Speaking Out and Being Heard Residents’ Committees in Quebec’s Residential Long-Term Care Centre

Approximately 11 % of residents are under the age of 65, and also unable to live at home due to a disability or illness MSSS [15].

They are elected during general assemblies of residents and their families.

This broad interpretation of autonomy is based on the works of Paul Ricœur [20]. An individual is autonomous when he has the capacity to say (to express and own a point a view), to act (to have some influence on the way things are done) and to recount (to be the narrator of one’s own life story). However, a committee is not an individual or an agent. Ricœur’s definition of autonomy or agency must be adapted, especially when it comes to the third capacity (narrating). The committee is autonomous when his members are able to speak, to have a level of influence on the decision and to change the understanding of the events, the needs, the story or the experiences of the residents. Our work is a continuation of the few studies conducted elsewhere on residents' committees, based mainly on the autonomy and influence of committees, while seeking to broaden the perspective Funk [7], Meyer [14], O'Dwyer and Timonen [18].

Five CHSLD were located in a large city (n = 5), two in a small town (n = 2) and two in a rural setting (n = 2). The size of the residential and long-term care centre varied from less than 50 to more than 150 beds. In total, we attended 42 meetings. We took notes of the object of the discussions (topics or issues discussed), the content of the discussion (questions, answers, information shared), the flow and speaking order (agenda, case tracking, outside speakers, members interventions, public speaking support), the requests, recommendations or demands made, as well as how they were sent to those responsible, links with management (presence of the coordinator, information and answers given, follow-up to previous requests) and other bodies within and outside the institution.

All eight residential and long-term care centres are located in an urban area. Interviews were conducted with 24 committee members (3 for every committee) and 7 interviews with administrators who attend the meetings and address the demands. The interviews focused on the functioning of the committee, the nature of the discussions, the motivation of its members to engage in it, the relationship with management and its autonomy. We assisted one meeting of each committee in situ observation.

The two studies were approved by the research ethics committee of the Centre de santé et de services sociaux de la Vieille-Capitale on October 3rd 2008 and September 19th 2012 (projects # 2008-2009-16 and #2012-2013-13).

A code is used to identify examples and comments. Roman numerals indicate from which study the observation or comment is taken from; Arabic numerals indicate the committee where the observation or comment was collected.

The main functions of the regional agencies are the coordination and development of health and social services in a region and to allocate regional resources to long term care facilities and community organizations.

The issue of loyalty has been addressed elsewhere Gagnon et al. [9].