Women, old and aware: living as a minority in extended care institutions

The purpose of this phenomenological study was to describe the everyday lived experiences of old, cognitively intact women, residing in an integrated extended care facility among an overwhelming majority of confused elderly people. The research question was "From your perspective, what is the impact of living in an environment where the majority of residents, with whom you reside, are cognitively impaired?". A purposive sample of five older women participated in multiple in-depth interviews about their subjective experiences. All five live at different sites of the Juan de Fuca Hospitals Society, a 512 bed, integrated, extended care facility in Greater Victoria, British Columbia. Data analysis of the essential meaning of participants way of being in the hospital world was guided primarily by van Manen's (1990) work on researching lived experience and Colaizzi's (1978) phenomenological analytical approach. A number of significant statements were extracted and clustered into themes reflective of the participants' perspectives. The findings revealed that the systematic procedures, practices and policies of the institutions where they resided, came before the needs they themselves identified as important. The women in this study did not feel heard by the hospital decision makers. The data suggests that integrating cognitively well residents with people who are confused is not in the best interests of alert residents. The issues raised by participants suggest that without sufficient staff, more staff training and funding, care geared to specific client needs will not be possible. It is recommended that: - the understanding given dementia by staff also be given to the cognitively well; - that the company of people able to communicate in challenging and supportive ways could dramatically increase the quality of life for the cognitively well; - that structures be created to enable cognitively well residents to have a voice in the organisational goals and objectives; - and that structures be created to ensure those working in the field the time to listen to clients voices.Arts, Faculty ofSocial Work, School ofGraduat