Changing the culture of long-term care through narrative care: Individual, interpersonal, and institutional dimensions

- Living in a nursing home represents a major challenge to narrative identity.
- Strategies for maintaining narrative identity are proposed.
- Scaffolded participation in everyday conversations sustains narrative identity.
- Institutional culture should include a shared, inclusive narrative.
- The use of narratives lies at the very core of person-centered care.

Interest in the practice of narrative care with older adults is continuing to grow (Kenyon & Randall, 2015). Significant attention has been paid thus far to various formal interventions or programs that enhance the narrative development of individuals in later life by helping them to express and explore their unique life story. Comparatively little, however, has been paid to the many informal opportunities for practicing narrative care in long term settings that occur amidst everyday interpersonal interactions - e.g., staff-resident interactions in nursing homes. Even less attention has been paid to the importance of cultivating an overarching institutional narrative that provides a supportive context for the practice of narrative care in general. This paper will contribute to discussions of “person-centered care” by arguing the need to change the culture of long-term care so that narrative care is practiced on all three levels at once: individual, interpersonal, and institutional.