title: "Small" things matter: residents' involvement in practice improvements in long-term care facilities.
abstract: OBJECTIVE
  The process of involving older clients with regard to their care arrangements has been the subject of previous studies. However, a more general overview of the issues addressed by older people living in long-term care (LTC) facilities, in order to inform practice improvements, is missing. This article explores which aspects of care that older people in LTC facilities want to improve, by means of a collective policy agenda-setting project, during which the participants voice their own experiences and concerns regarding LTC.
  
  
  METHODS
  Seven LTC facilities for older people in the Netherlands joined a collective agenda-setting project in which a total of 58 residents participated. Qualitative methods were used: participant observations (80 h in total) and semi-structured interviews (n=16), which were analysed according to the principles of a qualitative content analysis.
  
  
  RESULTS
  There were many similarities between the seven organisations with regard to the proposed practice improvements. Nine topics were found to be important in improving the lives of older residents: a sense of community, feeling at home, social contacts between residents, independence, maintaining own hobbies and lifestyle, interpersonal conduct between residents and caregivers, being informed, security within the LTC facility, and food.
  
  
  CONCLUSIONS
  Narratives about the daily lives and experiences of residents provided a rich understanding of what living in a LTC facility means, as well as the changes the residents wish to see. We found that according to the residents, the relatively 'small things' in life may have a big influence on improving the quality of life within LTC facilities.
authors.affiliation: VU University Medical Center, EMGO+Institute for Health and Care Research, Department of Medical Humanities, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: femke.boelsma@vumc.nl.
authors.forename: Femke
authors.initials: F
authors.lastname: Boelsma
authors.affiliation: VU University Medical Center, EMGO+Institute for Health and Care Research, Department of Medical Humanities, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: v.baur@vumc.nl.
authors.forename: Vivianne E
authors.initials: VE
authors.lastname: Baur
authors.affiliation: VU University Medical Center, EMGO+Institute for Health and Care Research, Department of Medical Humanities, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: s.woelders@vumc.nl.
authors.forename: Susan
authors.initials: S
authors.lastname: Woelders
authors.affiliation: VU University Medical Center, EMGO+Institute for Health and Care Research, Department of Medical Humanities, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: t.abma@vumc.nl.
authors.forename: Tineke A
authors.initials: TA
authors.lastname: Abma
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008134:Long-Term Care / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D008297:Male; D009426:Netherlands; D009735:Nursing Homes / Q000458:organization & administration* / Q000592:standards; D057766:Policy; D036301:Qualitative Research; D058996:Quality Improvement / Q000458:organization & administration*; D011788:Quality of Life
keywords: Agenda-setting; Long term care facilities; Practice improvements; Qualitative research; Resident involvement