Creating and maintaining good social connections and relationships when transitioning to a care home are central to promoting good physical and mental health of older people and to maintaining a good quality of life. Older people relate to others within a complex web of social networks which situates them in relationships with other residents, relatives, visitors, external health-care professionals, and internal care and ancillary staff in their care home. If this social network of connections is operating successfully, then it can offer emotional support, physical care, social engagement, and a sense of belonging. Williamson (2010) outlines a number of key indicators relating to the quality of life for older people, which include healthy relationships with others and having someone to talk to, a comfortable living environment, good physical health, a sense of humour, independence, the ability to communicate, a sense of personal identity, the ability and opportunity to engage in activities, and the ability to practise faith or religion. Nolan et al's (2006) ‘Senses Framework’ lists a sense of security, a sense of belonging, a sense of community, a sense of purpose, a sense of achievement, and a sense of significance as the elements required for a good quality of life in a care home for the residents, but also for the good quality working environment for the staff and a good environment for visiting. My Home Life England (2022a) sets out a framework for achieving good relationships and quality of life for all that live, die, visit, and work in care home settings. It writes that, ‘We need to consider what gives each individual a sense of security (feel safe), belonging (feel part of things), continuity (make connections between past, present and future), purpose (have goals), achievement (moving towards their goals) and significance (matter as a person)’ (My Home Life England, 2022b).

This chapter explores how older people and their visiting adult child relatives enable an expression of these well-being indicators when they transition to long-term care. How do adult child relatives and the care staff create a comfortable and welcoming environment for the older person in the care facility, and what is important in this process? How can older people discover a sense of autonomy, independence, and identity expression through these relationships? And how can communication be facilitated in the care environment when there are limits to physical mobility and cognition?