How do nurses advocate for the remaining time of nursing home residents? A critical discourse analysis.

ABSTRACT

INTRODUCTION: Due to the global aging trend, the number of older people who will spend the last years of their lives in nursing homes is increasing. However, nursing homes have long confronted negative social and public discourses, including stigmas on dementia and life in such facilities. Nevertheless, the remaining time of residents with dementia holds significance, for them and their families, as they seek respect and the ability to make meaningful end-of-life decisions. OBJECTIVE: To explore how nursing home nurses advocate for the remaining lifetimes of residents with dementia. DESIGN: A qualitative research design. SETTING(S) Four nursing homes in Korea from January 2023 to February 2023. PARTICIPANTS: Twenty nurses who provide direct caregiving for residents with dementia and have a minimum of two years' experience in nursing homes were recruited. METHODS: This study employed a critical discourse analysis. Twenty interviews conducted with nursing home nurses were examined to explore the connections between the grammatical and lexical aspects of the language used by the nurses to construct their identities as advocates for residents with dementia and the broader sociocultural context. FINDINGS: Four discourses regarding nursing home nurses advocating for the value of life of residents with dementia were identified (1) Bridging perspectives I am a negotiator between medical treatment and residents' families with differing views; (2) Embracing a shared humanity Residents are no different from me; they just need professional help; (3) Affirming belongingness Residents still belong to their families, even when care has been delegated; and (4) Empowering voices for change We are struggling to provide better care in a challenging reality. CONCLUSIONS: This paper highlights the importance of nursing advocacy in safeguarding the remaining time and dignity of individuals with dementia, challenging the stigma surrounding dementia and nursing homes and calling for greater societal and political recognition of the efforts nurses make to preserve the personhood and well-being of these older adults.