Moral dimensions of family involvement in nursing homes

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Promotion N. Hovenga

Dutch society faces major challenges in caring for nursing home residents, particularly due to a growing shortage of staff. Politicians are striving to strengthen family involvement. However, family involvement brings uncertainties and tensions, with moral dimensions often underexposed. This thesis of Nina Hovenga examines these moral aspects from the perspective of family and develops strategies to strengthen family involvement.

Family members face challenges in caring for their loved one in a nursing home, especially in their relationship with the nursing home staff. They often find it difficult to communicate their wishes and concerns because of their sense of vulnerability. After admitting their loved one, they hand over many caregiving tasks to nursing home staff, but they are often unsure of what to expect and what is expected of them, which often goes unspoken. Family members also experience psychosocial challenges such as guilt, loneliness, and coping with their loved one's deteriorating health.

Interventions that can help strengthen the relationship of trust between family and nursing home staff include: prioritizing informal conversations, discussing mutual expectations, and making nursing home staff more aware of family emotions. Striving for reciprocity, familiarity, transparency, empathy, and setting realistic goals are essential.

To enhance family involvement, the implicit division of care responsibilities must be addressed. Therefore, fostering an ongoing dialogue between nursing home staff and family is recommended, aimed at building moral consensus on the division of care responsibilities. A good relationship of trust is essential to ensure open and transparent communication.