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

successfully complete a self-report measure of quality of life, the Schedule for theEvaluation of Individual Quality of Life (SEIQoL). Therefore, it should not be takenfor granted that dementia sufferers are unable to report on their own quality of life.Indeed, encouraging dementia sufferers to activate and use any retained abilitiesto communicate can serve to improve the quality of life of people with dementia(O’Shea and O’Reilly, 1999). Through increased communication, dementia patientscan make their needs and feelings better understood and have improvedinteractions with other people and the environment.In cases where dementia patients are incapable of reporting their own qualityof life, proxy assessments may be utilised. Family members are usually the bestproxies but staff members may also be trained to be reliable proxies. Proxy rating,however, poses a difficult undertaking as proxies must attempt to rate the qualityof life of the resident from the resident’s perspective, not from the perspectiveof the rater themselves (Coen, 1999). This means that a degree of objectivity andimpartiality is needed. Addington-Hall and Kalra (2001) found that proxy assessmentsmay be influenced by the feelings and experiences of caring for the patient.As a group, proxies tend to rate a patient’s quality of life worse than the patientthemselves would rate it. Kane (2003c) found that proxy reports correlated poorlywith those of residents thereby raising concern about the validity of such measures.713.5 Quality of Life Domains for Older PeopleIn recent decades there has been an increasing acknowledgment of the importanceof the measurement and enhancement of quality of life of older people in particular.Increases in life expectancy in the twentieth century have resulted in an increasedolder population in Western developed countries. Accompanying this has been anemergence of a more positive view of old age as a period when people are freedfrom formal social responsibilities such as employment and parenting and are freeto enjoy an active and fulfilled retirement. This means that older people will striveto maintain and enhance the quality of their lives in order to fully enjoy this stageof the life-cycle. In a study carried out by Gabriel and Bowling (2004) on the qualityof life of older people living in private households in Britain, the main quality of lifethemes that were revealed included: having good social relationships, help andsupport; living in a home and neighbourhood that is perceived to give pleasure,feels safe, is neighbourly and has access to local facilities and services includingtransport; engaging in hobbies and leisure activities (solo) as well as maintaining