Health Policies in Residential and Long-Term Care for Older Adults: A Systematic Review of Textual Evidence

Background/Objectives: Policies for residential long-term care seek to safeguard quality, dignity and residents’ rights, yet their translation into practice remains uneven. This review synthesised textual evidence on policies, guidelines and regulatory frameworks for long-term care facilities in European countries with public or universal health systems. Methods: A Joanna Briggs Institute systematic review of textual evidence was conducted (PROSPERO CRD420251132804). CINAHL, MEDLINE, ProQuest Dissertations and Theses, MedNar and Google Scholar were searched (March–May 2025; updated May 2026), with citation searching and targeted searches of EU and OECD repositories. Two reviewers independently screened, appraised and extracted data; findings were integrated through thematic synthesis. Results: Of 2468 records identified, 35 sources (1993–2026) were included: three policy or guidance texts and 32 empirical, review or policy-analysis publications (eight policy analyses or conceptual papers, 20 primary studies and four reviews). Five themes were developed: governance and regulation; guideline implementation; workforce and organisational dynamics; rights, autonomy and ethics; and anticipated pressures and emerging care models. Staffing instability, limited training, fragmented governance and organisational constraints affected implementation. Conclusions: Participatory governance, workforce investment, relational implementation strategies and human rights principles emerge as priorities, with nursing leadership central to translating policy into care. Source heterogeneity and the interpretative synthesis limit generalisability.