gms | German Medical Science

Background and Purpose: The demographic change, a growing need for care- and rehabilitation-related tasks and staff shortage, makes it necessary to consider staff and grade mix in nursing homes. However, little is known about the existing types of different mixes in German nursing homes and how they are implemented in practice. The part of the study “Multidisciplinary staff and grade mix in nursing homes” (PERLE) discussed here, focuses on these two challenges.

Methodological and Theoretical Focus/Methods: The study follows the methodological principles of reconstructional qualitative social research. 31 episodic interviews were conducted with managers, caregivers and residents out of 8 nursing homes in Baden-Wuerttemberg (Germany). Data were analyzed using contextual analysis (Jansen, et al. 2015). While Bohnsacks’ documentary method was interested in milieus of youth groups and migrants, this scientific approach is focusing the organization and different rationales of the actors.

Results: For each facility a contexture has been reconstructed. Firstly, different types of staff and grade mix could be identified. Managers developed and established mixes with a varying range of goals. Staff and residents were marginally involved. Secondly, perspectives of managers, staff and resident were heterogeneous. Managers’ narratives were influenced by technical feasibility according to staff shortages. Staff emphasized work climate and atmosphere, and residents typically did not distinguish between the different professions.

Conclusions: Actually models of multidisciplinary staff and grade mix are still at the beginning and not fully developed. More research is needed to identify influencing factors and how these models work in practice.