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 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.