Care-related quality of life in old age : the concepts, models and empirical findings

It’s a core issue at the heart of elder care: while best-practice data exist for long-term care, quality of life as a concept, measure and standard for care outcomes remains elusive. The result of an ambitious European research initiative, the Care Keys Project addresses quality of life issues among frail, care-dependent seniors, taking their social as well as health needs into account. Care-Related Quality of Life in Old Age explains the theory behind Care Keys, its methodology, empirical findings, and practical considerations in promoting effective, efficient elder care aimed at social and emotional well-being and including disabled and cognitively impaired patients. This important book: * Brings together gerontological knowledge from medical, psychology, nursing, sociology, economics, and health care systems perspectives. * Introduces an integrated theory of care-related quality of life that emphasizes social, emotional and mental aspects as well as physical longevity. * Presents a practice oriented framework for quality management of long-term care toward improving elders’ quality of life. * Examines quality of life in home and long-term care settings across the five European member countries of Care Keys. * Describes the Care Keys Toolkit, featuring innovative measures for monitoring and evaluating care and troubleshooting for problem areas. For those charged with improvements at any level of this vital area—administrative, policy, research, professional, or student—this volume will bring new insights and stimulation for potential answers on the complex challenges of elder health care. The ageing of populations across the world poses a crucial challenge for the twenty-first century. Society faces three major changes: firstly, increasing numbers of active older people demanding new social structures and oppor- nities; secondly, increasing numbers of frail or disabled older people requiring new interventions and improved health and social care with resulting economic consequences; and finally complex economic, technological, organisational and social challenges involved in the ageing of society. If society wants to benefit from these changes, innovative social, organisational and technological responses are needed. This book presents the findings of the Care Keys project—“Keys for Quality Performance Management of the Care of Older Persons in Europe”—and is an example of how research can respond to the challenges outlined above. Care Keys was the fruit of European Union research funding, made possible under the Quality of Life and Management of Living Resources specific programme 1 (1998–2002) under the EC's Fifth Framework Programme for Research, Te- nological Development and Demonstration. The activity promoting such research was Key Action 6 on the “Ageing Population and their Disabilities”. Cover ......Page 1 Foreword......Page 6 Preface......Page 8 Contents......Page 12 1 The General Framework and Methods of the Care Keys Research......Page 14 2 Instrumentation of the Care Keys Research......Page 30 3 Care Keys Data and Statistical Methods......Page 56 4 The Concept of Care-Related Quality of Life......Page 73 5 The Concept of Quality of Long-Term Care......Page 110 6 Quality Management in Long-Term Care......Page 133 7 Subjective Quality of Life of Care-Dependent Older People in Five European Union Countries......Page 159 8 Quality of Life of Older Homecare Clients......Page 174 9 Quality of Life in Institutional Care......Page 202 10 Quality of Life and Dementia......Page 223 11 The Target Efficiency of Care—Models and Analyses......Page 240 12 Quality Management and the Care Keys Quality Matrix......Page 261 13 The Care Keys Toolkit......Page 287 14 Care-Related Quality of Life - An Overview......Page 305 Subject Index......Page 331 Cover 1 Foreword 6 Preface 8 Contents 12 PART I: RESEARCH FRAMEWORK 14 1 The General Framework and Methods of the Care Keys Research 14 2 Instrumentation of the Care Keys Research 30 3 Care Keys Data and Statistical Methods 56 PART II: THEORETICAL RESULTS 73 4 The Concept of Care-Related Quality of Life 73 5 The Concept of Quality of Long-Term Care 110 6 Quality Management in Long-Term Care 133 PART III: EMPIRICAL RESULTS 159 7 Subjective Quality of Life of Care-Dependent Older People in Five European Union Countries 159 8 Quality of Life of Older Homecare Clients 174 9 Quality of Life in Institutional Care 202 10 Quality of Life and Dementia 223 11 The Target Efficiency of Care—Models and Analyses 240 12 Quality Management and the Care Keys Quality Matrix 261 13 The Care Keys Toolkit 287 PART IV: SUMMARY 305 14 Care-Related Quality of Life - An Overview 305 Subject Index 331 It’s a core issue at the heart of elder care: while best-practice data exist for long-term care, quality of life as a concept, measure and standard for care outcomes remains elusive. The result of an ambitious European research initiative, the Care Keys Project addresses quality of life issues among frail, care-dependent seniors, taking their social as well as health needs into account. This resulting volume explains the theory behind Care Keys, its methodology, empirical findings, and practical considerations in promoting effective, efficient elder care aimed at social and emotional well-being and including disabled and cognitively impaired patients. Examines the relationship between quality of care and quality of life of frail older persons who depend on external support and care. This book addresses this issue by developing a concept of "care-related quality of life."