From Family Involvement to Family Inclusion in Nursing Home Settings: A Critical Interpretive Synthesis.
Gloria Puurveen, Jennifer Baumbusch, Preet Gandhi
PMID 29455580WHAT IT FOUND
Nursing home family members often did staff tasks such as bathing and toileting, monitored care, and changed visit patterns over time.
Staff and family disagreed about roles, and family knowledge was sometimes devalued.
Key findings
01Family members sometimes did tasks normally assigned to staff, including bathing, showering, toileting, and helping their relative to bed.
02In a longitudinal study of 35 family members, 37% had less contact, 40% had the same amount, and 23% visited more frequently one year later.
03Staff believed family members should be limited to socioemotional roles, while family members believed they should be more involved in personal care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a synthesis of 32 studies, not a trial; it cannot show whether family inclusion improves care or outcomes. No formal quality appraisal was done, and study reporting varied, so some included studies may be weak. Most studies gathered data at one point in time, so they cannot show how involvement changes over time. The reviewed studies mostly included frequently visiting, heavily involved family members, so less involved families' experiences are unclear. Many studies did not report sampling, age, race, class, or context, limiting comparison across groups. The review excluded intervention studies, end-of-life care, and transition into the nursing home, so it does not cover those situations. Most studies were from Canada and the United States, so transferability to other settings may be limited.
Declared interests
The authors declared no potential conflicts of interest. The research was supported by the Canadian Institute for Health Research.
The easy way to misread this
Do not read this as evidence that family inclusion improves nursing home care or reduces staff workload. The review synthesises family members' reported experiences and staff-family relationships; it did not test an intervention or measure patient outcomes.