Quality of life in long-term care facilities in Gauteng, South Africa: an institutional ethnographic study of older adults’ perspectives

Introduction The increasing demand for long-term care (LTC) services in resource-constrained settings has highlighted significant gaps in both the quality of care and the quality of life (QoL) for older adults. The objective of this study is to examine the lived experiences of QoL among older indivi...

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Main Authors: Lieketseng Ned, Naomi Hlongwane
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/5/e099448.full
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author Lieketseng Ned
Naomi Hlongwane
author_facet Lieketseng Ned
Naomi Hlongwane
author_sort Lieketseng Ned
collection DOAJ
description Introduction The increasing demand for long-term care (LTC) services in resource-constrained settings has highlighted significant gaps in both the quality of care and the quality of life (QoL) for older adults. The objective of this study is to examine the lived experiences of QoL among older individuals in LTC facilities.Methods Using an institutional ethnographic approach, we conducted indepth interviews with 20 residents, aged 62–98 years, across five LTC facilities in Gauteng, South Africa. Indexing and mapping were used to identify emergent categories. The authors used reflexive methods, and member checking was conducted.Results Analysis revealed seven interconnected dimensions of QoL: health and physical well-being, social connectedness and companionship, spiritual fulfilment and faith, independence and autonomy, dignity and respect, emotional well-being and acceptance and adaptation. These aspects are closely linked to institutional factors such as staff capacity, resource allocation and care policies. Participants emphasised the importance of meaningful social interactions, spiritual practices, autonomy and dignity in enhancing their QoL.Conclusion The study underscores the complex relationship between institutional care practices and the QoL of older adults in resource-constrained environments. Findings advocate for culturally sensitive, person-centred care strategies to improve the multifaceted QoL of LTC residents, offering valuable insights for policy reforms and interventions in similar resource-constrained settings.
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spelling doaj-art-1c6eea3c00a34df59b2d9ce8e444f4f42025-08-20T03:53:12ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2025-099448Quality of life in long-term care facilities in Gauteng, South Africa: an institutional ethnographic study of older adults’ perspectivesLieketseng Ned0Naomi Hlongwane1Division of Disability and Rehabilitation Studies, Department of Global Health, Faculty of Medicine and Heatlh Sciences, Stellenbosch University, Cape Town, South AfricaDivision of Disability and Rehabilitation Studies, Department of Global Health, Faculty of Medicine and Heatlh Sciences, Stellenbosch University, Cape Town, South AfricaIntroduction The increasing demand for long-term care (LTC) services in resource-constrained settings has highlighted significant gaps in both the quality of care and the quality of life (QoL) for older adults. The objective of this study is to examine the lived experiences of QoL among older individuals in LTC facilities.Methods Using an institutional ethnographic approach, we conducted indepth interviews with 20 residents, aged 62–98 years, across five LTC facilities in Gauteng, South Africa. Indexing and mapping were used to identify emergent categories. The authors used reflexive methods, and member checking was conducted.Results Analysis revealed seven interconnected dimensions of QoL: health and physical well-being, social connectedness and companionship, spiritual fulfilment and faith, independence and autonomy, dignity and respect, emotional well-being and acceptance and adaptation. These aspects are closely linked to institutional factors such as staff capacity, resource allocation and care policies. Participants emphasised the importance of meaningful social interactions, spiritual practices, autonomy and dignity in enhancing their QoL.Conclusion The study underscores the complex relationship between institutional care practices and the QoL of older adults in resource-constrained environments. Findings advocate for culturally sensitive, person-centred care strategies to improve the multifaceted QoL of LTC residents, offering valuable insights for policy reforms and interventions in similar resource-constrained settings.https://bmjopen.bmj.com/content/15/5/e099448.full
spellingShingle Lieketseng Ned
Naomi Hlongwane
Quality of life in long-term care facilities in Gauteng, South Africa: an institutional ethnographic study of older adults’ perspectives
BMJ Open
title Quality of life in long-term care facilities in Gauteng, South Africa: an institutional ethnographic study of older adults’ perspectives
title_full Quality of life in long-term care facilities in Gauteng, South Africa: an institutional ethnographic study of older adults’ perspectives
title_fullStr Quality of life in long-term care facilities in Gauteng, South Africa: an institutional ethnographic study of older adults’ perspectives
title_full_unstemmed Quality of life in long-term care facilities in Gauteng, South Africa: an institutional ethnographic study of older adults’ perspectives
title_short Quality of life in long-term care facilities in Gauteng, South Africa: an institutional ethnographic study of older adults’ perspectives
title_sort quality of life in long term care facilities in gauteng south africa an institutional ethnographic study of older adults perspectives
url https://bmjopen.bmj.com/content/15/5/e099448.full
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