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The transition to institutional living : the experience of elderly people Allen, Natalie Ruth

Abstract

The purpose of this study is to identify how elderly subjects perceive their transition from home to institutional living. The study was conducted with a convenience sample of five subjects, 6-13 months following their admission to a unit which provides care for dependent elderly clients. The methodology introduced by Glaser and Strauss (1967), for the discovery of grounded theory, was used. A conceptualization of the transition to institutional living as five sequential and inter-related phases is introduced. These phases are: anticipation, reaction, interpretation, negotiation and integration. In the first two phases subjects' responses to challenges to development, introduced by the transition, tend to predominate. The third and fourth phases are characterized by subjects' working through these challenges to achieve mastery within the new situation. The final phase is manifest in each individual's attributing personal meaning to the transition within the context of his or her total life. Mastery within the new situation is achieved through problem solving approaches to increasing dependency, acceptance of personal responsibility for adjustment, and the perception of institutionalization as but one incident in each individual's life history. This transition was found to differ from those described amongst younger populations. It is proposed that this difference occurs as a function of developmental stage, frailty, and the environmental situation. The findings of this study a) emphasize the holistic nature and complexity of nursing practice with frail elderly clients, b) support the use of concepts from developmental theory as a basis for nursing practice with elderly clients, and c) suggest ways in which nursing education and research may contribute to the development of nursing care for elderly clients.

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