What’s it like living in aged care? Researchers shed new light on quality of life

A new study provides fresh insights into the topical question of how to enhance the quality of life of aged care residents, highlighting the importance of autonomy and meaningful relationships.

A new study provides further insights into the topical question of how to enhance the quality of life of aged care residents, highlighting the importance of autonomy and meaningful relationships.

The researchers say their findings show that aged care facilities should strive for continuity of frontline care workers so that staff can nurture trusting relationships with residents.

The qualitative study, based on interviews with 18 residents, found that many were not included in decision-making and found it difficult to forge meaningful personal connections.

Enabling new residents to make more decisions about their care and the activities on offer would be one way of facilitating a successful transition and adaption to residential aged care life, the study found.

“Three themes emerged reflecting the reality of residential aged care life for these participants: loss of autonomy, dignity and control; valuing important relationships; and resigned acceptance,” according to the study’s authors, Helen Walker of Deakin University and Penelope Paliadelis of Federation University.

Residents felt that staff provided adequate clinical care but didn’t always have enough time to engage in meaningful social interactions and could not actively engage in building friendships.

This finding is in line with previous research that identified an “over-emphasis on aged care facility staff providing clinical services and completing documentation rather than nurturing social interactions with and between older persons,” the researchers said.

The study found:

“Australia’s aged care system is dominated by regulations that contribute to a reduced sense of identity and this has had a significant impact on the participant’s experience of residential aged care life.”

The findings support earlier studies that found a lack of choice and control, and maintenance of dignity and privacy, all affect residents’ quality of life, the researchers said.

It was clear that the impact of living in aged care elicited strong emotions for the residents even though they had resigned themselves to the constraints of living in a facility.

The study found there were practical ways that facility staff could address residents’ loss of autonomy and ameliorate their sense of grief, which included providing activities and outings specifically orientated towards individual preferences.

The new findings come amidst increasing sector interest in resident wellbeing, with quality of life included in the national program of quality indicators in residential aged care currently being implemented.

Last month Australian Ageing Agenda reported that veteran industry CEO Mike Rungie had called on fellow providers to start measuring and benchmarking their residents’ quality of life as a way of fostering industry-wide collaboration to ensure older people live better lives (read that story here).

The new study on quality of life was published in the recent Australasian Journal on Ageing.

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Tags: deakin-university, federation-university, Helen Walker, mike-rungie, Penelope Paliadelis, quality indicator, quality-of-life, relationships, slider, wellbeing,

4 thoughts on “What’s it like living in aged care? Researchers shed new light on quality of life

  1. Fantastic… quality of life should go beyond clinical needs! A focus on QoL is highly relevant in any aged care space whether experienced in a CHSP service, HCP or resi care. I recently identified the lack of QoL indicators or framework for people ageing with addictions.

    However, we must separate QoL indicators between orgs and people (and their family or support network) as each group will have different meanings about QoL. None should be privileged but together they could offer a picture of the person’s QoL.

  2. In the view of many Australians, the care provided to the residents of nursing homes – my preferred description rather than that of residential aged care facilities – falls well below their expectations of what constitutes reasonable care. The considerable support for Change.org petitions citing appalling care bears this out. Further, having spent in excess of 2,000 hours in various nursing homes, I have no hesitation in saying that the life of a typical nursing home resident is decidedly miserable.

    One of my key concerns is that of the failure of nursing homes to maintain the mobility of residents. This is notwithstanding the fact that one of the 44 Nursing Home Outcomes specifically refers to the optimization of resident mobility and dexterity. I attribute this dismal failure to 2 points. Firstly, the wording of the Outcome is so brief as to be effectively meaningless for the purposes of transparency, scrutiny and accountability and, secondly, the Aged Care Funding Instrument makes no mention of mobility but instead focuses on pain mitigation initiatives that the Australian Physiotherapy Association has portrayed as having little benefit to residents.

    Tragically, the absence of clarity in regard to the mobility of residents is also apparent in the wording of other crucial Outcomes. Phrases such as adequate hydration, sufficient staff and management of continence condemn residents to poor care and widespread neglect.

    In 2005, the Quality and Equity in Aged Care Inquiry recommended that the Outcomes be re-drafted to provide greater certainty as to what can be expected from nursing home providers, which would facilitate true transparency, scrutiny and accountability. Sadly, Recommendation 14 has not been adopted. A prescriptive approach to the wording of the Aged Care Accreditation Standards and Outcomes would bring about a sea change in residential aged care, albeit one that would undoubtedly be rejected by the nursing home peak bodies, ACSA, LASA and The Aged Care Guild.

    Putting aside the issues of hydration, continence, mobility and staffing, the scope of activities in nursing homes is another area that requires urgent attention. My grim observation is that the activities on offer are perfunctory in nature and therefore fail to address the many, many hours of mindless boredom that residents must face daily.

    Successive Federal Governments and senior bureaucrats in Canberra have failed nursing home residents across Australia. The problems are clearly known, as are the solutions. All that is needed is a political will and recognition that the interests of residents are paramount in any regulatory regime rather than those of the providers.

  3. Absolutely no disagreement that QoL is dependent on far more than clinical care. Human beings on the whole thrive better when relationship and need for independence are recognised and maximised.

    It is true that many of our carers are task focused and feel they have to get the work done in a certain time period and we do have an expectation of documentation to meet our legislative requirements. It must also be understood that funding in the aged care arena does not allow for a great deal of extra time for staff to be relational with clients.

    It is also important to recognise that what I for example might see as an important QoL aspect for my parents may not be shared by my parents. When we consult, and we do, are we listening to the residents / clients more than their children / person responsible? Often the relatives have a louder voice of what they believe should be and as they are more likely to be the ones making a complaint, often receive greater attention.

    I agree with the results of the study but the answers are not simplistic despite our desire that they are.

  4. More good money wasted on very ordinary research. It’s concerning that everyone’s so quick to extrapolate conclusions from a study of only 18 people. Although I’d be really interested in a study of how to find the time to implement all these genius strategies and still keep cutting the number of care staff.

    The propensity to talk about an individual’s sense of worth like it’s wrapped in a neat little package belies the complexity of one’s history and current circumstances. I see we’ve even got a groovy new label too…QoL…oh please!

    And don’t expect any valid definitions from the national quality indicators team…have a close look at the obfuscating farce they developed for measuring pressure injury rates. Thankfully, it’ll take them at least another 4 years before they put another useless indicator on the table.

    Mr Fraser is the voice of reason here. Why is clinical suddenly such a dirty word? Is this another component of the agenda to remove RNs from the game or is everyone really that naive? Why does it have to be one or the other?

    Of course we should be looking for better ways to engage everyone, but before jumping on this rickety bandwagon it would be prudent to determine some priorities. Just what set of ‘QoL’ (!) indicators do you suggest we apply to a bed-bound and incontinent 93 year old with advanced dementia? it doesn’t seem like the Wellbeing brigade have thought this through properly.

    Clinical care is the foundation. You cant play bingo when you’re hospitalised because of dehydration and sepsis.

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