Skip to main content
    • Aa
    • Aa

Developing personal relationships in care homes: realising the contributions of staff, residents and family members


Personal relationships are an integral part of living, working and visiting in care homes, but little research has made relationships the main focus of enquiry, and there have been few studies of the perspectives of residents, staff and family members. The study reported here sought to redress this neglect. Using a constructivist approach, the nature and types of relationships between residents, staff and family members were explored in three care homes in England using combined methods including participant observation, interviews and focus groups. The data collection and analysis occurred iteratively over 21 months and three types of relationships were identified: ‘pragmatic relationships’ that primarily focus on the instrumental aspects of care; ‘personal and responsive relationships’ that engage more fully with the particular needs of individual residents; and ‘reciprocal relationships’ that recognise the roles of residents, staff and family members in creating a sense of community within the home. This paper explores the contributions made by staff, residents and family members in the development of these relationships. The findings enhance our understanding of the role of inter-personal relationships in care home settings and of the factors that condition them. The implications for developing improved practice in care homes are also considered.

Corresponding author
Address for correspondence: Christine Brown Wilson, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL, United Kingdom. E-mail:
Hide All
N. Baldwin , J. Harris and D. Kelly 1993. Institutionalisation: why blame the institution? Ageing & Society, 13, 1, 6981.

M. Barnes 2005. The same old process? Older people, participation and deliberation. Ageing & Society, 25, 2, 245–59.

T. R. O. Beringeer and V. L. S. Crawford 2003. Admissions to elderly care institutions in the United Kingdom. Reviews in Clinical Gerontology, 13, 1, 95101.

J. Bouisson and J. Swendsen 2003. Routinization and emotional well being: an experience sampling investigation in an elderly French sample. Journals of Gerontology: Psychological Sciences, 58, 5, P280–2.

B. J. Bowers , B. Fibich and N. Jacobson 2001. Practice concepts. Care-as-service, care-as-relating, care-as-comfort: understanding nursing home residents' definitions of quality. The Gerontologist, 41, 4, 539–45.

M. Daly 2002. Care as a good for social policy. Journal of Social Policy, 31, 2, 251–70.

S. Davies and M. R. Nolan 2004. ‘Making the move’: relatives' experiences of the transition to a care home. Health and Social Care in the Community, 12, 6, 517–26.

M. Deutschman 2001. Redefining quality and excellence in the nursing home culture. Journal of Gerontological Nursing, 27, 8, 2836.

M. T. Duncan and D. L. Morgan 1994. Sharing the caring: family caregivers' views of their relationships with nursing home staff. The Gerontologist, 34, 2, 235–44.

H. Evers 1981. Multidisciplinary teams in geriatric wards: myth or reality? Journal of Advanced Nursing, 6, 3, 205–14.

L. Finlay 2002. ‘Outing’ the researcher: the provenance, process and practice of reflexivity. Qualitative Health Research, 12, 4, 531–45.

J. E. Gaugler 2005. Staff perceptions of residents across the long-term care landscape. Journal of Advanced Nursing, 49, 4, 377–86.

C. Grasser 1996. Reciprocity in staff/resident interactions in nursing homes. Journal of Women and Aging, 8, 1, 519.

E. Haggstrom , K. Skovdahl , B. Flackman , A. L. Kihlgren and M. Kihlgren 2005. Work satisfaction and dissatisfaction: caregivers' experiences after a two-year intervention in a newly opened nursing home. Journal of Clinical Nursing, 14, 1, 919.

A. Hertzberg and S. Ekman 2000. ‘We, not them and us?’ Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes. Journal of Advanced Nursing, 31, 3, 614–22.

A. Hertzberg , S. Ekman and K. Axelsson 2001. Staff activities and behaviour are the source of many feelings: relatives' interactions and relationships with staff in nursing homes. Journal of Clinical Nursing, 10, 3, 380–8.

E. M. Jackson 1997. Dimensions of care in five United States nursing homes: identifying invisible work in care-giving. International Journal of Nursing Studies, 34, 3, 192200.

R. A. Kane , A. L. Caplan , E. K. Urv-Wong , I. Freeman , M. Aroska and M. Finch 1997. Everyday matters in the lives of nursing home residents: wish for and perception of choice and control. Journal of the American Geriatrics Society, 45, 9, 1086–93.

U. M. Kellett 1998. Meaning-making for family carers in nursing homes. International Journal of Nursing Practice, 4, 2, 113–9.

C. L. Lindgren and A. M. Murphy 2002. Nurses' and family members' perceptions of nursing home residents' needs. Journal of Gerontological Nursing, 28, 8, 4553.

A. Mattiasson and L. Andersson 1997. Quality of nursing home care assessed by competent nursing home patients. Journal of Advanced Nursing, 26, 6, 1117–24.

K. S. McGilton and V. M. Boscart 2007. Close care provider-resident relationships in long-term care environments. Journal of Clinical Nursing 16, 11, 2149–57.

M. Minkler 1996. Critical perspectives on ageing: new challenges for gerontology. Ageing & Society, 16, 4, 467–87.

P. Mitchell and T. Koch 1997. An attempt to give nursing home residents a voice in the quality improvement process: the challenge of frailty. Journal of Clinical Nursing, 6, 6, 453–61.

W. Moyle , J. Skinner , G. Rowe and C. Gork 2003. Views of job satisfaction and dissatisfaction in Australian long-term care. Journal of Clinical Nursing, 12, 2, 168–76.

A. Netten , R. Darton and J. Williams 2003. Nursing home closures: effects on capacity and reasons for closure. Age and Ageing, 32, 3, 332–7.

K. Pillemer , C. Hegerman , B. Albright and C. Henderson 1998. Building bridges between family members and nursing homes staff: the partners in caregiving programme. The Gerontologist, 38, 4, 499503.

M. J. Rantz , M. Zwygart-Stauffacher , L. Popejoy , V. Grando , D. R. Mehr , L. L. Hicks , V. Conn , D. Wipke-Tevis , R. Porter , J. Bostick and M. Meridean 1999. Nursing home care quality: a multidimensional theoretical model integrating the views of consumers and providers. Journal of Nursing Care Quality, 14, 1, 1637.

N. Raynes 1998. Involving residents in quality specification. Ageing & Society, 18, 1, 6578.

J. Reed 1992. Individualised care: some implications. Journal of Clinical Nursing, 1, 1, 712.

J. Reed and S. Bond 1991. Nurses' assessment of elderly patients in hospital. International Journal of Nursing Studies, 28, 1, 5564.

J. Reed , G. Cook and D. Stanley 1999. Promoting partnership with older people through quality assurance systems: issues arising in care homes. NT Research, 4, 5, 353–63.

J. Ronch 2004. Changing institutional culture: can we re-value the nursing home? Journal of Gerontological Social Work, 43, 1, 6182.

A. A. Ryan and H. F. Scullion 2000. Nursing home placement: an exploration of the experiences of family carers. Journal of Advanced Nursing, 32, 5, 1187–95.

J. Sandberg , U. Lundh and M. R. Nolan 2001. Placing a spouse in a care home: the importance of keeping. Journal of Clinical Nursing, 10, 3, 406–16.

J. Sandberg , M. R. Nolan and U. Lundh 2002. ‘Entering a new world’: empathic awareness as the key to positive family/staff relationships in care homes. International Journal of Nursing Studies, 39, 5, 507–15.

D. Seddon , K. Jones and M. Boyle 2002. Committed to caring: carer experience after a relative goes into nursing or residential care. Quality in Ageing, 3, 3, 1626.

M. Thorman Hartig 1998. Expert nursing assistant activities. Western Journal of Nursing Research, 20, 5, 584601.

T. Wells 1980. Problems in Geriatric Nursing. Churchill Livingstone, Edinburgh.

A. Zisberg , H. Young , K. Scepp and L. Zysberg 2007. A concept analysis of routine: relevance to nursing. Journal of Advanced Nursing, 57, 4, 442–53.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Ageing & Society
  • ISSN: 0144-686X
  • EISSN: 1469-1779
  • URL: /core/journals/ageing-and-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 13
Total number of PDF views: 85 *
Loading metrics...

Abstract views

Total abstract views: 486 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 17th October 2017. This data will be updated every 24 hours.