Developing a Quality of Life Tool for Routine Use in Care Homes v5.18
Research type
Research Study
Full title
Developing a Quality of Life Tool Around Resident and Family Priorities Which Can Be Used Routinely to Support Quality of Care in Care Homes
IRAS ID
278856
Contact name
Adam Gordon
Contact email
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
When older people in care homes, their relatives and staff are interviewed, they say that maximising quality of life is important. However, we are unable to measure changes in quality of life in care homes because the measures that are available are not designed for routine use in care homes.
This project aims to develop and test a quality of life tool for routine use in care homes. We will be conducting a series of consultation and validation exercises that will involve input from care home residents, their families and staff at three points:
Firstly, individual interviews about how quality of life is currently understood and measured. These interviews will be semi-structured and focused on current practice to help make decisions about what items should be included in the tool.
Secondly, two consultation events to help develop tool items which are acceptable and feasible for care home use. Participants will be presented with proposed items for inclusion in a quality of life tool and asked to comment on, and possibly change, to ensure they reflect the priorities and needs of care home residents.
Thirdly they will be asked to test the quality of life tool in practice, to see if it is easy to understand and use. This will involve residents, staff and family members using the tool, under direct observation, whilst speaking their thoughts aloud.
These components described will be either face-to-face or use videoconferencing. These will be audio (if face-to-face) or video (if online) recorded, to provide materials for the research team to analyse after completion of interviews and meetings. The first two parts of the study will not include residents who lack capacity. However, the third part will include people who lack capacity to understand how the tool works for people with advanced cognitive impairment.
Lay summary of study results: The purpose of this study was to develop an understanding of older care home residents’ Quality of Life (QOL) priorities from the perspectives of older residents, their relatives and care home staff and identify strategies and practices that can help achieve or maintain or improve these priorities in care homes.
The study identified seven priorities of QOL (dimensions of QOL) for older residents, strategies and practices to achieve these, and overall organisational resources required to support these practices.
The first dimension was care-related QOL; practices identified include meeting residents’ basic physical needs and rights, such as good nutrition, safety, dignity and respect. The second is the care home culture, which includes staff creating a more familial and inclusive culture by referring to residents as “family members” and not wearing uniforms. The third is maintaining identity, including staff exploring residents' life histories to interact with them in a way that resonates with their histories. The fourth is daily life. This involves prioritising flexible daily routines based on residents’ preferences, such as residents doing activities they enjoy and when they want to.
Fifth is social interactions/ relationships, which include staff building relationships with residents by spending one-on-one time with them. Sixth is keeping residents connected to the outside world. This includes care homes having shared lounges to encourage conversations among visitors and residents, especially for residents who rarely get visits. Seventh is a home-like environment. This includes having family-style meals where staff, residents, and relatives eat together at the same table based on residents’ preferences.
The overall organisational resources needed to implement these practices include care homes having a care model based on person-centeredness principles, prioritising residents' emotional and physical well-being, attracting and retaining staff carers and training staff on QOL strategies/practices.
The study also found that some strategies and practices can be used to achieve, maintain, or improve multiple dimensions of QOL. For example, the practice of family-style dinners in care homes can create a home-like environment and provide opportunities for residents to interact, connect, and build relationships with other residents, staff, and relatives. Additionally, family-style dinners involve sitting at a table with other people to eat, which can encourage residents to eat better, thus meeting their nutritional needs. Therefore, family-style dinners can help improve residents’ QOL dimensions of care-related QOL (good nutrition), social interactions and relationships, and a home-like environment.
Furthermore, the study revealed potential tensions or limitations when implementing some strategies and practices. For instance, the tension between independence and safety. For example, providing residents with a flexible routine may only be possible for independent residents because care homes may prioritise safety if staff are unavailable for residents who require support.
REC name
South Central - Berkshire Research Ethics Committee
REC reference
21/SC/0203
Date of REC Opinion
21 Jun 2021
REC opinion
Favourable Opinion