The philosophy concerning long-term care for frail seniors has shifted from a provider-driven, medical model toward a more client-centred, social model. While this philosophy emphasises the decision-making abilities of clients and respect for their values and preferences, evidence suggests that there are difficulties in understanding and implementing the philosophy. Qualitative in-depth interviews were conducted with residents of adult family living and assisted living programmes in western Canada to better understand the elements that residents themselves felt were integral to client-centred care.

Three main themes emerged from the data analysis: (1) the physical setting, people within the setting, and the community were important areas of expression of residents' values and preferences; (2) the decision about where to live influenced whether the residential care environment was congruent with residents' values and preferences; (3) contentment resulted when there was a good fit between preferences and experiences, reflecting the essence of residents' perspective of client-centred care. Choices among models of care, appropriate staffing levels and training, and recognition of family contributions may improve the practice of client-centred care.