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

Heather Davila, David R. Johnson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1155-1166
Number of pages12
JournalClinical Gerontologist
Issue number5
Early online dateMar 23 2021
StatePublished - Mar 23 2021

Bibliographical note

Funding Information:
Heather Davila’s time to work on this manuscript was supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Health Services Research, the Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System. The contents of this paper do not represent the views of the VA of U.S. Government. The authors would like to thank the individuals who participated in this study, as well as the organizations that collaborated with us in conducting the research. Heather Davila would also like to thank Drs. Joseph Gaugler, Melissa Haynes, Robert Kane, Rosalie Kane, and Jean King who provided feedback on earlier stages of this work.

Publisher Copyright:
© 2021 Taylor & Francis Group, LLC.


  • Long-term services and supports
  • Q methodology
  • person-centered care
  • values
  • well-being


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