A Narrative Exploration of Family Members' Perspectives of Life Story Phases Following Transition of an Older Family Relative Into Long-Term Care.

Abstract

Background: The transition of an older person from a home environment into long-term care is frequently unplanned and complex. Little is known about how relatives make sense of supporting the transition of their relatives to long-term care.

Objective: This study explored family members' narratives of the process of supporting the transition of their older relative into long-term care.

Method: Life stories of six relatives who supported transitioning their older family relatives into a nursing home were collected using open narrative questioning in accordance with the Biographical Narrative Interpretive Method. Data was analysed using a dialogic/performance analysis narrative analytic method.

Results: Four key life story phases were identified: before transition, crisis event, transition and after transition. These phases varied in time duration and involvement of healthcare providers. The longest phase was 'before transition' where a process of slow deterioration became more apparent to the participants retrospectively. This was followed by the shortest period 'crisis event' where the older person was admitted to tertiary care. Two permeating themes: family dynamics and knowledge/understanding underpinned all life story phases.

Conclusions: Relatives' knowledge, family dynamics and positioning of self-informed the duration of the life story phases of participants as they navigated the transition. Understanding nuanced differences in relatives' life story phases highlights how timing of information provision can affect the emotional adjustment of relatives experiencing this challenging process.

Implications for practice: Both community and gerontological nurses' offer real potential to provide tailored and effective responses to relatives depending on each life phase. Sequencing of information appropriate to the life phase could potentially ease the stress associated with transitioning to nursing home care, possibly preventing a crisis event from occurring. Anticipatory conversations also offer potential to alleviate relatives' concerns through life story phases.