Maximizing Well-Being in the Context of Long-Term Services and Supports: A Q Methodological Approach

Objectives: The goal of this study was to investigate diversity in stakeholders' perspectives on how best to maximize older adults' well-being when they use long-term services and supports (LTSS). Methods: We used Q methodology, an exploratory method, to investigate preference patterns among a purposive sample of older adults, family members, and leadership professionals (n = 57). Participants categorized 52 items related to 9 domains of LTSS quality relevant to well-being into categories of importance. We used factors analysis and qualitative methods to identify groups of individuals who identified similar priorities. Results: The analysis identified four shared viewpoints, each prioritizing different aspects of well-being: 1) physical health and safety; 2) independence; 3) emotional well-being; and 4) social engagement. Individual and contextual factors, including stakeholder role, care needs, and expectations for LTSS, appeared to influence participants' perspectives. Conclusions: Distinct viewpoints on how to maximize well-being when older adults use LTSS exist. Our results affirm the importance of person-centered care yet demonstrate that shared preference patterns LTSS exist. Clinical Implications: Engaging with older adults' values and preferences is critical to improving their experiences with LTSS. Better understanding common preference patterns could help providers deliver person-centered care more efficiently and effectively.