Understanding Adaptive Leadership in the Context of Nursing Homes

Author:

Wang Jing1ORCID,Anderson Ruth2ORCID,Perez Janelle Santos2ORCID,Estabrooks Carole A.3ORCID,Berta Whitney4ORCID,Lanham Holly J.5ORCID,Duan Yinfei3ORCID,Iaconi Alba3,Beeber Anna6ORCID

Affiliation:

1. College of Health and Human Services, University of New Hampshire, Durham, NH, USA

2. School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

3. Faculty of Nursing, University of Alberta, Edmonton, AB, Canada

4. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

5. Joe R. & Teresa Lozano Long School of Medicine, University of Texas Health, San Antonio, TX, USA

6. School of Nursing, Johns Hopkins University, Baltimore, MD, USA

Abstract

Rapidly growing populations of older adults rely heavily on formal long-term care services such as those provided in nursing homes. Nursing home staff are confronted with complex challenges. We explored how staff ( N = 88), particularly care aides, interpreted challenges and responded to them by taking adaptive leadership roles, and engaging in technical and adaptive work in nursing homes. We conducted analysis of the ethnographic case studies. In long-term care settings, staff face complex challenges in improving resident care due to contextual barriers. These include demanding work conditions and inadequate resources. Additionally, top-down communications, despite being well-intentioned, often lead to misinterpretation and a lack of staff motivation. Nonetheless, we found that certain staff managed to overcome these contextual barriers and effectively execute change initiatives by assuming adaptive leadership roles. Formal leaders have a vital role in empowering staff, including care aides, and facilitating their adaptive leadership behaviors.

Funder

Canadian Institutes of Health Research

Publisher

SAGE Publications

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