What quality of life domains are most important to older adults in residential care?

ABSTRACT

Quality of life is a critically important outcome measure in aged care. However, few studies have provided a detailed examination of what quality of life means to older adults living in residential care. In the current study, N = 43 older adults (67 to 99 years) living in six residential aged care facilities in four Australian states took part in semi-structured interviews. Participants had normal cognition through to mild /moderate cognitive impairment as measured by the PAS-Cog, were able to provide informed consent, and could participate in an interview conducted in English. Interviews were transcribed, and data was analyzed in NVivo using thematic analysis. Both physical and psycho-social aspects were identified as important for older adults’ quality of life with six key quality of life domains identified: independence, mobility, pain management, social connections, emotional well-being, and activities. More research is needed to test these domains with a more diverse sample of older adults living in residential aged care, in particular older adults from culturally and linguistically diverse communities. Such qualitative work is essential for the development of suitable quality of life measures for this population and provides valuable information to inform improvements to care practices and service provision. Some ways in which the identified quality of life domains could be used to enhance care provision are discussed.

KEYWORDS:

• Outcomes
• qualitative research
• quality of life
• residential aged care
• long-term care

Key points

• There are few international qualitative studies on QoL in residential care settings.

• Physical and psycho-social aspects of QoL were identified as important.

• Regular monitoring of QoL should include what is important to older adults.

• These domains can be used to develop a new QoL instrument for use in aged care.

• The QoL domains can also be used to inform care practices and service provision.

Acknowledgments

We would like to thank Helping Hand, Uniting Agewell, Uniting ACT NSW, Presbyterian Aged Care, Willochra House and Kalyra Aged Care for supporting the recruitment of participants for this project. We also extend our thanks to Alexandra Mudd who conducted some of the South Australian interviews.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics statement

Ethics approval was provided by Flinders University Human Research Ethics Committee (application no: 8399).

Author contributions

The study was conceptualised by JR, RW, RM and KS. CH and JC developed the interview schedule, CM and JC collected the data and conducted the first round of coding under the supervision of CH. All authors contributed to the second round of coding and discussed and agreed the final results. The first draft of this paper was developed by CH. All authors contributed to the manuscript and approved the submitted version.

Additional information

Funding

This work was supported by an Australian Research Council Linkage Project grant [LP170100664]. Additional funding support was provided by our partner organisations Helping Hand; ECH; Uniting Agewell; Uniting ACT NSW; Presbyterian Aged Care and by the Caring Futures Institute at Flinders University.