Nursing home resident relationship types: What supports close relationships with peers & staff?

AIMS AND OBJECTIVES: To describe from the nursing home resident perspective (a) the types and dimensions of relationships residents develop with others in the nursing home and (b) the conditions that influence the development of close relationships.

BACKGROUND: Close relationships are considered the fundamental building block of person-centred care. Prior studies have examined the various types of relationships residents develop with peers and staff, but few have focused specifically on articulating the characteristics and dimensions of a close relationship or the factors that can support or detract from their development.

DESIGN: Grounded theory.

METHODS: Fifteen cognitively intact residents from two nursing homes were recruited for one-on-one, unstructured interviews. Interview questions started broadly and became more focused as the study progressed. Data were analysed using open, axial and selective coding.

RESULTS: Residents described developing a range of relationships with peers and staff (adversarial, utilitarian, and friendly). Residents used "friendly" to describe many different types of relationships including acquaintanceships, casual friendships and close friendships. Few residents had close relationships with peers or staff. Several conditions promoted development of positive and friendly relationships. Physical proximity and access to peers with similar interests, who could communicate clearly, fostered friendly peer relationships. Spending noncare time, providing little extras, treating residents as special and responding positively to care requests fostered friendly staff relationships.

CONCLUSIONS: Findings add new evidence regarding nuances in resident relationships and demonstrate how development of close relationships may be limited in practice. Careful assessment of resident relationship needs and goals may be critical to setting appropriate social goals.

RELEVANCE TO CLINICAL PRACTICE: Nurses can be intentional about resident placements in the facility to promote social interactions and keep social goals in mind when making medical or staffing decisions to prevent interruption of important relationships.