How Residents’ Quality of Life are Represented in Long-Term Care Policy: A Novel Method to Support Policy Analysis

Context: In one’s final years, quality of life (QoL) is a fundamental desire. In Canada, a publicly-funded long-term care (LTC) system is governed provincially through multiple policies about housing and care provision. A pan-Canadian research team investigated federal and provincial policies’ influence on the QoL of older people living in residential LTC in four provinces: British Columbia, Alberta, Ontario, and Nova Scotia. Objective(s): This paper describes a novel method of policy analysis developed by the authors to analyse the inclusion of QoL domains within these LTC policies, and assess implications for residents, their families, and staff. Method(s): Within the novel method mentioned there were four stages in the method that consisted of an iterative and collaborative approach to understanding the relationships between LTC regulations and resident QoL domains through four perspectives (resident, staff, family, volunteer). At first, inclusion/exclusion criteria were applied to select appropriate policies, and secondly, policy texts were to coded according to Kane’s (2001) QoL domains. The third stage involved assigning a level of regulatory power, with the final stage interrogating the policy categorisation data from four perspectives: residents, families, volunteers and workers. Findings: The outcome revealed a dominant discourse of safety, security, and order over other domains such as dignity, privacy, and spirituality. Limitations: Policies dictate regulatory and guiding principles, and are only one part of the story. How these policies are implemented is beyond the scope of our research, but we recognize that understanding these implementation practices are essential to fully capture the experiences of residents, their families, and staff. Implications: This novel method is useful in exploring how QoL is supported across a high number of complex cross-jurisdictional policies. We conclude that our approach to policy analysis enables a re-examination of policies affecting LTC and assesses whether these policies reflect the values of the residents and society at large