Improving Quality of Life for Older People in Long-Stay Care ...

Chapter EightCare Environmentand Ethos of Care8.1 Introduction152This chapter examines the impact of care environment and ethos of care on thequality of life of long-stay residents in Ireland. This was one of the four themes thatemerged from the qualitative research undertaken with residents and staff in thetwelve study sites. The value of the study site material is that it allows the voiceof residents and staff to be heard directly. It is not possible, however, to extrapolatefrom the study site material, particularly in respect of comparative care. One of themessages from the research is that there is evidence of good and bad practice inall types of long-stay facility. Consequently, we cannot say that one type of careregime is unambiguously better than another for quality of life. Thus, pronouncementson sectoral quality of life are not made in a comparative sense; rather, the experiencesof residents and staff are reported to assist the reader to make sense of generalquality of life in long-stay care.In this chapter, the emphasis is on care environment and the underlying ethos ofcare in the study site. As part of the qualitative research, residents described theirday-to-day experiences, from the time they woke up until the time they went tosleep for the night. They also spoke about their capacity to make choices in thelong-stay facility and the extent to which they were included in decisions abouttheir care. They spoke about the attitudes of staff to caring. Staff also describedthe ethos of care in the facility and identified factors which impacted on day-to-daycare. Four categories were identified as important: promoting autonomy; promotingand maintaining independence; staffing and physical resources; and the carephilosophy.Improving Quality of Life for Older People in Long-Stay Care Settings in Ireland