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This article is derived from a larger Australian research study using multiple qualitative methods to investigate truth-telling in aged-care.

To analyse and discuss findings associated with residents', personal care assistants' (personal carer, enrolled nurse) and the registered nurses' perceptions about the nursing-home. The thesis is that the health of the resident in a nursing-home is directly linked to care provision that encourages autonomy.

Research participants' personal journals, group discussions, follow-up in-depth discussions and the author's field journal across five nursing-homes.

The nursing-home is described as endowed with suspicious awareness and mutual pretence, overloaded with tasks, short of staff and starved of time with little engagement with the residents.

Residency that claims to have as its primary focus ‘the resident’ ought to take …