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Enhancing relationships in long-term care
For elderly people in long-term care, a large part
of their world is their nurses. The quality of their
relationships with care providers has a huge impact
on their quality of life. Dr. Katherine McGilton, a
Scientist at Toronto Rehab, is studying ways to make
those relationships better.
"I'm interested in learning how to measure and
enhance relationships between care providers like health
care aides or registered practical nurses and the clients
who live there. I also look at relationships between
supervisors and care providers. Because families play
such an important role in long-term care environments,
I'm interested in relationships between clients' families
and staff as well."
The ideal client-nurse relationship in the long-term
care setting is often described as 'therapeutic.' Dr.
McGilton questions this. "In a therapeutic relationship,
the nurse is trying to change the client's behaviour,"
she says. "That's the last thing most older clients
want.
"Relationships are defined in different ways by
different clients. Part of my task is figuring out what
having a relationship means in the long-term care setting.
Another part is helping nurses develop the skills they
need to care for vulnerable elderly persons in these
environments. This can help them develop effective ways
of relating with clients.
"In the long-term care setting, many relationships
are about being familiar, getting to know our clients'
likes and dislikes, being there for them, listening
to what they tell us and responding to their needs." |
Dr. Kathy McGilton
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Quick
Biography
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Dr. McGilton is a research scientist at Toronto
Rehab. She is also an affiliate scientist
at the Kunin-Lunenfeld Applied Research Unit at
Baycrest Centre for Geriatric Care.
She holds a Lecturer position at the Faculty of
Nursing and is a Co-Investigator with
the Nursing Effectiveness, Utilization and Outcomes
Research Unit, at the University
of Toronto. Her research program is focused on
two primary interests: the
development and application of outcome measures
in gerontological
practice, and development of intervention studies
that focus on enhancing
relationships between nursing staff and clients
and between staff and their
supervisors. Her PhD in Nursing is from the University
of Toronto.
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When communicating with the elderly, verbal communication
may be only part of the picture. "Clients are less
influenced by what we say than how we say it and the
way we act," says Dr. McGilton. "Our manner,
posture and tone of voice are important. Nurses in long-term
care settings have to constantly ask, 'how can we acknowledge
and respect the humanity of our clients?'"
Training can improve nurses' ability to develop appropriate
relationships. Dr. McGilton has actually measured changes
in the behaviour of nurses who have been specifically
trained to relate to clients.
The quality of long-term care also depends in part
on the unit supervisor. Because supervisors are such
an important part of the team, Dr. McGilton is developing
ways of measuring how effective they are, and whether
they are perceived by staff as being empathic and dependable.
Dr. McGilton was first attracted to this area of research
because she saw the opportunity to have a major impact
on patient care. "My work is practical - and it's
unique." she says. "It contributes to both
gerontology and administration. That is a very unusual
combination." Dr. McGilton has published a number
of papers in the areas of gerontology and long-term
care.
She is President-Elect of the Nursing Research Interest
Group of the Registered Nurses Association of Ontario
(RNAO).
Contact Information
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