Quality of Life for Older Australians

The term quality of life is multidimensional and highly subjective. At a basic level, it describes the ability for an individual to be healthy, comfortable and participate in life events (Jenkinson 2020).

In healthcare, quality of life includes emotional, physical, material and social wellbeing (Jenkinson 2020).

Ensuring that clients enjoy a high quality of life is an essential component of delivering person-centred care (Gilkes 2017).

The importance of facilitating quality of life for clients is outlined in several of the Aged Care Quality Standards, which apply to all government-funded aged care services: Standard 1: Consumer Dignity and Choice, Standard 3: Personal Care and Clinical Care, Standard 4: Services and Supports for Daily Living, Standard 5: Organisation’s Service Environment and Standard 8: Organisational Governance.

What Does Quality of Life Encompass?

As stated, quality of life is a broad and subjective concept that depends upon an individual’s perceptions, values and goals. In aged and home care settings, quality of life can mean:

• Being treated with dignity and respect;
• Feeling safe and secure;
• Being supported and encouraged to raise any concerns they may have;
• Absence of uncomfortable physical symptoms (e.g. pain, nausea);
• Emotional wellbeing;
• Physical and cognitive ability to function in daily life;
• Maintaining meaningful and close interpersonal relationships;
• Ability to participate in and enjoy social activities;
• Financial satisfaction;
• Sexuality, body image and intimacy;
• Having the ability to make informed decisions;
• Adequate hydration and nutrition;
• A dining experience that allows for variety, choice and comfort;
• Maintaining hydration and nutrition;
• The ability to maintain independence (if possible); and
• Having a sense of purpose and identity;

(COTA 2018; Besdine 2019; ACQSC 2019)

It is also important to be aware that a patient’s values and perspectives are not static and may change over time (Besdine 2019).

What can Negatively Affect Quality of Life?

In addition to understanding and providing what clients require in order to maintain quality of life, it is also important to identify factors that may adversely affect their quality of life. These factors may not necessarily be anticipated before they arise (Besdine 2019). Examples include:

• Chronic physical or mental illness;
• Institutionalisation;
• Reduced life expectancy;
• Cognitive impairment;
• Disability;
• Chronic pain;
• Social isolation;
• Impaired functional status; and
• Previous experiences with healthcare.

(Besdine 2019; Browning & Thomas 2013)

How to Assess Quality of Life

The subjectivity of an individual’s quality of life means that no single model can be used to perform an assessment. Gaining a proper understanding of someone else’s perspective requires a thoughtful conversation wherein the person can express their preferences (Besdine 2019).

Clients with cognitive impairments should also have an avenue through which to express their thoughts, even if that means using simple questions or inviting family members to participate in the conversation (Besdine 2019).

How can Care Providers Ensure Quality of Life?

In healthcare, it is important we treat clients as whole people, taking into account their:

• Physical and mental health;
• Spiritual, emotional and social life;
• Relationships;
• Attitudes;
• Cultural values; and
• Family and community.

(ACQSC 2019)

Providing care that facilitates quality of life means clients should feel like they have adequate control, privacy and the ability to contribute to their own lives; simply offering opportunities is not enough on its own without providing the ability for choice (ACQSC 2019).

Conclusion

A client’s quality of life often depends on the care they are receiving; therefore, it is important to ensure you take a multi-dimensional approach in order to meet the needs of patients across physical, emotional, material and social domains (Besdine 2019).

Quality of life is highly subjective and in order to thoroughly assess a patient’s perceptions about their life, you should listen to and engage with their values, wishes and goals.

Additional Resources

• Aged Care Quality and Safety Commission, Working With Aged Care Consumers
• Aged Care Quality and Safety Commission, Guidance and Resources for Providers to Support the Aged Care Quality Standards
• COTA, Measuring Quality and Consumer Choice in Aged Care

References

• Aged Care Quality and Safety Commission 2019, Guidance and Resources for Providers to Support the Aged Care Quality Standards, Aged Care Quality and Safety Commission, viewed 18 May 2020, https://www.agedcarequality.gov.au/sites/default/files/media/Guidance_%26_Resource_V9.pdf
• Besdine, R W 2019, ‘Quality of Life in Older People’, MSD Manual, viewed 19 May 2020, https://www.msdmanuals.com/professional/geriatrics/aging-and-quality-of-life/quality-of-life-in-older-people
• Browning, C & Thomas, S 2013, ‘Enhancing Quality of Life in Older People’, InPsych, vol. 35 no. 1, viewed 19 May 2020, https://www.psychology.org.au/publications/inpsych/2013/february/browning
• COTA 2018, Measuring Quality and Consumer Choice in Aged Care, COTA, viewed 19 May 2020, https://www.cota.org.au/wp-content/uploads/2018/09/Quality-and-Choice-in-Aged-Care-Project-Report-FINAL-Feb-2018.pdf
• Gilkes 2017, Quality of Life for Older Australians, Ausmed, viewed 18 May 2020.
• Jenkinson, C 2020, Quality of Life, Encyclopedia Britannica, viewed 18 May 2020, https://www.britannica.com/topic/quality-of-life