“Home is Home:” Exploring the Meaning of Home across Long-Term Care Settings

Abstract

To feel “at home” in long term care (LTC) is an important programmatic goal. Few large studies, however, have examined resident perspectives about feeling at home across different types of LTC settings. We asked 632 older adults living in nursing homes, assisted living, and adult foster homes in Oregon whether or not their setting felt “like home” and to describe their experiences with “at-homeness.” Our qualitative analysis revealed five distinct themes that encompassed social connection; autonomy, control, and choice; engagement with the physical environment; organizational environment; and perceptions and coping. Our findings demonstrate how organizational features, interacting with resident characteristics, can facilitate or constrain the experience of home in LTC settings.

Keywords:

• Person-centered care
• homelike
• qualitative methods
• assisted living
• nursing homes
• adult foster home

Acknowledgments

We thank the hundreds of residents for their time, insights, and openness in sharing their experiences and opinions, and the dozens of administrators and staff who facilitated this work.

Disclosure statement

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Notes

1 Although Assisted Living Communities are required to provide a kitchenette in each apartment, Residential Care Communities are not. For more information on differences among care settings, please see the Supplemental Materials.

Additional information

Funding

This research was supported by grants from the Oregon Department of Human Services, Quality of Care Fund [IAA #158501] and Civil Money Penalty Fund [IAA #155717].