Abstract
Background: Vital Communities (VCs) are emerging as innovative living arrangements within long-term care (LTC), designed to support individuals with complex care needs in leading meaningful lives while remaining connected to their communities. A VC seeks to integrate formal LTC with informal, community-based care, aiming to foster a more inclusive society for people requiring LTC. However, the conceptualization of VCs for people with LTC needs is underdeveloped in current literature. This study will explore the meaning of a VC where some residents have LTC needs. Additionally, there is a lack of understanding about how these VCs operate in practice and whether current initiatives share the same goals or diverge while using the same terminology. Therefore, the research question is: how can a VC be conceptualized and what are its empirical appearances?
Approach: The study design is twofold. First, a hermeneutic review was conducted, followed by focus groups to conceptualize a VC. Second, a multiple case study was designed. In the multiple case study, 47 interviews were conducted with stakeholders—such as care professionals from care organizations, employees from involved municipalities, employees of housing corporations, and residents—across five initiatives in the Netherlands.
These initiatives, varying in development phase and initiator, all identify as community-based. The interviews included questions about the practical implementation of various aspects of a VC, as derived from the first part of the research.
Results: The first part of this research identified seven key dimensions within a pyramid structure that underpin a Vital Community (VC). At the foundation lies interaction, a critical prerequisite for both the development and maintenance of a community. The second tier encompasses the "activity level" of active participation and reciprocity—actions taken by members to benefit the community as a whole. Transitioning to the third level, the community is forged through the cultivation of desire to belong, a sense of community, and adherence to community norms. These elements transform a collection of individuals into a cohesive community. Finally, resilience crowns the pyramid, encapsulating the overarching outcomes of this community-building process.
In the second part of the study, findings show that residents in a VC engage in diverse forms of interaction and activities—not only with fellow residents but also with family members, staff, and members of local associations in which they are active. This interconnectedness fosters a community where members care for one another and where everyone is treated with respect, regardless of their care needs.
Implications: This study illustrates the various aspects of a VC and how they are translated into practice. Furthermore, it shows that there is a variation in the practical implication of a VC between different initiatives. These findings can provide valuable guidance to other organizations seeking to establish or facilitate a VC.
Future research should focus on the needs of community members, as these initiatives are often shaped by organizational interests. While professionals work within the community, residents must live there, making it essential to understand and prioritize their needs and interests.