Defining Quality of Life for seniors
In health care we often use the term “Quality Of Life” in connection with describing an ultimate goal, a service, or when proposing a full range of care to patients. For some, quality of life (QOL) may seem unattainable. When faced with chronic health conditions, depleting assets, lack of familial support, limited social engagements, and overall lack of resources-QOL may seem outside their grasp.
QOL is fantastic in theory , however, formulating a plan with QOL at the center requires a deeper and a broader understanding of care. QOL is multi-dimensional in scope and views the care recipient in a holistic manner. Let’s consider three elements that contribute to heightened QOL.
- Social Interactions-A general sense of connection to other people, other groups, pets, or whatever brings the person a sense of meaning.
- Engagement with activities that promote a sense of purpose and feelings of physical wellness
- Stimulation of the mind in the form of learning, creativity, or idea exchange
- A fourth proposed element is- Spiritual well-being.
This concept has less to do with religion and more to do with what feeds someone’s “spirit” . Hobbies, worship, art, etc. Something that brings deeper satisfaction and contributes to deeper meaning. Though, religious traditions and occasions should not be overlooked as unimportant to a person’s QOL. Many religious rituals and traditions have great meaning and could become distressing if not adhered to. For instance, a client who values the Sabbath or who has a kosher home has specific rituals and practices that if overlooked, diminishes that person’s view on their QOL.Quality care and Quality Of Life are sometimes used interchangeably, and they have similar approaches, however, QOL is a broader concept. Traditionally, quality care focuses on the issues at hand. Specialized patient care that aligns with current diagnosis and treatment or comfort care. QOL expands on that approach to include fulfillment and engagement in the person’s life, despite cognitive or physical limitations, despite diagnosis- QOL approach considers the whole person-Past, present, and future.The World Health Organization has defined health as a “state of complete physical, intellectual, and social well-being and not merely the absence of disease or infirmity”.
When addressing the client’s QOL holistically, caregivers and health professionals may adopt these four principles:
- Assessing his/her needs and interest
- Focus on those needs
- Develop and implement an activity plan that will address those needs
- Evaluate success or failures and refine the plan
One example of how this could can be utilized in a practical way:
Mrs. H was an avid gardener and bird watcher. She would sit on her porch for hours watching the birds and planting flowers in her garden. She loved to smell her roses and would always have fresh flowers in her kitchen. One winter, Mrs. H had a massive stroke and could no longer garden or sit outside without company. Her case manager worked with the family to install raised beds with wide edges on her porch where she could still plant smaller plants. They installed a few bird feeders so she could still sit and watch the birds. The case manager arranged for home care services a few days a week- the caregiver would assist Mrs. H with her gardening. The case manager made a schedule that included help from other family members.
Her ability to still do what she enjoys-gardening and bird watching, had tremendous impact on her quality of life .
The holistic approach may seem time consuming and tedious but it can be achieved-with help and support. The question to ask yourself is- What if this were me? Wouldn’t I want someone to invest the time to make my later years, quality years? Of course you would.
One way to achieve these goals is to tap into informal support networks. These include, friends, neighbors, church members, volunteers, and grand-children.. I have a client who has a live in caregiver but separate from that care, the family created a monthly calendar of events which includes involvement of all family members. Children, grand-children and great-grandchildren share in the responsibility of engaging the client. They go out to eat, go for rides, go on trips etc. they are a wonderful example of what coordination, communication, and love can achieve.
Remember, the key is to first develop an action plan that incorporates-respect, realistic goals, and client responsiveness.
Remember to respect the client’s comfort level with any proposed activity. Honor his/her desire to participate or not. Some activities may require some gentle encouragement and repeated tries.
The person may find certain activities overwhelming and may resist participation. Set realistic goals based on abilities and not just on ideas.
Keep an open mind, adjust when necessary, and follow the client’s lead when planning activities.
Addressing a person’s QOL is an evolving process. It requires creativity, resourcefulness, and an interest in the humanity of the aging process. The results of your efforts will be well worth the investment of your time. A focus on QOL is a win-win for the older adult, for you, and for the wider branch of care partners. Many seniors feel invisible. This element of care provides an opportunity for them to connect with their whole selves- to feel important, appreciated, and visible.
Cress, C. J (2012). Handbook of Geriatric Care Management.