Struggles for autonomy in self-care: the impact of the physical and socio-cultural environment in a long-term care setting

Self-care has great significance in individuals' lives because it has been shown to support one's health and well-being in old age. This qualitative study of daily life in a nursing home ward employed an ethnographic design to observe routines and daily activities in the ward. Narrative interviews with the residents and staff were also conducted in order to learn about the environmental experience. The aim was to generate a deeper understanding about how the physical and socio-cultural environments and residents' cultural beliefs influenced participation in their own personal-care activities. The findings demonstrate how the physical and socio-cultural environment in the nursing home actually required older residents to overcome greater physical and cognitive challenges to maintain their participation, autonomy, and dignity in toileting, bathing, and dressing than would have been expected had the resident been living at home.