Staff-Patient Relationships in Nursing Homes: Sources of Conflict and Rehabilitation Potential

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Research is reviewed indicating that staff-patient interactions often function to encourage dependency among residents while discouraging independent behaviors. Hypotheses are developed as to why staff members tend to elicit dependency; these include the operation of culturally and cognitively based stereotypes about the aged, adherence to the medical model of providing help, institutional constraints of nursing homes, and burnout. Additional research is presented showing that continued dependency and passivity are detrimental to the health of patients, and that interventions aimed at decreasing dependency reduce the likelihood of disease and death. Interventions to instruct staff members in specific skills for encouraging independent and active engagement by residents are suggested. Possible changes in institutional policies within nursing homes, such as rewarding staff according to residents' outcomes, and implementing tactics to prevent burnout among staff members, are also discussed.

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