With the aging of our population and the higher risk of chronic illness and disability with age, more and more family members may be faced with the experience of having a relative transition into a long-term care (LTC) home. This reality necessitates greater understanding of family care partner needs to ensure wellness throughout their caring career. Using participatory action research, notions of wellness were explored for family partners in care with relatives residing in LTC homes. Using two LTC homes from a privately owned company called Specialty Care, ten family members were interviewed, followed by one focus group at each of the two LTC homes. Three major themes were revealed, each with several sub themes: (1) understanding wellness amidst challenges to keep a sense of wellness in life; (2) self-appraisal: becoming aware of personal beliefs and perceptions that influence wellness; and (3) assessing LTC homes and their influence on the experience of wellness. We not only revealed more about wellness and how it is experienced in the caring context, we also discovered leisure’s role in maintaining wellness and how embedded leisure’s influence is on the various aspects of wellness that family partners in care experience. Relationship-centred care is a framework we used to guide this study. It highlights the importance of family member needs, along with the needs of the residents and staff. With our enhanced understanding of family care partner needs, recommendations were made to the Specialty Care communities so they can work together to ensure optimal wellness is maintained for all parties, including family partners in care.

With the aging of our population and the higher risk of chronic illness and disability with age, more and more family members may be faced with the experience of having a relative transition into a long-term care (LTC) home. This reality necessitates greater understanding of family care partner needs to ensure wellness throughout their caring career. Using participatory action research, notions of wellness were explored for family partners in care with relatives residing in LTC homes. Using two LTC homes from a privately owned company called Specialty Care, ten family members were interviewed, followed by one focus group at each of the two LTC homes. Three major themes were revealed, each with several sub themes: (1) understanding wellness amidst challenges to keep a sense of wellness in life; (2) self-appraisal: becoming aware of personal beliefs and perceptions that influence wellness; and (3) assessing LTC homes and their influence on the experience of wellness. We not only revealed more about wellness and how it is experienced in the caring context, we also discovered leisure’s role in maintaining wellness and how embedded leisure’s influence is on the various aspects of wellness that family partners in care experience. Relationship-centred care is a framework we used to guide this study. It highlights the importance of family member needs, along with the needs of the residents and staff. With our enhanced understanding of family care partner needs, recommendations were made to the Specialty Care communities so they can work together to ensure optimal wellness is maintained for all parties, including family partners in care.

Collaborative care is a philosophy which guides the work of interdisciplinary teams and patients and their families internationally. It has been demonstrated to improve quality of care, safety, and patient and staff satisfaction, yet applying this philosophy still requires much investigation. This thesis describes processes of change directed towards a vision to enhance collaborative care relationships with patients and families within one hospital site of a non-acute academic health science centre in Ontario, Canada. By building focused conversations around existing patient and family centred education and using an initial conceptual framework of customer service, healthcare providers, mid- and senior level leaders shared their perspectives, negotiated meanings and created innovations to enhance collaborative relationships within the organization. Based within the critical paradigm, a critical collaborative ethnography was constructed with the use of sequential and mixed research methodologies. The ethnography evolved over three phases in a step-wise and additive design during the three year period of study. Phase 1 examined the perspectives of healthcare providers in an exploratory case study which contributed to mid-level leaders’ discussions in Phase 2. Cumulative findings from Phases 1 and 2 were brought to discussions with senior leaders in Phase 3. Members of a participative action research team assisted with research design and study processes. Shared meanings and innovative change ideas were developed and captured through the use of semi-structured focus groups and interviews, survey, participant observation and inductive analysis. A conceptual framework of ‘partners-in-care’ emerged and was used to assist participants to make sense of the values and factors important in their work with respect to collaborative relationships. The research processes facilitated the development of many innovations to enhance collaborative practice within the hospital. The organization was described by the research as undergoing directed change to enhance collaborative care as evidenced through participant self-reports, observed initiatives and the ethnographic descriptions. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2012-06-25 15:06:24.687