Abstract
Promoting quality of life is a central theme in recent ageing policies, but what quality of life means in concrete terms for people in different stages of old age is rather unclear. This study presents a multi-dimensional model of care-related quality of life (crQoL) and, based on analyses of three Finnish cross-sectional datasets from the years 2004–2007, examines the distinctions between dimensions of QoL by age and gender, with a special focus on older home care clients. Correlation analyses (Pearson) and stepwise linear regression were applied to analyse variation in QoL by age group and the association between QoL and perceived quality of home care. The results suggest that individual QoL and the priorities of (physical, psychical, social, and environmental) dimensions in the assessment of QoL by older persons vary considerably and exhibit distinct profiles in different stages of ageing. In addition, four dimensions for good care corresponding to the crQoL model were identified and their empirical relevance demonstrated. From the perspective of older people in need of help, home care is not just about giving them the instrumental help they need to perform their daily activities, but rather about giving responsive care that reflects their personal preferences or their view on a “good life”, and treats them with dignity and respect. The criteria for the evaluation of quality of home care should reflect these insights, and policy measures should take these differences into account.
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References
Baltes PB, Baltes MM (1990) Psychological perspectives on successful aging: the model of selective optimization with compensation. In: Baltes PB, Baltes MM (eds) Successful aging. Perspectives from the behavioural sciences. Cambridge University Press, Cambridge
Boumans N, Berkhou A, Landeweerd A (2005) Effects of resident-oriented care on quality of care. Well-being and satisfaction with care. Scand J Caring Sci 19:240–250
Bowden A, Fox-Rushby JA (2003) A systematic and critical review of the process of translation and adaptation of generic health-related quality of life measures in Africa, Asia, Eastern Europe, the Middle East, South America. Soc Sci Med 57:1289–1306
Bowers BJ, Fibich B, Jacobson N (2001) Care-as-service, care-as-relating, care-as-comfort: understanding nursing home resident`s definition of quality. Gerontologist 41(4):539–545
Bowling A (2004) Measuring health: a review of QoL measurement scales, 3rd edn. Open University Press, Buckingham
Bowling A (2007) Quality of Life in older age: what the older people say. In: Mollenkopf H, Walker A (eds) Quality of life in old age. International and multi-disciplinary perspectives. Springer, New York, pp 15–30
Brown J, Bowling A, Flynn T (2004) Models of quality of life: a taxonomy and systematic review of the literature. FORUM Project, University of Sheffield, Sheffield. Available via http://www.shef.ac.uk/ageingresearch
Cummins RA (1997) Assessing QoL. In: Brown RI (ed) QoL for people with disabilities. Models, research and practice. Stanley Thornes, Cheltenham
Felce D, Perry J (1997) Quality of life: the scope of the term and its breadth of measurement. In: Brown RI (ed) Quality of life for people with disabilities: models, research and practice. Stanley Thornes, London
Folstein M, Folstein S, McHugh P (1975) Mini mental state a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:187–198
Gerritsen D, Steverink N, Ooms M, Ribbe M (2004) Finding a useful conceptual basis for enhancing the quality of life of nursing home residents. Qual Life Res 13:611–624
Hellström Y, Persson G, Hallberg IR (2004) Quality of life and symptoms among older people living at home. J Adv Nurs 48:584–593
Hughes B (1990) Quality of life. In: Peace SM (ed) Researching social gerontology: concepts, methods and issues. Sage, London, pp 46–58
Koskinen S, Aromaa A, Huttunen J, Teperi J (eds) (2006) Health in Finland. National Public Health Institute (KTL), National Research and Development Centre for Welfare and Health (Stakes) and Ministry of Social Affairs and Health. Vammalan Kirjapaino, Helsinki
Larsson G, Wilde Larsson B (1998) Quality of care: relationship between the perceptions of elderly home care users and their caregivers. Scand J Soc Welf 7:262–268
Lasslett P (1996) A fresh map of life. The emergence of the third age, 2nd edn. Macmillan, London
Lawton MP (1983) Environment and other determinants of well-being in older people. Gerontologist 4:349–357
Lawton MP (1991) A multidimensional view of quality of life in frail elders. In: Birren J, Lubben J, Rowe J, Deutchman D (eds) The concept of measurement of quality of life in frail elders. Academic Press, San Diego, pp 3–27
Lawton MP (1994) Quality of life in Alzheimer disease. Alzheimers Dis Assoc Disord 8:138–150
Lawton MP (2003) The Philadelphia geriatric centre morale scale. Available via: http://www.abramsoncenter.org/PRI/scales.htm)
Löwenstein A, Ogg J (Eds) (2003) OASIS. Old Age and Autonomy: The role of service systems and intergenerational family solidarity. Final report. Haifa: University of Haifa. Available via: http://www.dza.de/forschung/oasis_report.pdf
Mollenkopf H, Walker A (eds) (2007) Quality of life in old age. International and multi-disciplinary perspectives. Springer, New York
Netten A (2004) The social production of welfare. In: Knapp M, Challis D, Fernandez JL, Netten A (eds) Long-term care: matching resources and needs. Ashgate, Aldershot
Ormel J, Lindenberg S, Steverink N, Vonkorff M (1997) Quality of life and social production functions: a framework for understanding health effects. Soc Sci Med 45:1051–1063
Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 16(1):139–144
Oswald F, Wahl HW (2005) Dimensions of the meaning of home. In: Rowles GD, Chaudry H (eds) Home and identity in late life: international perspectives. Springer, New York, pp 21–45
Øvretveit J (1998) Evaluating health interventions. An introduction to evaluation of health treatments, services, policies and organizational interventions. Open University Press, Buckingham
Pieper R, Vaarama M (2008) The concept of care-related quality of life. In: Vaarama M, Pieper R, Sixsmith A (eds) Care-related quality of life in old age. Concepts, models, and empirical findings. Springer, New York, pp 65–101
Power M, Quinn K, Schmidt S, WHOQOL-OLD Group (2005) Development of the WHOQOL-Old module. Qual Life Res 14:2197–2214
Rapley M (2003) Quality of life research. A critical introduction. Sage, London
Skevington SM, Lofty M, O’Connell K, The WHOQOL Group (2004) The World Health Organisation’s WHOQOL-Bref quality of life assessment: psychometric properties and the results of the international field trial. A Report from the WHOQOL Group. Qual Life Res 13:299–310
Tiit E, Saks K, Vaarama M (2008) Care Keys data and statistical methods. In: Vaarama M, Pieper R, Sixsmith A (eds) Care-related quality of life in old age. Concepts, models, and empirical findings. Springer, New York, pp 45–61
Vaarama M, Kaitsaari T (2002) Ikääntyneiden toimintakyky ja koettu hyvinvointi. (Subjective well-being in older Finns). In: Heikkilä M, Kautto M (eds) Suomalaisten hyvinvointi (Welfare in Finland in 2002). Gummerus Printing, Jyväskylä, pp 120–148
Vaarama M, Ollila K (2008) Koettu hyvinvointi ja elämänlaatu kolmannessa iässä (Subjective wellbeing and quality of life in the third age). In: Moisio S, Karvonen S, Simpura J, Heikkilä M (eds) Suomalaisten hyvinvointi (Welfare in Finland in 2008). Vammalan kirjapaino Oy, Vammala, pp 116–139
Vaarama M, Tiit E (2008) Quality of life of older home care clients. In: Vaarama M, Pieper R, Sixsmith A (eds) Care-related quality of life in old age. Concepts, models, and empirical findings. Springer, New York, pp 168–195
Vaarama M, Ylönen L (2006) Kotihoidon laatu ja tuloksellisuus Espoossa. Asiakkaiden näkökulma. (Quality of life and quality of home care in Espoo—the perspective of the clients). Espoon kaupunki ja Stakes. Espoon kaupunki. Sosiaali- ja terveystoimen julkaisuja 3/2006. Available via: http://www.espoo.fi/default.asp?path=1;28;11884;8532
Vaarama M, Hakkarainen A, Laaksonen S (1999). Vanhusbarometri 1998. (Old age barometer 1998). Sosiaali- ja terveysministeriön selvityksiä 1999:3. Helsinki. OY Edita AB
Vaarama M, Luoma ML, Ylönen L (2006) Ikääntyneiden toimintakyky, palvelut ja koettu elämänlaatu. (Functional ability, services and quality of life in older Finns). In: Kautto M (ed) Suomalaisten hyvinvointi (Welfare in Finland 2005) Stakes. Gummerrus printing, Saarijärvi, pp 104–136
Vaarama M, Pieper R, Sixsmith A (eds) (2008) Care-related quality of life in old age. Concepts, models, and empirical findings. Springer, New York
Veenhoven R (2000) The four qualities of life. Ordering concept and measures of the good life. J Happiness Stud 1:1–39
Walker A, Mollenkopf H (2007) International and multidisciplinary perspectives on quality of life in old age. conceptual issues. In: Mollenkopf H, Walker A (eds) Quality of life in old age. International and multi-disciplinary perspectives. Springer, New York, pp 3–13
WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BFER quality of life assessment. Psychol Med 28:551–558
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Vaarama, M. Care-related quality of life in old age. Eur J Ageing 6, 113–125 (2009). https://doi.org/10.1007/s10433-009-0115-y
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DOI: https://doi.org/10.1007/s10433-009-0115-y