Quality of life from the perspective of older adults living at home, and the role of services
Miriam van Loon | VU University Medical Center
What are important elements of older adults’ quality of life from their own perspective? How do care services contribute to quality of life according to older adults? In the ASCOT-NL project, we aim at applying the Adult Social Care Outcomes Toolkit - a measure that evaluates the influence of care services on quality of life for older adults living at home - to the Dutch context.
Current evaluation of outcomes of (social) care services and interventions for older adults living at home is limited and tends to focus on functioning and on health. This implies that attention for other relevant issues, such as contribution to achieve one’s goals in a condition of limited health, is missing.
One of goals of the ASCOT-NL project is to investigate what quality of life means for older adults living at home, and to evaluate how various kinds of services contribute to their quality of life. For this part of our project, we conducted interviews with older adults living in different regions of the Netherlands.
In open-ended interviews, we first asked them about what aspects in their lives are important to them. Secondly, we distinguished four types of services that older adults receive at home: help with physical problems such as nursing care; help with mental health problems, support with social problems/activities and support and care for problems in everyday life such as housekeeping, meals services etc. Respondents who received different types of services were selected in order to analyze whether these services are important for different aspects of their quality of life.
First results show that different types of services can contribute to certain aspects of quality of life. An interesting finding at this point is how services can enable older adults to stay in their own home. Assistance with cleaning one’s house, or receiving physiotherapeutic help at home, or going to an older adults’ daily activity center, all contributed differently. Staying in one’s own home was seen as crucial for other domains of quality of life – such as autonomy - by many respondents. Final results of the study are expected in June 2016.
Eventually, we aim to use the results for adapting the ASCOT to the Dutch context, and for evaluating whether we need additional domains in ASCOT-NL for the evaluation of certain types of services. Our goal is to implement the ASCOT-NL as policy-instrument, to guide allocation of resources in long-term elderly care in the Netherlands.