Contextual Action Theory in Nursing Home Settings: A Conceptual Framework for Considering the Active Role of Residents

TL;DR

This paper proposes a new framework to highlight the active role of nursing home residents in shaping their care experiences.

Contribution

The novelty is introducing Contextual Action Theory as a framework to center residents in nursing home research.

Findings

Contextual Action Theory emphasizes residents' capabilities to form and act on preferences regardless of impairments.

The framework supports viewing nursing home experiences as co-constructed by residents, providers, and families.

Using CAT can help address ageism and promote personhood in nursing home research.

Abstract

Nursing home (NH) residents are often considered passive recipients of care with a limited role in shaping their experience. This perspective is often reproduced in NH research, which restricts resident participation, thereby upholding ageist views that cause discrimination of older adults living in NH settings. In this article, we propose using Contextual Action Theory (CAT) as a conceptual framework for exploring NH experiences in a way that incorporates the active role of residents. CAT supports the active role of NH residents by emphasizing the capabilities of human beings to form preferences and act on those preferences, without assumptions of rationality. The emphasis on human action allows researchers to consider NH experiences as co-constructed between residents, care providers, and family members, which means placing an emphasis on the actions and goals of NH residents, no matter their cognitive or physical impairments. CAT also supports personhood and social citizenship concerns in NH research, by acknowledging the differing preferences and thereby differing experiences of NH care by individual residents. We argue that CAT should be considered a useful framework for putting residents in the center of NH research.