As Nova Scotia’s population ages and the need for long-term residential care increases, the discussion surrounding the quality of life for residents has intensified. Results from an inter-provincial study on Long-Term Residential Care (LTRC) policy highlight how facilities can better balance the provision of safe care and quality of life for residents.

Dr. Mary Jean Hande

“Staff at Long Term Care facilities play an integral role in enhancing resident quality of life, but they need to be supported in policy to do so,” explains Dr. Mary Jean Hande. “We wanted to examine the broad range of staff-related long-term care regulations in Canada to help locate promising rules for staff to better enhance resident quality of life.”

Dr. Hande is a Postdoctoral Fellow working on the Seniors–Adding Life to Years research project led out of Mount Saint Vincent University’s Nova Scotia Centre on Aging, and lead author of the recently released manuscript Long-Term Residential Care Policy Guidance for Staff to Support Resident Quality of Life. The manuscript is the result of the team’s analysis of LTRC policy in four Canadian provinces; British Columbia, Alberta, Ontario, and Nova Scotia, to determine how resident quality of life is represented in regulations. The project is funded by the Canadian Institutes for Health ResearchResearch Nova Scotia, the Michael Smith Foundation for Health Research, and the Alzheimer Society of Canada.

Within the study, quality of life was measured by the presence of 11 domains, including dignity, physical comfort, autonomy, meaningful activity, and relationships, for example. After analyzing more than 60 existing regulatory documents for quality of life indictors, the team found not all domains were weighted equally, causing tension between staff duties and residents’ preferences. 

“Regulations prioritizing safety and security dominate almost every policy document,” says Dr. Hande. “This is concerning because overemphasizing safety and security can negatively impact residents’ overall quality of life, specifically, their autonomy, privacy, and ability to maintain meaningful relations both within and outside the LTRC facility.” 

However, Dr. Hande urges that when it comes to existing regulations, LTRC facilities do not need to start anew but should instead focus on interpretation. 

“Promising policy frameworks were found in all four provinces, characterized by interpretive rather than prescriptive language,” explains Dr. Hande. “These policies outline clear, flexible roles for staff to attend to resident preferences and overall quality of life.” 

Results from the project were published in The Gerontologist in January 2021. Dr. Hande and team hope the manuscript will help staff at LTRC facilities leverage existing policies that counteract the overemphasis on safety, security and order, and support a move toward a culture that places resident quality of life as central to the interpretation of policy. 

To read the manuscript and learn more about Dr. Hande’s research, visit the Seniors–Adding Life to Years website.