Transforming nursing home culture: Opinions of older people. A cross-sectional study in Belgium

A culture change movement is taking place in some nursing homes: from the traditional biomedical to more person-centred and relational environments. However, knowledge of the institutional preferences of older people among the general population is limited. We focused on identifying what is important to older people when choosing a nursing home. We also wanted to determine which type of environment (traditional or relational) they would be more inclined to enter; where they would feel better cared for and respected; where professionals would offer more adequate support; where older people would feel more at home, and where they would feel freer to live the life they wanted. A cross-sectional study based on the analysis of two brochures was conducted: one integrated traditional nursing home information, the other included information related to the culture change environment. Participants (n = 71) were first asked, when choosing a nursing home, what the most important features were. They were then asked to consider the two brochures and, after reading each, to assess their desire to enter the nursing home, their feelings about the care given by the professionals, the respect of their personal habits and their choices, the professional support, the home-like atmosphere and freedom to live their life. Finally, they were asked to choose one nursing home. The features cited by the participants were then evaluated by independent evaluators to identify their orientation (traditional or culture change nursing home). The majority was assessed as having a culture change in orientation. After reading the culture change brochure, participants felt more inclined to enter the nursing home, and believed that they would be better cared for, be more respected (habits and choices), and freer to live the life they desired in a home-like atmosphere, compared to the traditional brochure. Finally, most participants chose the culture change nursing home as their final choice. The results support the potential benefits of culture change within nursing home environments.