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Factors associated with quality of life in dementia patients in long-term care

Published online by Cambridge University Press:  20 December 2012

María Crespo*
Affiliation:
Department of Clinical Psychology, Complutense University, Madrid, Spain
Carlos Hornillos
Affiliation:
Department of Clinical Psychology, Complutense University, Madrid, Spain
Mónica Bernaldo de Quirós
Affiliation:
Department of Clinical Psychology, Complutense University, Madrid, Spain
*
Correspondence should be addressed to: María Crespo, PhD, Department of Clinical Psychology, Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain. Phone: +34-91-394-3079; Fax: +34-91-394-3189. Email: [email protected].

Abstract

Background: The aim of this study is to describe and determine the factors associated with the quality of life (QoL) of patients with dementia living in nursing homes as perceived by themselves and by proxies (both family and staff).

Method: Data on residents with dementia were collected in 11 nursing homes. The Quality of Life-Alzheimer's Disease Scale (QoL-AD) residential version was directly applied to residents with dementia diagnosis and Mini-Mental State Examination score of less than 27, randomly selected in each center. Residents’ QoL was further assessed from the perspective of some close relative and staff member. Altogether, 102 data sets from residents, 184 from relatives, and 197 from staff members were collected.

Results: Stepwise multiple linear regression analysis showed that depression and cognitive function were the best predictors of self-rated QoL. Predictors of family-rated QoL were resident's functional capacity to carry out activities of daily living (ADL), the family member paying for the nursing home fees, and use of feeding tubes as part of the resident's care. Predictors of staff-rated QoL were resident's functional capacity to carry out ADL, cognitive impairment and depression, staff-member's work pattern of shifts (rotating vs. permanent) and type of center administration (public vs. private). Explained variance for the three models was 42%, 25% and 41% respectively.

Conclusions: The QoL perception by persons with dementia living in a nursing home is mainly affected by their emotional state (depression level), while proxies’ perceptions (both family and staff) are mainly associated with patients’ functional autonomy in daily living. Therefore, perspectives of persons with dementia and their informants are not congruent. Moreover, facility features and family and staff members’ personal features do not affect QoL ratings.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Alexopoulos, G. A., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 271284. doi:10.1016/0006-3223(88)90038-8.CrossRefGoogle ScholarPubMed
Barca, M. L., Engedal, K., Laks, J. and Selbaek, G. (2011). Quality of life among elederly patients with dementia in institutions. Dementia and Geriatric Cognitive Disorders, 31, 435442. doi:10.1159/000328969.CrossRefGoogle Scholar
Beck, A. T., Steer, R. A. and Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corp.Google Scholar
Beer, C.et al. (2010). Factors associated with self and informant ratings of the quality of life of people with dementia living in care facilities: a cross sectional study. PLoS One, 5, e15621. doi:10.1371/journal.pone.0015621.CrossRefGoogle ScholarPubMed
Burgio, L. D., Fisher, S. E., Fairchild, J. K., Scilley, K. and Hardin, J. M. (2004). Quality of care in the nursing home: effects of staff assignment and work shift. The Gerontologist, 44, 368377. doi:10.1093/geront/44.3.368.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J. (1986). Agitated behaviors in the elderly II. Preliminary results in the cognitively deteriorated. Journal of the American Geriatrics Society, 34, 722727.CrossRefGoogle ScholarPubMed
Conde-Sala, J. L., Garre-Olmo, J., Turró-Garriga, O., López-Pousa, S. and Vilalta-Franch, J. (2009). Factors related to perceived quality of life in patients with Alzheimer's disease: the patient's perception compared with that of caregivers. American Journal of Geriatric Psychiatry, 24, 585594. doi:10.1002/gps.2161.CrossRefGoogle ScholarPubMed
Conde-Sala, J. L., Garre-Olmo, J., Turró-Garriga, O., Vilalta-Franch, J. and López-Pousa, S. (2010). Quality of life of patients with Alzheimer's disease: differential perceptions between spouse and adult child caregivers. Dementia and Geriatric Cognitive Disorders, 29, 97108. doi:10.1159/000272423.CrossRefGoogle ScholarPubMed
Crespo, M., Bernaldo de Quirós, M., Gómez, M. and Hornillos, C. (2012). Quality of life of nursing home residents with dementia: comparison of perspectives of residents, family and staff. The Gerontologist, 52, 5665. doi:10.1093/geront/gnr080.CrossRefGoogle ScholarPubMed
Edelman, P., Fulton, B. R., Kuhn, D. and Chang, C. H. (2005). A comparison of three methods of measuring dementia-specific quality of life: perspectives of residents, staff, and observers. The Gerontologist, 4, 2736. doi:10.1093/geront/45.suppl_1.27.CrossRefGoogle Scholar
Gage, H., Knibb, W., Evans, J., Williams, P., Rickman, N. and Bryan, K. (2009). Why are some care homes better than others? An empirical study of the factors associated with quality of care for older people in residential homes in Surrey, England. Health and Social Care in the Community, 17, 599609. doi:10.1111/j.1365-2524.2009.00861.x.CrossRefGoogle ScholarPubMed
González-Salvador, T.et al. (2000). Quality of life in dementia patients in long-term care. International Journal of Geriatric Psychiatry, 15, 181189. doi:10.1002/(SICI)1009-1166(200002)15:2<181::AID-GPS96>3.0.CO;2-I.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
Hoe, J., Hancock, G., Livingston, G. and Orrell, M. (2006). Quality of life in people with dementia in residential care homes. British Journal of Psychiatry, 188, 460464. doi:10.1192/bjp.bp.104.007658.CrossRefGoogle ScholarPubMed
Hoe, J., Katona, C., Orrell, M. and Livingston, G. (2007). Quality of life in dementia: care recipient and caregiver perceptions of quality of life in dementia: the LASER-AD study. International Journal of Geriatric Psychiatry, 22, 10311036. doi:10.1002/gps.1786.CrossRefGoogle ScholarPubMed
Hoe, J.et al. (2009). Changes in the quality of life of people with dementia living in care homes. Alzheimer Disease and Associated Disorders, 23, 285290. doi:10.1097/WAD.0b013e318194fc1e.CrossRefGoogle ScholarPubMed
León-Salas, B., Olazarán, J., Muñiz, R., González-Salvador, M. T. and Martínez-Martín, P. (2011). Caregivers’ estimation of patients’ quality of life (QoL) in Alzheimer's disease (AD): an approach using de ADRQL. Archives of Gerontology and Geriatrics, 53, 1318. doi:10.1016/j.archger.2010.05.021.CrossRefGoogle Scholar
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (1999). Quality of life in Alzheimer's disease: patient and caregiver reports. Journal of Mental Health and Aging, 5, 2132.Google Scholar
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (2002). Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine, 64, 510519.CrossRefGoogle ScholarPubMed
López-Mongil, R. and López-Trigo, J. A. (2007). Prevalencia de deterioro cognitivo y demencia en residencias españolas: estudio RESYDEM [prevalence of cognitive impairment and dementia in Spanish nursing homes: RESYDEM study]. Informaciones Psiquiátricas, 188, 97110.Google Scholar
Mahoney, F. I. and Barthel, D. W. (1965). Functional evaluation: the Barthel Index. Maryland Medical Journal, 14, 6165.Google ScholarPubMed
Maslach, C., Jackson, S. E. and Leiter, M. P. (1996). Maslach Burnout Inventory Manual, 3th edn. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Meliá, J. L. (1998). Cuestionario de Satisfacción Laboral S21/26 [Jon Satisfaction Questionnaire]. Available at: http://www.uv.es/meliajl/Research/Cuest_Satisf/S21_26.PDF; last accessed 15 September 2009.Google Scholar
Moyle, W. (2010). Is quality of life being compromised in people with dementia in long-term care? International Journal of Older People Nursing, 5, 245252. doi:10.1111/j.1748-3743.2010.00230.x.CrossRefGoogle ScholarPubMed
Moyle, W.et al. (2011). Factors influencing quality of life for people with dementia: a qualitative perspective. Aging and Mental Health, 15, 970977. doi:10.1080/13607863.2011.583620.CrossRefGoogle ScholarPubMed
Novella, J. L.et al. (2001). Agreement between patients’ and proxies’ reports of quality of life in Alzheimer's disease. Quality of Life Research, 10, 443452. doi:10.1023/A:1012522013817.CrossRefGoogle ScholarPubMed
Reisberg, B., Ferris, S. H., de Leon, M. J. and Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. The American Journal of Psychiatry, 139, 11361139.Google ScholarPubMed
Samus, Q. M.et al. (2005). The association of neuropsychiatric symptoms and environment with quality of life in assisted living residents with dementia. The Gerontologist, 45 (special issue I), 1926. doi:10.1093/geront/45.suppl_1.19.CrossRefGoogle ScholarPubMed
Sands, L. P., Ferreira, P., Stewart, A. L., Brod, M. and Yaffe, K. (2004). What explains differences between dementia patients’ and their caregivers’ ratings of patients’ quality of life? American Journal of Geriatric Psychiatry, 12, 272280. doi:10.1176/appi.ajgp.12.3.272.CrossRefGoogle ScholarPubMed
Sloane, P. D., Zimmerman, S. and Walsh, J. F. (2001). The physical environment. InZimmerman, S., Sloane, P. D. and Eckert, J. K. (eds.), Assisted Living (pp. 173197). Baltimore, MD: Johns Hopkins University Press.Google Scholar
Winzelberg, G. S., Williams, C. S., Preisser, J. S., Zimmerman, S. and Sloane, P. D. (2005). Factors associated with nursing assistant quality of life ratings for residents with dementia in long-term care facilities. The Gerontologist, 4 (special issue I), 106114. doi:10.1093/geront/45.suppl_1.106.CrossRefGoogle Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20, 646655. doi:10.1093/geront/20.6.649.CrossRefGoogle ScholarPubMed