Theme	Subtheme	Relevant Illustrative Quote
Completing the Life Story questionnaire	Central role of social workers	“There are families who are very capable of completing it on their own, and they do. The social worker, in theory—well, in best practice, and that’s how we try to do it here—reviews the Life Story to make sure there’s no missing information, or helps the family and/or the person complete it.” (PPAI-06) “Usually, the social worker fills it out either with the person or with a representative–either a relative or a legal guardian.” (PPAI-07) “Less commonly, it’s the hospital social workers. If the person was admitted to hospital and didn’t have a social worker before, then it’s the hospital team that provides [the information] to us.” (PPAI-09)
	Integration into the preadmission process	“We explain why it’s important and what kind of information we need in the Life Story–what will help us provide care, and better quality care.” (PPAI-02) “We’re seeing fewer and fewer Life Story questionnaires left incomplete before admission. Over the past year, there’s been real improvement–especially thanks to the Ministry’s recommendations. Before that, it was more difficult.” (PPAI-07) “We know our clients well–sometimes we’ve followed them at home for many years. So we think we’re maybe the best person to fill it out with the family or the client, because we know them well.” (PPAI-10)
	Exceptions and gaps in continuity	“When the request comes from outside the region, I’ll be the one to complete it with the family.” (PPAI-01)
Using the Life Story questionnaire in care delivery	Specific use for specific users	“Currently, there’s a copy of the Life Story—the original is kept in the resident’s file. That file is accessible to nurses, licensed practical nurses, doctors, social workers, physiotherapists, and occupational therapists (OT). For us, physio and OT are important, and they’ll refer to the Life Story when a situation arises. So, they all have access to the Life Story through the medical file on the unit. We also make a copy to include in the binder used by the personal support workers (PSWs). So the PSWs have access, and we also make a copy for the recreation staff, they have a binder with the Life Stories and they can consult it too.” (PPAI-05) “It’s also about being mindful and showing some sensitivity. For example, if there’s a woman who’s experienced sexual violence, that’s something important for the PSWs and nurses to know, because they provide direct care. But it may not be necessary for the kitchen staff or the housekeeping team to know that, you know?” (PPAI-02)
	From admission through long-term care	“At the team level, when they’re admitting someone, we definitely have a debriefing or team meeting where we discuss that a new resident is coming in, what they like, if they stay up late, and we’ll cover the basics. Then, we quickly make the Life Story accessible so they can refer to it, especially for things like the person’s habits, so they don’t have to wait a week wondering if they need a little light at night to sleep, it’s something they’ll already know.” (PPAI-01) “We can use the Life Story at any point, it’s not just for admission. It can be helpful in situations where the resident is having difficulty with hygiene care, or when we have questions, we’ll go check it, you know, it can be useful for any situation.” (PPAI-01)
	Contribution to individualized and compassionate care	“If we’re providing care and the person becomes agitated, and we know they like flowers or a certain topic, then we talk about that. We’re way more likely to reach them than if we bring up something like baseball and they don’t care about it, you know? That’s why the Life Story is really essential to me.” (PPAI-02) “If a resident tells us, ‘I need to get to work,’ we can meet them in their reality by saying something like, ‘Well, today’s Sunday, I think you might have the day off.” (PPAI-12)
Perceived benefits of the Life Story questionnaire	Humanizing care	“Every time I prepared an admission, I’d sit down with the families to explain how things work at the facility and I’d ask them: ‘What did your father do in life? What did he enjoy? Did he volunteer?’ People were happy to hear those questions. They’d say, ‘I’m glad you’re asking that. You’re not just focused on physical needs, you also want to know who my parent was before they lost so much of their independence.’ So, for families, it made the care feel more human.” (PPAI-02)
	Adapting interactions and activities for more meaningful connections	“The Life Story teaches us a lot about the resident’s past. It helps us build a positive relationship, especially with people who aren’t able to express themselves much anymore. If we know their story, whether they have children, or not at all, what their previous job was… It opens up opportunities for conversation when they arrive. We can ask questions and try to connect. It really makes things easier for staff.” (PPAI-11) “We’re really able to gather a lot of information, which means we’re really able to better adapt our interventions with that person. If it’s someone who loves animals, for example, then we know that zootherapy could work well.” (PPAI-09)
	Supporting emotional well-being	“Take the example of a man who used to work night shifts. If I’m a PSW and I show up at his door trying to force him back to bed, it’s going to cause a behavioral issue, anxiety, maybe disorganization. The nurse might have to give a PRN. It doesn’t work. She’ll call the doctor, and it turns into an escalation that we could avoid, for both the staff and the resident’s well-being.” (PPAI-08) “Before the resident arrives, I’d say it reassures the staff. In fact, here, they even ask for it: ‘I haven’t seen the Life Story, is it at the nursing station?’ The personal support workers are curious to see who they’ll be working with.” (PPAI-11)
Barriers and facilitators to completion and use of the Life Story questionnaire	Institutional level: Staff shortage and turnover	“Staffing challenges are real, there’s a shortage everywhere, and people come and go. Social workers already carry a heavy caseload, so finding the time to complete the questionnaire with residents is difficult. Many residents are alone and don’t have someone to complete it with them, which is also a barrier.” (PPAI-13) “Our regular staff have developed the reflex to consult the Life Story, but we often need to remind agency staff to do so: ‘Did you look at the Life Story?’ It’s not yet a reflex for them. Especially with temporary staff, the practice isn’t integrated—it’s not used everywhere in Quebec, so not everyone knows about it.” (PPAI-11)
	Institutional level: Access to the information	“We make the Life Story questionnaires available at the nursing station before the resident arrives, and then we file them in the personal support workers’ binders under the resident’s tab. For example, in room 115, we insert the Life Story there for regular, daily consultation. They’re not buried in the file among archives. […] They’re also scanned into our shared drive in case we lose a paper copy.” (PPAI-11)
	Inter-institutional collaboration: Collaboration between home care and LTCF care	“It’s the collaboration we have with home care staff. We used to be part of the same team, we had the same manager, so the practice emerged naturally. There’s trust between the caregiver and the home care worker, so it makes sense that the latter would be the one to gather that information. With the LTCF social worker, there’s no established relationship with the caregiver.” (PPAI-08)
	Organizational level: Cultural shift	“In theory, everyone would benefit from this, but even here in long-term care, it’s hard to change the culture. I could give you examples of changes I’ve been trying to make since I became a manager… There’s still resistance. People are used to doing things a certain way: ‘It’s working fine, why should I change?’ It’s hard to mobilize people when a change affects their routines and how they intervene. (PPAI-02)
	Recommendations	“I think it should be done by an educator, a social worker, or a human relations agent, a psychologist or someone like that. Someone with a background in intervention because sometimes powerful emotions come up. I’ve filled in Life Stories where the person started crying.” (PPAI-02) “Ideally, we’d sit down with the family and complete the questionnaire together. If we just send it to them to fill out on their own, they often don’t really understand its purpose or what kind of information is important to include.” (PPAI-02) “Just making it more visible would already be a big improvement. Maybe posting it in or near the resident’s room so that staff can easily say, ‘Oh right, this lady has this or that interest, maybe I can adapt how I interact.’ That would be better than having it tucked away in closed binders at the nursing station.” (PPAI-07)