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

The Health Act, 1970, should be amended to allow the subvention of residentsin voluntary and private homes by health boards, with the level of subventionvarying according to a resident’s needs.In order to be eligible for a nursing home licence, a nursing home must makea brochure available to prospective residents and their families providing detailsof the services provided, the charges, the qualifications of nursing home staffand other relevant information.The establishment of an independent inspectorate of care facilities for older people.The creation and implementation of a ‘code of good practice’ for nursing homes.44The report pointed to the fact that maintaining high standards of care for olderpeople who are in residential settings is essential to ensuring a good quality oflife for this vulnerable sector of the population. There was explicit recognition thatthe quality of residents’ lives is dependent upon the nature and quality of the careprovided by those who work in the institutions catering for older people. However,while the report recognised the importance of the quality of life of older people,it did not provide a clear definition of the concept of quality of life. It appears thatthe assumption was that people had an implicit understanding of the term ‘qualityof life’ that did not require further elaboration.The 2001 health strategy, Quality and Fairness: A Health System for You (DoHC,2001) recognised the need to develop a comprehensive approach to meeting theneeds of ageing and older people if problems in the care and quality of life of olderpeople were to be addressed. The strategy highlighted quality of life as one ofits central objectives and stated that ‘actions to improve social gain and quality oflife should form part of a coherent health strategy’. However, despite numerousreferences to the quality of life of older people and how this may be improved,the strategy failed to provide a clear or definitive explanation of quality of life ora coherent strategy to enhance quality of life for older people.Therefore, like The Years Ahead report, the strategy seems to take it for grantedthat people understand the term ‘quality of life’ and the mechanisms through whichcare can transform quality of life in residential settings. The strategy made twomain recommendations that, if implemented, would serve to enhance quality inlong-stay care: the widening of the remit of the Social Services Inspectorate toinclude residential care for older people; and the preparation of national standardsfor community and long-term residential care of older people – both are primarilyfocused on care rather than quality of life. The strategy made no explicit statementwith regard to quality of life domains within long-stay care or on the measures thatmight enhance quality of life for older people living in residential settings.Improving Quality of Life for Older People in Long-Stay Care Settings in Ireland