Knowing and being known: the qualities that make a long-term care facility a home

Abstract

There has been consistent pressure to transform long-term care (LTC) facilities into more homelike settings. The concept of home within institutionalized care-based living environments is not well understood. For this study, a supplementary analysis was conducted to address two questions: (1) What factors contribute to a sense of home for people living and working in rural LTC homes, and (2) What organizational structures enable or impede a rural LTC home’s ability to actualize the factors that help them feel homelike? Findings indicate that the physical environment should prioritize accessibility and personalization; the social environment should prioritize relationships and opportunities for connection; and psychological considerations should prioritize supporting choice, autonomy, and flexibility. Additionally, a sense of home in LTC is dependent upon leadership that empowers staff and enables a flexible and relational approach to care, which results in residents being truly ‘known’ by their care providers.