Improving Quality of Life for Older People in Long-Stay Care ...

The prevalence of quality deficits in residential care across OECD countries hasled to international concern about the quality of care and quality of life in long-stayinstitutions. In general, governments have focused on developing and enforcingbasic regulatory frameworks for minimally acceptable quality of care standards inresidential care. In addition, most countries have developed and implemented asecond layer of quality initiatives in order to ensure that standards of care exceedminimum requirements and positively enhance the health and well-being ofresidents. The development of a third layer of initiatives designed to enhancequality of life in residential care has not always been forthcoming, either voluntarilyor through regulation. Even allowing for definitional and measurement difficulties,more needs to be done to increase the regulatory and policy focus on quality of life,in addition to quality of care, in residential settings. Such an approach would focuson both the physical and social environment within long-stay settings and theirimpact on the quality of life of residents. It would challenge ageist attitudes amongproviders, place the focus firmly on the rights and needs of residents, and ensureperson-centred training for all staff providing care for older people. Quality of lifefor older people is an issue for everyone, both within residential care settings andoutside. As such, any initiatives designed to enhance quality of life for dependentpeople in residential care settings should apply equally to older dependent peopleliving at home.21312.2 Methodology and ModelAs a concept, quality of life can mean anything to anybody and there is noconsensus on the meaning of quality of life, especially with respect to olderpeople in long-stay care. The measurement of quality of life is a difficult andcomplex exercise. For this study, objective data was collected on dimensionsof residential care that previous research indicated were likely to impact on thequality of life of residents. This was conducted through a postal questionnaire toall known long-stay facilities in the country. The overall response rate to the surveywas 62 per cent. The subjective views on quality of life of both residents and staffin residential care were also explored, through study site work in 12 sites acrossthe country. The rationale for the study site work was the belief that an individuals’sown sense of the ongoing narrative of life is more meaningful than an outsideexpert’s construction of objective reality. Hearing the voice of older people wascentral to this study and the phenomenological nature of the study site interviewsfacilitated this, thus ensuring an authentic account of quality of life as older people