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Personal autonomy for older people living in residential care: An overview.
Vivien Rodgers, RN, BA, GDGN, MN, Lecturer School of Health Sciences, Massey University
Stephen Neville, RN, PhD, FCNA(NZ), Senior Lecturer School of Health Sciences, Massey University
Rodgers, V., & Neville, S. (2007). Personal autonomy for older people living in residential care: An overview. Nursing Praxis in New Zealand, 23(1), 29-36.
Autonomy has significance for everyone, including those in long-term residential care. This article looks at the concept of autonomy particularly in relation to the population of older persons living in residential care settings. It examines the values underpinning the exercise of personal autonomy and notes how an individual’s autonomy may be enhanced or restricted. The implications for gerontological nursing practice are outlined and suggestions offered as to how personal autonomy for older persons living in residential care may be preserved and promoted.
Key Words: Personal autonomy, residential care, older people, gerontological nursing.
Increasingly people are living longer, with more and more reaching their ninth and even tenth decade. New Zealand’s population, like that of the rest of the world, is ageing. As this phenomenon continues there will be a correspondingly dramatic increase in the proportion of the population aged 65 years and over (Statistics New Zealand, 2006). This trend will result in a greater proportion of the population being at risk of health and well-being issues (Neville, Keeling & Milligan, 2005). Therefore, it is likely that a concomitant increase in numbers of people living in residential care settings will occur. For most people admission to residential care is not an eagerly anticipated milestone. According to 2001 data, approximately 25,100 people over the age of 65 years, live in residential care (Ministry of Health, 2004). The decision to move into a residential care facility is frequently related to changes in personal circumstances, for example, deteriorating health, illness and the loss of a significant other whether that be a spouse, partner or caregiver. Frequently deteriorating health and associated illnesses equate with increasing dependence on another person. Older adults often fear that an illness or disability may lead to a loss of independence (Eliopoulos, 2005). Personal autonomy is central to the notion of independence.