Includes bibliographical references and index.

The movement away from task-oriented care toward the consistent provision of person-centered care (i.e., care based on care recipients' needs and preferences) is widely recognized as the goal of the residential care culture change movement. In 2009, I embarked on a PhD study to explore why the attainment of this goal has remained elusive for many residential care facilities, despite significant effort to alter practice. Based on the complexity of my research question, and because my ultimate aim for this study was to enable practice change in residential care facilities, I selected institutional ethnography as my method of enquiry. In an institutional ethnography, the textually mediated work processes that influence the day-to-day work practices of study participants are examined. Thus, I explored the social organization of residential care facilities by observing resident care attendants' work practices and examining the interaction of those practices with institutional texts. This case study provides an account of some of the practical aspects of using institutional ethnography as a method of enquiry in residential healthcare settings. The case sheds light on the particular challenges of conducting research in institutional healthcare settings and including individuals with dementia as study participants. Finally, the case will demonstrate the advantages of applying institutional ethnography as a method of enquiry when the ultimate goal of one's study is to produce changes in the "way things work."

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