Abstract
Objectives
interRAI launched this study to introduce a set of standardized self-report measures
through which residents of long-term care facilities (LTCFs) could describe their
quality of life and services. This article reports on the international development
effort, describing measures relative to privacy, food, security, comfort, autonomy,
respect, staff responsiveness, relationships with staff, friendships, and activities.
First, we evaluated these items individually and then combined them in summary scales.
Second, we examined how the summary scales related to whether the residents did or
did not say that the LTCFs in which they lived felt like home.
Design
Cross-sectional self-report surveys by residents of LTCFs regarding their quality
of life and services.
Setting/Participants
Resident self-report data came from 16,017 individuals who resided in 355 LTCFs. Of
this total, 7113 were from the Flanders region of Belgium, 5143 residents were from
Canada, and 3358 residents were from the eastern and mid-western United States. Smaller
data sets were collected from facilities in Australia (20), the Czech Republic (72),
Estonia (103), Poland (118), and South Africa (87).
Measurements
The interRAI Self-Report Quality of Life Survey for LTCFs was used to assess residents'
quality of life and services. It includes 49 items. Each area of inquiry (eg, autonomy)
is represented by multiple items; the item sets have been designed to elicit resident
responses that could range from highly positive to highly negative. Each item has
a 5-item response set that ranges from “never” to “always.”
Results
Typically, we scored individual items scored based on the 2 most positive categories:
“sometimes” and “always.” When these 2 categories were aggregated, among the more
positive items were: being alone when wished (83%); decide what clothes to wear (85%);
get needed services (87%); and treated with dignity by staff (88%). Areas with a less
positive response included: staff knows resident's life story (30%); resident has
enjoyable things to do on weekends (32%); resident has people to do things with (33%);
and resident has friendly conversation with staff (45%). We identified 5 reliable
scales; these scales were positively associated with the resident statement that the
LTCF felt like home. Finally, international score standards were established for the
items and scales.
Conclusions
This study establishes a set of standardized, self-report items and scales with which
to assess the quality of life and services for residents in LTCFs. The study also
demonstrates that these scales are significantly related to resident perception of
the home-like quality of the facilities.
Keywords
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References
- Formal and informal care for disabled elderly living in the community: An appraisal of French care composition and costs.Eur J Health Econ. 2012; 13: 327-336
- Scaling functional status within the interRAI suite of assessment instruments.BMC Geriatr. 2013; 13: 128-140
- National estimates of the quantity and cost of informal caregiving for the elderly with dementia.JGIM. 2001; 16: 770-778
- Daily life in a nursing home: Has it changed in 25 years?.J Aging Stud. 2002; 16: 345-359
- Depression in older nursing home residents: The influence of nursing home environmental stressors, coping, and acceptance of group and individual therapy.J Aging Mental Health. 2008; 12: 536-547
- Loneliness and social support among nursing home residents without cognitive impairment: A questionnaire survey.International J Nurs Stud. 2011; 48: 611-619
- Suicide prevention for older adults in residential communities: Implications for policy and practice.PLoS Med. 2010; 7: e1000254
- Relationship between perceived empowerment care and quality of life among elderly residents within nursing homes in Taiwan: A questionnaire survey.Int J Nurs Stud. 2006; 43: 673-680
- The nursing home as a home: A field study of residents' daily life in the common living rooms.J Clin Nurs. 2007; 17: 460-467
- Making home in the age of globalization: A comparative analysis of elderly homes in the U.S. and Korea.J Environ Psychol. 2014; 37: 80-93
- Anticipation of nursing home placement may be a precipitant of suicide among the elderly.J Am Geriatr Soc. 1991; 39: 407-408
- Home and Community Preferences of the 45+ Population.AARP Research Report. November 2010;
- Aging in Place in America.Study commissioned by Clarity and Ear Foundation. August 2007;
- International survey of nursing home research priorities.J Am Med Dir Assoc. 2014; 15: 309-312
- Transforming nursing home culture: Evidence for practice and policy.Gerontologist. 2014; 54: S1-S5
- Person-centered care for nursing home residents: The culture-change movement.Health Affairs. 2010; 29: 312-317
- Radical redesign of nursing homes: Applying the green house concept in Tupelo, MS.Gerontologist. 2006; 46: 533-539
- Resident outcomes in small-group nursing homes: A longitudinal evaluation of the initial green-house program.J Am Geriatr Soc. 2006; 55: 837-839
- Nursing home organizational change: The “culture change” movement as viewed by long-term care specialists.Med Care Res Rev. 2010; 67: 65S-81S
- What matters most to nursing home elders: Quality of life in the nursing home.J Am Med Dir Assoc. 2012; 13: 48-53
- Quality of life of residents with dementia in traditional versus small-scale long-term care settings: A quasi-experimental study.Int J Nurs Stud. 2012; 49: 931-940
- A multidimensional view of quality of life in frail elders.in: Birren J.E. Lubben J. Rowe J. Deutchman D. The Concept of Measurement of Quality of Life. Academic Press, New York1991
- Quality of life measures for nursing home residents.J Gerontol A Biol Sci Med Sci. 2003; 58: M240-M248
- The quality of life of older adults living in an urban environment: Professional and lay perspectives.Can J Aging. 2005; 24: 19-30
- Care-related quality of life: An overview.in: Vaarama M. Pieper R. Sixsmith A. Care-Related Quality of Life in Old Age. Concepts, Models, and Empirical Findings. Springer, New York2008: 301-326
- Predictors of long-term care facility residents' self-reported quality of life with individual and facility characteristics in Canada.J Aging Health. 2016; 28: 503-529
- Elderly people's definitions of quality of life.Soc Sci Med. 1995; 41L: 1439-1446
- Resident self-report quality of life in long-term care facilities.Can J Aging. 2015; 34: 149-164
- Predicting nursing facility residents' quality of life using external indicators.Health Serv Res. 2006; 41: 335-336
- Proxy sources for information on nursing home residents' quality of life.J Gerontol Ser B Psychol Sci Soc Sci. 2005; 60: S318-S325
- interRAI Self-report Quality of Life (QOL) Surveys and User's Manual. Ver 9.3.interRAI, Washington, DC2016
- Nursing home resident quality of life: Testing for measurement equivalence across resident, family, and staff perspectives.Qual Life Res. 2015; : 242365-242374
- Referentiekader integrale kwaliteit van wonen en zorg in de Vlaamse woonzorgcentra: Kwaliteit van leven van bewoners in de Vlaamse woonzorgcentra. Synthesenota.LUCAS KU Leuven/Agentschap Zorg en Gezondheid, Leuven/Brussel2013
- Meten van kwaliteit van leven in Vlaamse woonzorgcentra. Handleiding voor de woonzorgcentra/interRAI ‘kwaliteit van Leven’ – versie 1.2 (Measuring quality of life in Flemish nursing homes. Manual for Nursing Homes/interRAI ‘Quality of Life’ version 1.2).Agentschap Zorg en Gezondheid, Brussel2014
- MDS cognitive performance scale.J Gerontol. 1994; 49: 170-182
- Nursing homes in 10 nations: A comparison between countries and settings.Age Ageing. 1997; 26: 3-12
- Growth in number of elderly receiving nursing home services outstrips increase in home-based eldercare.(Available at:) (Accessed December 5, 2017.)
European Commission. Adequate social protection for long-term care needs in an aging society. Report jointly prepared by the Social Protection Committee and the European Commission, online, 2014.
Article info
Publication history
Published online: October 10, 2017
Footnotes
Partial support for this study was provided by interRAI (an international nonprofit organization that provides free use of its tools to governments and care providers in exchange for the use of their de-identified data). The secondary data came from interRAI fellows from surveys completed in their countries. In addition, the Canadian research was funded by the Canadian Institute for Health Information. In Poland the data has been collected in the frame of the Jagiellonian University research grant.
The authors declare no conflicts of interest.
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© 2017 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
