Social capital and atmosphere of care settings for older people: A comparative study of two care sectors

Background Social capital is a resource that is created by people through networks, interactions, trust and social norms that can help facilitate mutual gain. Atmosphere (or social climate) is the ‘personality’ or feel that one gets from entering a place and plays a large role when individuals are choosing a care setting. Social capital may provide insights into our understanding of life within these care settings, but has not been extensively investigated. Aims This comparative study of care homes and hospices aimed to address three research questions: 1. What is the relationship between the social capital of older residents/patients and the atmosphere of the setting in which they are cared? 2. Are the quality and quantity of interactions between staff and those being cared for different between the two care sectors? 3.What is the role that visitors and volunteers play in the life of those being cared for within the two care sectors? Methods A mixed methods approach was used designed as two overlapping phases in two care homes and two hospices. Phase one comprised quantitative structured observation of the quality of interactions, and questionnaires measuring the atmosphere of the care setting from a staff member and volunteer perspective. Phase two comprised semi-structured interviews conducted with different groups of people who live, work and visit the care sectors. Findings There were 2115 observed interactions conducted in total across both care sectors. In the care home sector, staff members were involved in and initiated the largest proportion of interactions. In the hospice sector, volunteers were involved in and initiated most interactions. There were no significant differences between care settings in terms of quality of interaction. Hospice settings were found to have a more positive atmosphere than care homes. Three key themes were identified from interviews. Integration describes the way that visitors and volunteers help integrate the communities inside the care settings with those outside. Demarcation refers to the physical boundaries of the care settings and the roles and restrictions that are placed on those that work and volunteer within the care settings. Cohesion was observed when the people in a care setting worked together to provide a mutual service, for a common goal. Conclusion Visitors and volunteers play an important role in the care of older people and can improve the social capital of the care settings. Hospices were found to have higher levels of social capital, and more positive atmosphere than care homes. Improving the social capital of older people within these care settings while controlling for the negative aspects of social capital could result in a better atmosphere that can be experienced by those who live, work and visit these care settings