Residential Care Homes in Austria, Brazil and the United Kingdom

Over many years, we have had the privilege of visiting and working within a wide variety of residential care homes, referred to in some countries as long-term care institutions (LTCIs). Dr. Manuela Hödl, based in Austria, has a unique position as a care home ‘researcher in residence’ one day a week for 5 years, thanks to an Austrian Science Fund grant. Dr. Kathryn Hinsliff-Smith, a specialist gerontology researcher, has been involved in numerous UK and Brazilian activities within residential care homes. Dr. Ruth Melo, a physiotherapist based in Brazil, has regular connections with local care homes in São Paulo through student placements and research activities.

Our research partnership and mutual interest in older people’s care commenced in 2019 when we attended a funded Global Challenges Research Fund (GCRF)/MRC initiative – Improving care in Long-Term Care Institutions in Brazil and Europe through Collaboration and Research (LOTUS) network programme.

Researchers collaborating with care homes are aware that, as researchers, we are working in someone’s home; hence we are privileged to be engaged with care homes that are often looking for improvements to the care offered to their residents. We are mindful that research is resource & time-limited, with longer-term engagement driven by the availability of research grants.

Through our joint work in Austria, Brazil and UK care homes, we recognise subtle and not-so-subtle differences in the settings. This is where our curiosity started. These differences, which exist across care homes, require careful consideration, especially when working with international partners and when collaborating with academics from other sectors and disciplines, such as architecture, technology and horticulture. 

So, what are these similarities and big differences?

Locked or unlocked access: One note of difference is that in Brazilian and UK care homes, most spaces are freely accessible, but all entrances are locked, mainly due to safety and risk assessments issues. This is in absolute contrast to Austrian care homes, which are not allowed to lock any entrances or exits, an act that is viewed as contravening EU rights to personal freedom or freedom of movement.

Residents’ access and use of outdoor spaces: Brazil has a much warmer all-year-round climate, unlike the majority of Northern Europe. This has an impact on the accepted use of outdoor spaces for regular activities. In Brazil, for example, all residents move freely and are often found sitting, enjoying the outdoor spaces which are always available. In comparison, legislation in other countries requires care homes to provide some outdoor spaces; however, but this is often fraught with managing resident needs’ against risk assessments and staffing. This is a known dimension in UK settings, not such an issue in Austria with their no-lock policies.

The interior look and resident rooms: Most of the care homes’ exteriors are similar regardless of the country or region; whether they operate as a charity, a public or a private provider. What is striking is the accepted occupancy of resident rooms. For example, in the UK it is quite rare to find shared accommodation for couples. Whereas in Austria, it is common practice for resident rooms to have multiple occupancy, even by those who have no previous connection, in essence, strangers. This is also the case in many Brazilian care homes. In some charity care homes, there may be just one or two large multiple occupancy bedrooms that are shared and designated by gender. Brazilian national regulations in 2005 have established minimum standards for residential care homes with four residents per designated bedroom.

Who’s cooking? In the Brazilian care homes we visited, residents were actively encouraged to join in with preparing meals, for example, sitting on a terrace peeling garlic and cutting onions. In Austria and the UK, residents are rarely included in food preparation due to hygiene and potential safety issues. However, in all three countries, we saw examples where separate resident kitchen areas were provided and to which relatives were invited to come and socialise. These tend to be in more the purpose-built, newer care homes.

Where do we see our current work? Over the past few years, we have conducted exchanges and visits to many care homes. This has allowed us the opportunity to review and capture images of different care homes within each country, to compare and review our perceptions as researchers. Curating an image repository has great value for anyone wishing to be involved in future care home research. We were delighted to present some of our image repository at the 2025 Annual Conference of the BSG, enabling a wider dialogue around this work. Our next step will include writing a grant proposal to develop this image repository for future use, including extending its international relevance.

The authors: We are three university academics who focus on care home research with shared perspectives from Austria, Brazil, and the UK.

Dr Manuela Hödl, University of Graz, Austria, and Dr Kathryn Hinsliff-Smith, De Montfort University, Leicester, UK; Dr Ruth Melo, Universidade de São Paulo (USP), Brazil.