Focus on: Well-being in Welsh Care Homes

Caitlin

Caitlin's research aims to use a mixed methods design to develop a better understanding and a more detailed view of well-being for older adults in residential care in Wales; to explore ways to improve and maintain older adult’s well-being and quality of life, and to offer recommendations for best practice in assessing and maintaining well-being and improving the mental health of older adults in residential care.

The first stage of the research will use a standardised well-being scale to measure the mental well-being of older adults in residential care. The findings will be used to inform and develop interview questions for the second, qualitative stage of the research.

 

What is your research investigating?

The PhD research focuses on developing a better understanding of what contributes to the mental well-being of older people in residential care and explores ways to promote and maintain their mental well-being and quality of life through using a mixed methods design. The first, quantitative stage uses the Mental Health Continuum Short Form (MHC-SF) to measure different components of well-being. The results from the first stage will then be used to inform and develop the interview questions for the second, qualitative stage of the research.

Lessons from carrying out research in Care Homes

Research with older people living in care homes taught Caitlin the importance of remembering that you are entering someone’s home, and also someone’s place of work. Care homes are busy and unpredictable places, staff are busy meeting the care needs of residents, and often with difficult staffing levels. It’s not surprising that research can often fall to the bottoms of the list of priorities. Therefore, it’s important to remember that with so many variables even the best laid plans are going to need to include an element of flexibility.

Planning ahead

It can be useful to think in advance of the peripheral things that might cause delay, such as managers or key staff being unavailable or leaving, illness within the care home or even bad weather. Caitlin learned not to take things for granted or to assume that everyone you meet has had a chance to familiarise themselves with the research materials. Which can be frustrating if the wrong information is passed on to residents.

Face to face contact 

While designing research Caitlin found that it’s best to overestimate how long it will take to recruit and collect data from care homes and residents. If you have a time frame in mind of how long it will take to initiate contact with care homes and care home managers, double it – at least! As with any research the response rate can be very low. Caitlin had a better response from speaking with care home managers directly and offering to meet with them to discuss the research. From speaking with care home residents and care home managers I’ve noticed that the care home population appears to be changing. With an emphasis on care in the community and keeping older people at home for as long as possible, the care home population is now older, more fail  and have more complex needs. Caitlin learned that it’s important to bear this in mind when planning research, and to be mindful of what we’re asking residents and staff to do. Even though a care home may have 40 residents, it may only be three or four residents that are able to take part in the research, to give consent, be free at the time of your visits and actually want to be involved. It’s important to take this in to consideration, Caitlin overestimated how many residents would be involved from each care home and underestimated how long the process can be.

 Be Prepared 

Time for each visit is another variable that needs more flexibility than first anticipated. The time to speak to each resident can vary greatly. For example, some residents will take 10 minutes to complete the questionnaire. On the other hand, some residents will want to speak to you about themselves while they’re completing the questionnaire which can take up to an hour or sometimes more. The things that the residents speak about can also sometimes be upsetting; some will talk to you about loved one’s they’ve lost or the crisis that led them to leaving their home and moving to the care home. This can be upsetting and distressing, and it’s important to be prepared for the possibility of encountering difficult situations whilst doing research. Caitlin also encountered some difficulty in reassuring residents that their answers on the questionnaire will remain anonymous and confidential.

Key Message:

Flexibility and perseverance are key in this type of research. Though even with all the challenges of conducting research in care homes, Caitlin found it to be a rewarding experience and met some wonderful and interesting people.