Skip to main content

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

Abstract

Residents’ councils in Quebec’s residential and long-term care centres have the mandate to promote the improvement of living conditions for residents, to assess their level of satisfaction, and to defend their rights. Based on two studies on the autonomy of councils, we examined how committees can express themselves on topics other than those the management is already aware of, to reveal various previously unknown aspects of the services, and to voice unexpressed concerns. We are especially interested in what makes management receptive, or not, to what the committee members say. The councils’ ability to express them selves is, in fact, inseparable from its capacity to listen to the management teams, and we seek to determine the conditions required to perform this dual capacity.

This is a preview of subscription content, access via your institution.

Notes

  1. 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].

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

  3. 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].

  4. 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.

  5. 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.

  6. 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).

  7. 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.

  8. 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.

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

Abbreviations

MSSS:

Ministère de la santé et des services sociaux

ASSS:

Agence de la santé et des services sociaux (Regional Health and Social Services Agency)

CHSLD:

Centre d’hébergement et de soins de longue durée (Residential long-term care centre)

References

  1. Abelson, J., Eyles, J., McLeod, C. B., Collins, P., McMullan, C., & Forest, P.-G. (2002). Does deliberation make a difference? Results from a citizens panel study of health goals priority setting. Health Policy, 66, 95–106.

    Article  Google Scholar 

  2. Beierle, T. C. (1999). Using Social Goals to Evaluate Public Participation in Environmental Decisions. Policy Studies Review, 16(3/4), 76–103.

    Google Scholar 

  3. Blacksher, E., Diebel, A., Forest, P.-G., Goold, D. D., & Abelson, J. (2012). What Is Public Deliberation? Hastings Center Report, 42(2), 14–17.

    Article  PubMed  Google Scholar 

  4. Bordeleau, L. & Gagnon, É. (2013). Une évaluation des comités de résidents du CSSS de la Vieille-Capitale, Centre de santé et de services sociaux de la Vieille-Capitale, Québec. (http://www.csssvc.qc.ca/telechargement.php?id=1016).

  5. Carlier, L. (2013). Les ambivalence de la démocratie urbaine. Politique et Sociétés, 32(1), 89–106.

    Article  Google Scholar 

  6. Forest, P.-G. (2003). Participation et publics dans le système de santé du Québec. In V. Lemieux, P. Bergeron, C. Bégin, & G. Bélanger (Eds.), Le système de santé au Québec (pp. 177–200). Québec: Les Presses de l’Université Laval.

    Google Scholar 

  7. Funk, L. M. (2003). Who Wants to be Involved? Decision-Making Preferences among Residents of Long-Term Care Facilities. Canadian Journal on Aging, 23(1), 47–58.

    Article  Google Scholar 

  8. Gadamer, H. G., (1989). Truth and Method, 2nd rev. edn. (1st English edn, 1975), trans. by J. Weinsheimer & D.G.Marshall. New York: Crossroad.

  9. Gagnon, É., Clément, M., Deshaies, M.-H., & Raizenne, É. (2014). Fonctions et limites de la participation publique. Les comités de résidents en centre d’hébergement et leur autonomie. Recherches sociographiques, LV, 1, 31–52.

    Article  Google Scholar 

  10. Grondin, J. (1993). L’universalité de l’herméneutique. Paris: PUF.

    Google Scholar 

  11. Grondin, J. (2002). Gadamer’s Basic Understanding of Understanding. In R. J. Dostal (Ed.), The Cambridge Companion to Gadamer (pp. 36–51). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  12. Hettema, T. L. (2014). Autonomy and its vulnerability: Ricœur’s view on justice as a contribution to care ethics. Medicine, Health Care and Philosophy, 17, 493–498.

    Article  Google Scholar 

  13. Lamoureux, J. (2008). Paroles dérangeantes, scènes inédites, subversion égalitaire. Réflexions sur la subjectivation politique. In L. Blais (Ed.) Vivre à la marge (pp. 213–240). Québec: Les Presses de l’Université Laval.

  14. Meyer, M. H. (1991). Assuring Quality of Care: Nursing Home Resident Councils. The Journal of Applied Gerontology, 10(1), 103–116.

    CAS  Article  PubMed  Google Scholar 

  15. Ministère de la Santé et des Services sociaux (MSSS). (2003). Un milieu de vie de qualité pour les personnes hébergées en CHSLD. Orientations ministérielles. Québec: Gouvernement du Québec.

    Google Scholar 

  16. Ministère de la Santé et des Services sociaux (MSSS). (2006). Cadre de référence sur l’exercice des fonctions à assumer par les membres des comités des usagers et des comités de residents. Québec: Gouvernement du Québec.

    Google Scholar 

  17. Nielson, C. R. (2013). Hearing the Other’s Voice: How Gadamer’s Fusion of Horizons and Open-ended Understanding Respects the Other and Puts Oneself in Question. Otherness: Essays and Studies 4.1 Philosophy and the Other, Sept. 2013.

  18. O’Dwyer, C., & Timonen, V. (2010). Rethinking the Value of Residents’ Councils: Observations and Lessons From an Exploratory Study. Journal of Applied Gerontology, 29(6), 762–771.

    Article  Google Scholar 

  19. Ricœur, P. (1986). Du texte à l’action. Essais d’herméneutique II. Paris: Éditions du Seuil.

    Google Scholar 

  20. Ricœur, P. (2001). Le juste II. Paris: Esprit.

    Google Scholar 

  21. Taylor, C. (1985). Philosophy and the Human Sciences. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  22. Taylor, C. (2002). Gadamer on the Human Sciences. In R. J. Dostal (Ed.), The Cambridge Companion to Gadamer (pp. 126–142). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  23. Young, I. M. (2000). Inclusion and Democracy. Oxford: Oxford University Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Éric Gagnon.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Gagnon, É., Clément, M. & Bordeleau, L. Speaking Out and Being Heard Residents’ Committees in Quebec’s Residential Long-Term Care Centre. Health Care Anal 25, 308–322 (2017). https://doi.org/10.1007/s10728-015-0301-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10728-015-0301-3

Keywords

  • Residents’ council
  • Rights
  • Participation
  • Users’ perspective