Residential Long-Term Care and the Built Environment: Balancing Quality of Life and Infection Control.

Abstract

This article explores expert insights into residential long-term care (RLTC), specifically regarding the built environment, its impact on infection control (IC) measures and on resident, staff, and family member quality of life. The interviews discussed in this report form part of a larger mixed methods research design, examining the planning, design, and operation of RLTC. Specifically, this report discusses findings from one aspect of this research, a series of semistructured interviews. Interviews were conducted online through video conferencing platform Zoom. The project's steering committee were asked to suggest key organizations involved in IC and RLTC provision and policy, with 23 representatives (17 organizations) being invited to interview. Where representatives were unable to participate, they suggested alternate representatives. The research team conducted 20 interviews with key representatives or "experts" from different aspects of RLTC provision, policy, and IC. A thematic analysis was employed to analyze and generate key themes. For brevity, the codes that had been mentioned by >5 interviewees, specific to the built environment, IC and quality of life were prioritized, resulting in 16 prioritized themes grouped according to spatial scale. This research demonstrates the growing awareness of the built environment as a critical partner in the RLTC health and social care model, as well as illustrating the need for a holistic design approach across all key spatial scales to support the health and well-being of older people in RLTC. Further research is needed on various aspects of RLTC, including the impact of care models and setting size on IC, quality of life, and cost implications. RLTC policy needs a more integrated approach to planning and design, specifically around RLTC location. This research suggests that RLTC providers look to evidence-based, inclusive design guidelines to inform the design and retrofit of RLTC. Additionally, the operation and management of space should be considered by providers.