Frontline nursing staff provisions for self-determination with nursing home residents with cognitive impairments: a scoping review in partnership with Loch Lomond Villa

Abstract

Making decisions about daily activities is important for older adults' health and well-being. In nursing homes, frontline nursing staff are challenged with preserving residents' self-determination in the face of ritualistic care routines and time pressures. Staff may also experience tension when their professional responsibilities require them to protect residents against their own unwise decisions that pose a risk to their safety. This tension is amplified in the care of residents with cognitive impairments. This report represents the findings from a scoping review about nursing staffs' provisions for self-determination in nursing homes. It was conceived and prepared in collaboration with Loch Lomond Villa (LLV) as a community partner. This report maps the boundaries of nursing staffs' role in negotiating residents' self-determination. Nursing staffs' roles as investigators, advocates, protectors, and assessors emerged as critical roles to providing for self-determination. Based on these findings, recommendations are offered for practice at LLV.