• Ezra van Zadelhoff, Hilde Verbeek, Guy Widdershoven, Erik van Rossum, and Tineke Abma.
• Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, School for Public Health and Primary Care CAPHRI, Maastricht University, Amsterdam, The Netherlands. e.vanzadelhoff@maastrichtuniversity.nl
• J Clin Nurs. 2011 Sep 1; 20 (17-18): 2490-500.

Aims And ObjectivesTo investigate experiences of residents, their family caregivers and nursing staff in group living homes for older people with dementia and their perception of the care process.BackgroundTraditional nursing homes for people with dementia have several shortcomings related to depersonalisation, passivity, loss of skills and use of physical restraints. Group living homes are seen as an alternative to regular nursing homes, but experiences with this new care setting have rarely been investigated.DesignThe study followed a naturalistic design. Qualitative data were collected over a period of 6 months in two group living homes located in the southern part of the Netherlands.MethodsSystematic participatory observations were carried out during daily life, care and activities in both homes. In addition, semi-structured interviews were held with residents, their family and nursing staff. These data were inductively analysed and related to Tronto's care ethical framework.ResultsAccording to all parties, group living homes create structural opportunities for individualised care and attention to the residents' personal needs. The increased attentiveness and responsiveness for residents' well-being was seen as a sign of good care and fits with the phases of caring about and receiving care of Tronto's care ethical model. However, tensions occurred relating to the phases of taking responsibility and carrying out care. Not all residents and family members want or are able to take responsibility and perform self-care.ConclusionsGroup living homes create conditions for good care and stimulate attentiveness and responsiveness. Tensions in these homes may relate to the new division of responsibilities and tasks.Relevance To Clinical Practice  Values of attention to needs and responsiveness are of high importance for nursing staff to provide good care for people with dementia in a nursing home setting.© 2011 Blackwell Publishing Ltd.

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