Democratic Care in Nursing Homes: Responsive Evaluation to Mutually Learn About Good Care

In a transition from paternalistic to democratic care, Dutch nursing homes are expected to concentrate on the well-being of their residents and to align care with residents’ signifcant others. Although this way of working is affrmed in nursing home policies, care staff experiences diffculties with providing democratic care in practice. In co-creation with care staff (n = 110) throughout 11 nursing homes in the Netherlands, we therefore developed the enjoying life approach, plan, and training program. A responsive evaluation was completed including observations, conversations during and outside training sessions, and semi-structured interviews with care staff, residents, and signifcant others (n = 81). The enjoying life approach values the participation of all people involved in the care process and strives for person-centered care by learning from each other through sharing narratives and building personal relationships. This is in line with democratic care’s notion that good care starts in the lifeworld of care receivers and is the result of an intersubjective dialogue between care receivers and their caregivers. In this chapter we present our learning experiences with the enjoying life project and discuss implications for the democratic potential of organizations. We show that the participation of residents and signifcant others within the care process can lead to a mutual understanding of what is deemed “good” in a specifc situation. However, this requires the cultivation of an organization culture wherein different and sometimes conficting perspectives on what good care entails are acknowledged and a space is created to engage in dialogues about good care.

This is an abstract of chapter 3: ‘Democratic Care in Nursing Homes: Responsive Evaluation to Mutually Learn About Good Care’ by Marleen Dohmen, Josanne Huijg, Susan Woelders en Tineke Abma, which was publicshed in the book ‘Institutions and Organizations as Learning Environments for Participation and Democracy’, University of Innsbruck, Springer, January 2023.