Understanding the experience of stigma in care homes: A qualitative case study in northeast Thailand

Abstract

Accessible summaryWhat is known on the subject? Stigma associated with care homes has been found to influence residents' lives, and it is a known risk factor for depression among older adults worldwide. Older residents in Asia and particularly, in Thai care homes commonly experience stigma due to being strongly influenced by a traditional cultural paradigm of filial piety. The understanding of how residents perceive and experience the stigma associated with residing in care homes, as well as its link to the development of depression, remains very limited. What does the paper add to existing knowledge? This research explains the dynamics of the process of the stigma associated with living care homes among Thai older residents. This research highlights the various ways in which stigma impacts residents, their families and care home staff. This study identifies mitigating stigma factors, including social support, coping strategies (karma, mindfulness and religious devotions) and activities that may mitigate perceived stigma associated with care home residency. What are the implications for practice? There is a compelling need to improve the well‐being of older people living in care homes and to combat the cultural stigma associated with living in care homes through promoting positive attitudes and educational interventions in society, communities and care homes themselves and involving residents' families in the planning and delivery of care for residents. We advocate that the government promotes security and sustainable life for all Thai older adults. AbstractIntroductionStigma associated with living in care homes is a known risk factor for depression among care home residents in Asia, including Thailand. However, little is understood about how such stigma is experienced among residents and care home staff.AimsTo examine older adults' perceptions of stigma and to understand how stigma associated with living in care homes causes or exacerbates depressive symptoms.MethodsA qualitative case study approach was used to gain an in‐depth view of stigma, from two public care homes in northeast Thailand. Data were collected by in‐depth interviews with 50 participants (30 older residents and 20 care home staff), and non‐participant observation was conducted over 1 month. Thematic analysis was used to analyse the data.ResultsThe study identified three major themes of stigma, comprising the causes of stigma, reactions toward stigma, and mitigating factors.DiscussionNegative beliefs about care homes and residents, contribute to stigma. Residents exhibited negative emotions and behaviours, including depressive symptoms. Residents reported using particular coping strategies that helped them cope with their perceptions of stigma.Implications for PracticeFuture research should focus on strategies or research to combat stigma in order to prevent depression and reduce perceptions of stigma.