I Am Not a "Relative": Self-Understanding of Relatives in Residential Long-Term Care - A Reflexive Thematic Analysis.

Abstract

Much is known about what relatives do in residential long-term care, yet the question of who they are as persons within this context remains unasked. Research frames relatives through functional categories, addressing their contributions but not their self-understanding, which is accessible only through their own accounts. This qualitative study examined how relatives of care-dependent persons in Swiss residential long-term care understand themselves as persons within the institutional context. Guided by McCormack and McCance's Person-Centred Practice Framework, we conducted interviews with seven relatives across three care facilities and analysed the data using Reflexive Thematic Analysis. Four themes position "being relative" as an ontological condition rather than a functional role: Being irreducibly relational: identity constituted through biographical relationships, not institutional categories; Being attentively co-bearing: felt responsibility for the entire care situation, including nursing staff; Being deeply anchored: the institution as constitutive of who relatives are, marked by simultaneous belonging and strangeness; and Being persistently unsettled: a self kept in motion by displaced identities, guilt, and moral impossibilities. These dimensions coexist as features of a condition for which person-centred care may need a vocabulary that recognises relatives' personhood rather than their function.