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

The findings also revealed that staffing levels and skill mix were major issuesin the provision of quality of care and, therefore, quality of life. Concern wasexpressed about registered nurse staffing levels and skill mix within the privatesector, particularly as there was a reliance on non-qualified care staff in theprovision of resident care. The public long-stay facilities were better staffedwhich impacted positively on the overall quality of life of residents.Residents highlighted the importance of identity and maintaining a sense of self inlong-term care facilities. The ease with which they achieved this varied across sites,with residents living in old, large public facilities having greatest difficulty. A numberof enabling or inhibiting factors were identified in relation to this theme. Chiefamong these was whether residents had a room of their own or a choice to shareif that was their preference. A private room was the norm within the private sectorbut rare within the public sector. Residents with a room of their own had greaterprivacy, more scope to live their life as they liked, and opportunities to adapt theirenvironment to suit themselves. In contrast, residents living in open-plan wardshad little privacy and limited opportunity to do as they pleased.30Residents who felt empowered perceived that they could shape their day and hadthe potential to make choices. Residents who felt disempowered felt constrainedby rules and routine. They perceived themselves as ‘one of a number’ rather than anindividual and this impacted negatively on their sense of self and personal identity.This could happen equally in public and private facilities but could be avoided by awillingness on the part of staff to personalise the life experience of residents in thefacility, making it a home away from home. The attitude of staff to the care processand their access to, and participation in, person-centred training contribute tomaintaining quality of life for residents.The majority of residents interviewed wanted to be more connected to the outsideworld. Visits from family and friends were very important to residents. Visits helpedto maintain family bonds and kept the older person in touch with what was happeningat home and in the local community. Proximity to family and community was seenas important in maintaining relationships. A number of factors were found thateither enhanced or diminished residents’ potential to retain their connections andrelationships with people and place; an open visiting policy, a feeling of welcome,a homely atmosphere and strong links with the local community were the mainenhancing factors. Perceptions that children were unwelcome, lack of privacy,having to talk to visitors in public and poor links with the local community inhibitedresidents’ connectedness. In general, relationships between staff and residentswere good with the majority of residents describing staff as caring, kind and helpful.Improving Quality of Life for Older People in Long-Stay Care Settings in Ireland