Promoting and Protecting Against Stigma in Assisted Living and Nursing Homes

To determine the extent to which structures and processes of care in multilevel settings (independent living, assisted living, and nursing homes) result in stigma in assisted living and nursing homes. Ethnographic in-depth interviews were conducted in 5 multilevel settings with 256 residents, famili...

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Bibliographic Details
Published in:The Gerontologist 2016-06, Vol.56 (3), p.535-547
Main Authors: Zimmerman, Sheryl, Dobbs, Debra, Roth, Erin G, Goldman, Susan, Peeples, Amanda D, Wallace, Brandy
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging
Anthropology, Cultural
Assisted Living Facilities
Attitude of Health Personnel
Ethnography
Female
Health services
Humans
Independent living
Long term health care
Male
Nurses
Nursing Homes
Prejudice
Privacy
Qualitative research
Social Stigma
Stigma
Studies
Training
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Summary:To determine the extent to which structures and processes of care in multilevel settings (independent living, assisted living, and nursing homes) result in stigma in assisted living and nursing homes. Ethnographic in-depth interviews were conducted in 5 multilevel settings with 256 residents, families, and staff members. Qualitative analyses identified the themes that resulted when examining text describing either structures of care or processes of care in relation to 7 codes associated with stigma. Four themes related to structures of care and stigma were identified, including the physical environment, case mix, staff training, and multilevel settings; five themes related to processes of care and stigma, including dining, independence, respect, privacy, and care provision. For each theme, examples were identified illustrating how structures and processes of care can potentially promote or protect against stigma. In no instance were examples or themes identified that suggested the staff intentionally promoted stigma; on the other hand, there was indication that some structures and processes were intentionally in place to protect against stigma. Perhaps the most important theme is the stigma related to multilevel settings, as it has the potential to reduce individuals' likelihood to seek and accept necessary care. Results suggest specific recommendations to modify care and reduce stigma.
ISSN:0016-9013
1758-5341
DOI:10.1093/geront/gnu058