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

often not designed to meet the specific needs of residents. For example, althoughall of the homes surveyed had beds on more than one floor, only one third of thebuildings had lifts. In addition, handrails were rarely fitted in sitting or dining roomsand ramps were provided as an alternative to stairs in less than half of all homessurveyed. Therefore, the physical design of the nursing homes tended to engenderincreased dependence rather than to facilitate or promote greater independenceof residents. In relation to staffing, the results revealed that the ratio of full-timeequivalent nurses to residents was higher in private nursing homes than voluntaryhomes. The study also noted the high number of nursing aides employed by bothtypes of home.The qualitative study (O’Connor and Thompstone, 1986) was undertaken in arepresentative random sample of twenty nursing homes. Almost three quarters ofresidents reported that they were contented living in a nursing home while just overa quarter were unhappy or felt isolated. More women than men reported feelings ofhappiness or contentment. The residents reported that the best features of living ina home were the security and protection it provided and that the residents’ day-todayneeds were looked after leaving residents free to enjoy their retirement. Negativeaspects of living in a nursing home cited by residents included a lack of ‘real homelife’, loss of friendships and loss of control over daily aspects of their lives.51In 2003, Age & Opportunity commissioned a small-scale, yet pioneering study toelicit the views of residents on social gain and quality of life in three long-stay caresettings – two were run by a health board and the third by a religious order. Theinstitutions were selected to reflect the variety in type and geographical settingrather than being representative of all Irish long-term residential care settings.The research identified ten quality of life domains:Companionship and loneliness – many residents had experienced lonelinessprior to moving to residential care and the availability of companionship inresidential care significantly contributed to the quality of life of residents.However, some residents still experienced loneliness, in particular residentswho suffered from a hearing or communication impairment, or individualswho had no shared interests with other residents.Personal identity and privacy – residents’ personal identity was commonlyexpressed in their personal space and the ability to have their personalpossessions near them. Private rooms were important in order to maintainpersonal identity and, thus, significantly contributed to quality of life. Theabsence of privacy and space for personal belongings undermined the qualityof life of residents.