Latitude of choice among the institutionalized elderly : resident and staff perceptions
Creators: name: Jang, Gail
Publisher: name: University of British Columbia
Year: 2010

description: The establishment of intermediate care facilities in British Columbia, as well as the establishment of similar facilities throughout the rest of Canada, was and still is a well-intentioned approach to meet the long term care needs of the elderly. The practices and procedures adopted by long term care facilities, however, tend to inhibit the personal autonomy of residents (Thomasma, 1985). Specifically, a facility's practices and procedures tend to inhibit residents' latitude of choice regarding daily living activities. Residents' latitude of choice may also be lessened when nurses implement well-intentioned helping interventions based on their own motivations and goals, rather than those of elderly residents. Latitude of choice measures the extent to which an individual's perceived degree of choice includes activities of importance to him/her. At present, there is limited research addressing both resident and staff perceptions regarding the autonomy (freedom of choice) of residents, particularly in relation to their daily activities. Accordingly, this study's purpose was to determine the institutionalized elderly residents' and their caregivers' perceptions of residents' latitude of choice regarding activities of daily living. From determining these specific staff and resident perceptions, significant differences were isolated. This study was conducted in two intermediate care facilities located in a large city within the province of B.C. The data collection instruments in this study included selected questions from Hulicka et al.'s (1975) revised Importance, Locus and Range of Activities Checklist, as well as a demographic data sheet developed by the researcher. Forty-five intermediate care 1 residents and forty-five nurses (Registered Nurses, Licensed Practical Nurses and Nurses' Aides) completed the study questionnaire and the demographic data sheet. The researcher studied the residents' and staff's responses to the Importance, Locus and Range of Activities Checklist by using non-parametric techniques for statistical analysis. The researcher used these techniques to determine the existence and location of differences in perceptions among the residents and staff. Significant differences exist in residents' and staff's perceptions when each group's importance ratings are combined with choice ratings. Isolation of the above importance and choice components for individual analyses indicate that the residents and staff had significantly different response patterns regarding a) the importance residents attach to daily living activities and b) the degree of choice residents associate with daily living activities. The above findings indicated that residents' latitude of choice may not be realized to a greater extent if the staff do not attach a degree of importance to a particular activity(ies) similar to that attached by the residents. Residents' latitude of choice may not be recognized to a greater extent if staff do not perceive that residents associate "some" or "no choice" with an activity of particular importance to them.