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

222The physical environment and attitudes of staff can also enhance the connectednessof residents both inside and outside the facility. Good social relationships arefundamental to quality of life and have consistently been mentioned by older peopleas fundamental to health and well-being (Bowling et al., 2003). A fundamentalaspect of quality of life in residential care is being able to develop new relationshipsand maintain existing relationships. Connectedness requires residential caresettings to be part of local communities rather than seen as places of exile thatolder people retreat to when they cannot be cared for in their own homes. Somefacilities are better than others in facilitating greater connectivity among residents,between residents and their families, and between the facility and the widercommunity. But much more can be done in this regard. Firstly, design issues needto be resolved to encourage family and social relationships to grow and develop,including the provision of meeting rooms and play areas for young children visitingthe facility. Secondly, the attitudes of staff need to change regarding the balancebetween the private and the social within long-stay care. Thirdly, connectednessextends beyond families to incorporate local communities through visiting and otherforms of communication. Fourthly, the balance between risk and safety may needto be recalibrated in favour of the former, with residents encouraged to remain partof their own local communities. It is clear from the data in this study that whensocial relationships are strong and attachments to people and places aremaintained, quality of life is enhanced.12.6 Activities and TherapiesAnother key finding from the study is that quality of life is enhanced when residentshave plenty to do, particularly if what they have to do is meaningful and, to someextent at least, is freely chosen. The findings revealed that most facilities areexpending significant effort and resources to provide daily activities for residents.Some facilities had even set up a specific activities department dedicated to theprovision of activities. Unfortunately, some residents did not participate in activitiesbecause they did not perceive them to be of personal interest or did not like theway in which they were structured. Two important issues emerge in respect ofactivities within long-stay care. Firstly, residents’ interests should drive the provisionof activities. For this to happen, there should be an assessment of residents’interests and capacities on admission and a review of these on a regular basis.The schedule of activities should be driven by residents and their inclusion indrawing up a schedule would be of great benefit. To maintain resident interest,Improving Quality of Life for Older People in Long-Stay Care Settings in Ireland