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Chapter 1: Introduction and Background
Figure 1.2: Residential Units by Regional Health Office: Percentage
Distribution of Patients Resident at 31 December 2008 by Bed Type and
Medico-Social Status (CSO, 2008)
It is of paramount importance that older people who are no longer able to continue
living in their own homes can experience a satisfactory quality of life in residential
care. Researchers who have specifically focused on quality of life in residential care
have found that autonomy, choice and control are central to quality of life (Murphy
et al., 2007; Tester et al., 2004; Edwards et al., 2003; Ball et al., 2000; Kane and
Kane, 2000; National Council on Ageing and Older People, 2000). Further evidence
suggests that older people themselves feel that autonomy is important for good
quality of life (Barkay and Tabak, 2002; Edwards and Staniszewska, 2000; Edwards,
Staniszewska and Crichton, 2004; Murphy, 2007).The United Nations (UN) Madrid
International Plan of Action on Ageing (MIPAA, 2002 and 2008) recognised that
there is global acknowledgement of the need to include older adults in autonomous
decision-making processes. The Irish courts have stated that the constitutional rights
of every person include the right to autonomy and self-determination (National
Council on Ageing and Older People, 2008). The National Council on Ageing and
Older People (NCAOP) was established in 1997 with the aim of improving the lives
and autonomy of older people who are affected by illness and impairment. However,