The culture of a Taiwanese nursing home

Aim. To explore and understand the culture of nursing home life for older residents in Taiwan. Background. The environment, the care providers and the residents all influence how the nursing home operates and performs. The literature has shown that there has been a move from understanding nursing home culture to changing it. However, there is no literature illustrating nursing home culture in Taiwan. It is appropriate to understand the phenomenon before making any changes. Design. Ethnographic methodology was used to understand this phenomenon. Methods. Three methods, participant observation, in-depth interviews and examination of related documents, were used to collect information from July 2005-February 2006. All the data were recorded in either field notes or verbatim transcripts and were analysed concurrently. Results. Three themes have been generated including collective life, care rituals and embedded beliefs. 'Living in a public area', 'mealtime is the highlight', 'every day is the same', and 'the ceiling is my best mate' are used to explain the collective life. Under care rituals, there are 'the perception of inadequate staffing in spite of legal requirements being met' and 'task-oriented care'. The embedded beliefs can be described by the notions of 'patients and hospitalisation' and 'compromise'. Conclusions. A tedious, monotonous, idle and lonely life is experienced by the residents, and insufficient staffing is obvious, despite the legal staffing requirements being met. This is exacerbated by the provision of care that is task-oriented rather than individual driven. The residents, whether consciously or not, consider themselves to be the patients of a hospital. They easily compromise to maintain harmony and balance in the nursing home life. Relevance to clinical practice. The findings contribute to the understanding of Taiwanese nursing home culture and filling the gaps in nursing knowledge for the purpose of improving care of residents.