Ethical and methodological challenges in conducting institutional ethnography within South African long-term care facilities

Institutional ethnography offers a critical framework for examining how institutional structures coordinate everyday experiences, yet its application in long-term care settings introduces unique ethical and methodological challenges. This paper reflects on the first author's experiences in conducting an institutional ethnographic study in five South African government-subsidized long-term care facilities, where the quality of life of older residents is coordinated by complex social and ruling relations. Using a triangulated approach that combines in-depth interviews, participant observation, and institutional text analysis, the study identifies key methodological and ethical tensions: navigating ethical complexities, negotiating institutional gatekeeping, managing multiple data sources, and maintaining researcher reflexivity and positionality. Practical strategies to address these challenges are proposed, contributing to the methodological discourse on conducting research in resource-limited and structurally constrained environments. These reflections underscore the necessity for methodological flexibility, ethical responsiveness, and critical reflexivity in resource-limited and structurally constrained environments. The insights provided herein offer valuable guidance for researchers aiming to employ institutional ethnography in similar social care contexts.