Dr Linda Roberston
As New Zealand's population continues to age and members of the baby boomer generation begin to move into retirement, the quality of care offered by residential homes for the elderly has become an increasingly topical issue.
This is particularly the case for occupational therapists, says Otago Polytechnic Occupational Therapy lecturer Linda Robertson. Occupational therapists play a vital role in the residential home environment, facilitating activities, assisting with daily living skills and helping to ensure that residents continue to live engaged and meaningful lives. Residential homes, and in particular the way that residents view their homes, have been a significant focus of Robertson's research for several years. She was often surprised, however to learn that there was very little in the available literature that differentiated appropriately between the very different types of residential care on offer.
"It was interesting to discover how little attention has been paid to the way that rest homes are conceptualised," Robertson says. "There is very little reference to different types of rest homes in the literature, and yet the services on offer and the overall culture differ significantly from home to home." Robertson joined forces with Ruth Fitzgerald from the University of Otago to address this gap, designing a qualitative study based on semi-structured interviews with staff from two New Zealand residential homes: one that prides itself on a hotel-like ambience, and a more traditional, ‘homely' residence. "The key theme that emerged was that there is a cultural environment in a residential home and it is very powerful," Robertson says. "It's influenced by management and how they organise their home and instruct their staff."
In the hotel-like home, she says, a high level of care was equated with efficiency and high-quality service, whereas the traditional home was more focused on establishing homeliness through recognising the individual histories of residents and blurring boundaries between the home and the community. "Considering the negative focus of much research on residential homes, it's important to point out that in both of the homes we looked at, people seemed happy in their environments," Robertson says. "But the differences were significant, particularly in terms of staff expectations.
"For occupational therapists, it highlights the importance of understanding the culture you're working within, whether or not it suits your personal preferences, and making the most of the opportunities that exist within it."