Practices for making residents' wishes fit institutional constraints: a case of manipulation in dementia care

Logoped Phoniatr Vocol. 2019 Apr;44(1):7-13. doi: 10.1080/14015439.2019.1554851. Epub 2019 Jan 29.

Abstract

Purpose: The study aims to show how practices of manipulation are used by a member of staff in a care situation where the member of staff has to perform two tasks at once.

Method: The study is an ethnomethodological conversation analytic single-case study of a care situation in residential dementia care. The analyses are based on video recordings and observations conducted during 9 months of fieldwork at a residential care facility for persons with dementia.

Results: The study details the methods by which a member of staff engages in manipulation by constructing her actions as responses to a resident's wish which has in fact never been stated.

Conclusion: The study discusses how manipulation may be understood as care staff practices for making a residents' wishes fit the institutional constraints they are subjected to and for "doing what is best for the resident."

Keywords: Dementia; conversation analysis; manipulation; person-centered care.

MeSH terms

  • Attitude of Health Personnel
  • Behavior Control* / standards
  • Cognition
  • Dementia / diagnosis
  • Dementia / psychology
  • Dementia / therapy*
  • Female
  • Guideline Adherence
  • Health Knowledge, Attitudes, Practice
  • Homes for the Aged
  • Humans
  • Language
  • Memory
  • Nursing Homes
  • Patient Compliance
  • Patient-Centered Care / methods*
  • Patient-Centered Care / standards
  • Practice Guidelines as Topic
  • Professional-Patient Relations*
  • Single-Case Studies as Topic
  • Treatment Outcome