What Matters to Residential Long-Term Care Residents: Contextualizing Perceptions of Person-Centered Care

OBJECTIVES: This study compares what matters to residents and how they experience personalized care across nursing facilities, assisted living facilities, residential care facilities, and adult foster homes in Oregon. DESIGN: Secondary data analysis of qualitative comments collected through validation of the Resident Voicing Importance, Experience, and Well-Being (ResidentVIEW) instrument. SETTING AND PARTICIPANTS: Residents were from 32 nursing facilities (n = 245), 31 assisted living facilities/residential care facilities (n = 212), and 119 adult foster homes (n = 188) in Oregon (December 2017-September 2019). METHODS: Practical thematic analysis to develop codes consisting of complete phrases, and biweekly meetings to refine themes. RESULTS: Three key themes emerged from the data. The first, loss, disregard, or limitation of personhood, described how residents across all care settings experienced a restriction in their decision-making. The second, "sometimes" nature of independence and choice, highlighted the inconsistency of autonomy, where choices were overridden by rigid institutional schedules. The third, respecting and including the person behind the "resident," emphasized the importance of staff recognizing residents as individuals, along with residents' value of social inclusion, meaningful engagement, and being part of the community rather than simply existing within it. CONCLUSIONS AND IMPLICATIONS: Findings reveal the nuanced ways in which person-centered care is experienced and how it can be either fostered or limited by the care setting. Residents' experiences of autonomy and dignity are fluid and shaped by the context of their care setting. Staff training must be supported by consistent staffing practices that actively uphold and reinforce personhood across all types of care environments. There is a clear call from residents to be heard, valued, and seen as integral members in the environment they are living in.