The Feeling of Powerlessness in Older People Living in Nursing Homes

Introduction and All societies in the world are experiencing burgeoning numbers of "elders", defined as persons aged 65 year and older. It is expected that at least 40% of the population over 75 years need extensive health care services in the last years of their lives. Countries with an ageing society have developed long term care policies for older people. In Iran, as the rate of transferring the elderly to the nursing homes is increasing, it would be important to investigate the experience of self-determination, respect and value among elderly people living in these settings. The powerlessness results in loss of hope. In addition, older adults who feel powerless may also lose their independence. In this situation, family members or health professionals take over and make decisions for them. Elder's empowerment can promote their quality of life and well-being. This study aimed at description of the experience of powerlessness in elderly who are living in nursing homes. The research question was "how is the experience of powerlessness in elderly who are living in nursing homes? The qualitative phenomenological approach with purposive sampling was used in this study. Participants in this study were elderly residents of private and governmental nursing homes in Esfahan city. Sampling continued till data saturation occured with 10 participants. The data were collected through in-depth interviews. Researcher used field notes for completing data collection process. Colaizzi's method was applied for data analysis. The rigor criteria of the present study were based on transferability and credibility. Three themes were extracted from the data (structural components of the experience), including: 1) compulsory tolerance, 2) Waiting for exiting permit, and 3) Constrained autonomy. In this study, some participants experienced lack of ability in changing conditions and also compulsory tolerance of the situation, two main findings from which the concept of powerlessness was perceived. Transferring to nursing home is a source of fear and anxiety in the end years of life. For the institutionalized elders, empowerment can come through participating in making decisions regarding patient care and other aspects of life in this setting. In addition, mental, spiritual and physical needs of elders should be met through whole care, because simply focusing on physical needs deprive hopeful, meaningful and purposive life in nursing homes.