The need for a social revolution in residential care
The need for a social revolution in residential care
复制标题
DOI：
10.1016/j.jaging.2015.08.011
复制
发表时间：
2015-12-01
影响因子：
2.3
通讯作者：
Rozanova, Julia
中科院分区：
文献类型：
--
作者：
Theurer, Kristine;Ben Mortenson, W.;Rozanova, Julia
孤独和抑郁是严重的心理健康问题，从养老院到辅助和退休生活。为解决这些问题而向居民提供的社会心理护理通常是基于长期以来“轻”社会活动的传统，如游戏、旅行和社交聚会，由工作人员计划和实施。虽然这些活动为一些人提供了乐趣，但孤独和抑郁持续存在，而且缺乏居民的投入，使居民成为被动的护理接受者的刻板印象得以延续。居民们继续报告说，他们的生活缺乏意义，贡献的机会有限，对与工作人员的家长式沟通感到沮丧。痴呆症患者面临更多歧视，导致一系列需求得不到满足，包括缺乏自主权和归属感，这两者都与人际暴力有关。然而，研究表明，促进参与和同伴支持的项目为居民提供了社会生产力和发展有价值的社会身份的机会。本文的目的是提供当前实践的重新概念化。我们认为，在我们试图提高社会心理护理质量的过程中，居民代表了一个很大程度上尚未开发的资源。我们建议通过引入一种以居民贡献和同伴支持为中心的新方法来推翻专注于娱乐和分散注意力的做法。我们提供了一个居民参与和同伴支持（REAP）模型，用于设计干预措施，促进居民的社会认同，加强互惠关系，提高社会生产力。这种模式有可能彻底改变当前的社会心理实践，从住院医生护理转向住院医生参与。(C) 2015爱思唯尔公司版权所有。
Loneliness and depression are serious mental health concerns across the spectrum of residential care, from nursing homes to assisted and retirement living. Psychosocial care provided to residents to address these concerns is typically based on a long-standing tradition of 'light' social events, such as games, trips, and social gatherings, planned and implemented by staff. Although these activities provide enjoyment for some, loneliness and depression persist and the lack of resident input perpetuates the stereotype of residents as passive recipients of care. Residents continue to report lack of meaning in their lives, limited opportunities for contribution and frustration with paternalistic communication with staff. Those living with dementia face additional discrimination resulting in a range of unmet needs including lack of autonomy and belonging both of which are linked with interpersonal violence. Research suggests, however, that programs fostering engagement and peer support provide opportunities for residents to be socially productive and to develop a valued social identity. The purpose of this paper is to offer a re-conceptualization of current practices. We argue that residents represent a largely untapped resource in our attempts to advance the quality of psychosocial care. We propose overturning practices that focus on entertainment and distraction by introducing a new approach that centers on resident contributions and peer support. We offer a model Resident Engagement and Peer Support (REAP) for designing interventions that advance residents' social identity, enhance reciprocal relationships and increase social productivity. This model has the potential to revolutionize current psychosocial practice by moving from resident care to resident engagement. (C) 2015 Elsevier Inc. All rights reserved.