For example, rights and autonomy provide the foundation for discussion of many contemporary national issues, including health care reform, gun control, education reform, and abortion rights. Autonomy can mean self-determination, informed consent, a cognitive process or personality trait, control, choice, or an orientation of the person to their environment, including the resident's values, unique life history, interpersonal interactions and their use of time and space. Social Model of Care - emphasizes the social aspects of nursing home life for nursing home residents, at least as much, if not more than the health care aspects of nursing home life. Interpersonal relationships among staff, residents, and families, activity programs, and those focused on social support of residents are emphasized in this model. The social model of care emphasizes the impact of the psychosocial environment on resident health and well being.
Structure includes organizational charts, job descriptions, and decision-making power.
Work processes include all the ways in which residents, nurses, and members of the interdisciplinary term interact with one another to contribute to the residents' highest possible level of well being and overall quality of life. Because members of the department of nursing have the greatest amount of direct contact with residents and usually comprise the largest employee group, the department of nursing and the DON have the opportunity to have the most dramatic impact on the internal organizational environment of an institution. Each element contributes barriers and opportunities for the enhancement and promotion of resident autonomy. The long term care facility is a unique type of health services organization. Residents live for long periods of time in the setting and almost all aspects of their personal lives are controlled and influenced by the organization.