Care Practices Supporting Older Adult Mobility in Institutional Long-Term Care: An Ethnographic Study.

backgroundOlder adults living in institutional long-term care (ILTC) generally have decreased mobility, and their mobility care is often insufficient. Residents spend much of their day being sedentary, even though sedentary behaviour and inactivity are known to have many negative effects on health and functional capacity. More qualitative research describing care practices that support residents' everyday mobility in ILTC is needed. The aim of this study is to describe how care workers support residents' mobility in one ILTC unit.

methodsA focused ethnographic study was conducted. Data were collected by observing care workers (n = 10) and residents (n = 12) in one ILTC unit in May and June 2023. Data collection was guided by Spradley's framework. In addition, informal interviews were conducted with the care workers during the observations. The data were analyzed using thematic analysis.

resultsCare workers carried out mobility care through situational compromises between person-centred mobility care and institutional expectations. While mobility care was person-centred, supporting residents' autonomy and grounded in residents' mobility needs, it was also shaped by institutional expectations. Institutional expectations were evident when other essential care activities were prioritized and routine practices were utilized in mobility care.

conclusionsMobility care occurs in the interaction process between care workers and residents. Supporting residents' mobility requires care workers to balance person-centred mobility care and institutional expectations. Therefore, care workers need guidance for communication with residents with dementia, sufficient resources, and shared practices to enable quality mobility care in ILTC. Mobility care should also be embedded in institutional values and guidelines to prevent it from becoming a mechanical activity of the residents' day.