Trust of Nursing Home Staff Caring for Residents with Advanced Dementia: A Qualitative Descriptive Study of Family Caregivers' Perspectives.
Anita Hendrix Rogers, Fayron Epps, Meghan Hendricksen and 3 others
PMID 34583234WHAT IT FOUND
Caregivers of nursing home residents with advanced dementia, Black and White, described trust when staff knew their relative, met needs, and kept them informed.
Mistrust followed perceived lack of care or poor communication.
Key findings
01Family caregivers described three ways of trusting nursing home staff: complete trust, complete mistrust, and differential mistrust.
02Complete trust was described when caregivers believed staff knew and loved the resident, met care needs, and kept them informed; complete mistrust was described when caregivers felt these were absent.
03Some caregivers who described complete trust preferred residents to stay in the nursing home rather than be transferred to hospital, while some who described complete mistrust expressed pain or regret.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The interviews were part of a secondary analysis and were not originally designed to ask about trust. The sample had 19 Black and 25 White caregivers, so comparisons by race were not balanced. Only one interview implicitly mentioned race, so the idea that racial concordance shaped trust is not established. Caregivers came from 13 nursing homes in four US hospital referral regions, and no home contributed more than four caregivers. The study describes caregivers' perceptions, not patient outcomes or tested interventions.
Declared interests
The paper is listed as supported by NIH extramural research. The authors declared no conflicts of interest.
The easy way to misread this
Do not read these trust categories as proof that communication training will improve care or reduce hospital transfers. This was a secondary qualitative analysis of caregiver perceptions and did not test an intervention. Do not conclude that race caused the differences; only one interview implicitly mentioned race.