Making room for a dignified life in long-term care? An institutional ethnography of residents living with dementia

Introduction: Social perceptions of older adults living with dementia substantially influence the care and services provided to this population, such as long-term care facilities (LTCs), which often have a poor, and sometimes even disastrous, reputation. This article aims to answer the following question: How is the dignity of residents in Quebec LTCs maintained in a context of institutionalization?

Methodology: An institutional ethnography was conducted in a long-term care facility. Data generation included participant observation (133 hours), leisure-time interviews with residents living with dementia (n=4), and an analysis of policies and internal documents. Results: The results highlight that dignity is maintained primarily through healthy, reciprocal social relationships and the sharing of past memories, which promote identity within these relationships. Discussion: Beyond cognitive impairments, residents remain capable of actively contributing to the institutional dynamics that shape everyday life in long-term care. These findings invite greater attention to the resources residents mobilize to sustain their dignity and to support a culture of care that values and fosters their capabilities.