No one wants to be dependent on others for basic human necessities, yet at some point in life most of us will require assistance to ensure that our intimate personal care needs are met. This study aims at understanding what is quality person-centered intimate care and the barriers and facilitators to achieving it in nursing homes and in the delivery of home care services.

Objective

Discussions around intimate dependencies, such as needing help with bathing, toileting, and feeding, evoke strong emotions in those who are recipients of such care. No one wants to be dependent on others for these basic human necessities; yet because of illness or infirmity, most of us will require assistance to ensure that our intimate personal care needs are met. Being dependent on assistance with intimate personal care can cause people to feel helpless, vulnerable, and that they are a burden to others. Although having ones’ intimate personal care needs met is critical to the maintenance of health, physical comfort, and quality of life, regardless of the setting, such care is reduced to bits of labour often performed by low-paid paraprofessionals, who frequently work under difficult conditions that prioritize efficiencies over emotional care.

The main purpose of this study is to examine the structures and processes of intimate care delivery in order to determine what constitutes quality person-centered intimate care and the barriers and facilitators to achieving it. The three main research objectives of the project will be to:

  • Identify the salient indicators of quality intimate personal care provision from the perspective of care providers and care recipients.
  • Determine the barriers and facilitators to the provision of quality intimate personal care in those receiving nursing home care and home care.
  • Compare and contrast the experience of providing and receiving intimate personal care these populations.

Method

Using a focused ethnographic design, we will examine data on the intimate care processes, the physical environment, and organizational characteristics, to develop a rich nuanced understanding of how health systems characteristics, as well as individual care providers shape intimate care delivery, and how the
receipt of care is experienced by nursing home residents and clients on home care. Data was gathered through interviews with care providers and care recipients, focused observation (in nursing home only) and a review of relevant policies and documents on person-centered practices and intimate care
provision.

Summary of Findings

 

Significance

When unable to perform the care needed to meet one’s own intimate care needs, relying on others for this care is necessary, despite the psychological distress it may cause. In order to improve the health care experience for all patients, including reducing risk and improving patient safety, research is needed that will identify the care behaviors associated with the provision of quality intimate personal care and the contextual and environmental factors that facilitate or constrain it. Delineating these factors will help shape health care systems and care processes that honor, respect, and preserve human dignity when people are most vulnerable and require assistance with intimate care. Equipped with the knowledge of the structures and processes of care that support quality person-centred intimate care delivery and the barriers and facilitators that constrain it, we can develop responsive and safe care practices which improve the health care experience of all patients by supporting dignity, reducing risk, and bolstering quality of life.

Research Team

This project is being led by Dr. Genevieve Thompson (College of Nursing) with Dr. Susan McClement (College of Nursing), Dr. Tom Hack (College of Nursing), Dr. Harvey Chochinov (College of Medicine), Dr. Laura Funk (Sociology)

Funder

Canadian Institutes of Health Research (CIHR).