van institusionalisering is die verbetering van die kwaliteit van lewe van die bejaarde. In die beskouing van hierdie proses moet 'n aantal fasette in aanmerking geneem word. Eerstens, moet die proses in verhouding tot die toestand waarm die persoon wat geïnstitusionaliseeer word verkeer, gesien word. Tweedens, die proses verteenwoordig 'n buitengewone verandering in die lewe van die bejaarde persoon. Om dit te vergemaklik moet 'n gedetaileerde verduideliking en volle openbaarmaking van die proses wat voorlê aan die persoon gegee word en, indien nodig, toepaslike berading aan die persoon verskaf word. Derdens, die persoon moet simpatieke en sensitiewe bystand in die proses van aanpassing tot die nuwe situasie verleen word. Vierdens,die gesin van die persoon moet baie duidelik onder die indruk gebring word van die belang van voortgesette en intieme belangstelling in die persoon deur hulself Hierdie aspek bring die belangrikheid van besoek deur die gesin na vore. Die betekenis en doel van besoek moet deeglik verstaan word. Die behoefte van betekenisvolle besoek moet benadruk word en die status van die persoon as gerespekteerde lid van die gesin beklemtoon word. Die bejaarde mag nooit afgesny, afgesonder of verwaarloos word nie. Besoeke mag nie toevallig, planloos en doelloos geskied nie. Besoeke moet altyd gerig wees op die verbetering van die kwaliteit van die lewe van die bejaarde. Ten spyte van haar gevorderde jare en afgetakelde toestand bly die bejaarde persoon iemand met eie denke, gevoelens, emosies, moeilikhede en probleme. Sy benodig tyd en aandag. Die gewone of gereelde patroon van besoek bereik oor die algemeen nie hierdie doeleindes nie. Iets meer word vereis, naamlik gespesialiseerde besoek. Dit is duidelik verskillend van die gewone, normale sosiale besoek. Dit is meer intensief, meer gekonsentreerd en meer gereeld. Dit beliggaam bestendige en deurlopende kontak. Dit is gerig op doelbereiking. Dit is nooit planloos of doelloos nie en het altyd as oogmerk om die kwaliteit van lewe van die bejaarde te verbeter. Die gespesialiseerde besoeker en die inwoner leer mekaar goed ken sodat hulle mekaar vertrou, en besef dat die oogmerk van die besoeke meer behels as 'n uitruil van beuselagtighede. Gespesialiseerde besoek druk 'n besorgdheid VIT die bejaarde uit. Dit gee aan hulle ondersteuning, stabiliteit, sekerheid en sekuriteit. Dit is so omdat die gespesialiseerde besoeker vanuit 'n innerlike oortuiging, 'n onbegrensde roeping en 'n ernstige lewensdrang optree. Dit is nie 'n taak nie maar 'n roeping. Baie faktore dra by tot die verhoging van die kwaliteit van lewe van bejaardes. Drie hiervan is institusionalisering, besoek en die rol wat die gespesialiseerde besoeker onderneem.

This thesis is an ethnographic analysis of a Continuing Care Retirement Community (CCRC) in the American Midwest. I examine salient aspects of American culture, and how persons in the American Midwest understand relationships and themselves in the context of eldercare, and particularly, how issues of personhood and kinship are conceptualised in a long-term care facility. Rather than focusing exclusively on just the labour of caregivers, or how the residents in the CCRC receive care, my study is grounded in the interaction and relations that obtain during specific regimes of caregiving. Because the exigencies of ageing are met with certain exigencies of care, this study touches upon three dominant themes that make sense of the tensions that emerge when principles and practices do not square up. The first theme deals with how ageing and care are constituted, and made relational to one other. Secondly, I demonstrate that in the CCRC where I conducted fieldwork, ageing is constructed as a process and institutionalised, resulting in a distinctive way in which space and time are dealt with and unravelled from their inextricability. The resulting consequences affect not just the older residents and the CCRC staff, but also impacts how caregiving takes on specific forms and meanings. Thirdly, I investigate how formal (professional) caregivers and care receivers produce a type of social relation, which cannot be understood alone by conventional studies of kinship and economic relations. Ultimately, this thesis sets the frame for future debate on the ontological commitments involved in eldercare, and how the segregation of care and of the elderly in society relate to wider social norms regarding ageing and marginality.