Improving quality of life in nursing homes

January 3, 2014

A person’s quality of life (QOL) is influenced by a number of factors. For nursing home residents, QOL is highly impacted by the amount of personal attention received from facility staff, according to new research from the School of Public Health.

Findings from the study indicate the average time nursing home residents spend with activity staff is only 20 minutes per day. Yet, despite this short amount of time, activity staff hours have a consistent positive impact on residents’ QOL. By augmenting quality of care initiatives with efforts designed around increasing social and mentally stimulating activities, nursing homes can dramatically increase QOL for residents.

The study, led by University of Minnesota professor Tetyana P. Shippee, Ph.D., in collaboration with Robert Kane, M.D., Carrie Henning-Smith, M.P.H., M.S.W., and Teresa Lewis, B.A. of the Minnesota Department of Human Services, appears today in the journal The Gerontologist.

To arrive at their results the researchers used data from 13,433 in-person interviews with nursing home residents, resident clinical data from the Minimum Data Set, and facility-level information from the Minnesota Department of Human Services to understand facility-level and resident-level influences on QOL. Minnesota is one of few states in the country to collect in-person interviews about resident QOL from residents in all nursing homes in the state.

“Although there is substantial research on quality of care in nursing homes, less is known about residents’ views on what contributes to their QOL,” said Shippee. “Research that evaluates care and physical needs also should take into account the social, psychological, environmental and functional aspects of residents’ lives.”

Shippee explained that because nursing homes are restricted environments and residents of nursing homes are frail, QOL takes on greater significance.

The latest study measured six QOL domains including: environment, personal attention, personal engagement, food enjoyment, negative mood, and positive mood. Across all domains, the number of activity staff hours was positively associated with QOL.

The study also showed that residents in larger nursing homes, for-profit (vs. non-profit) and facilities with higher percent of Medicaid residents reported lower QOL.

Resident characteristics also impacted QOL. Residents who are older, have function and cognition limitations, and mental health disorders are at higher risk of lower QOL. Nursing staff should be paying particular attention to residents with these at-risk characteristics. Even when accounting for various resident and facility characteristics, the effect of activity staff and social worker hours on resident QOL remained.

“Our findings indicate that care should go beyond residents’ physical needs to include social and goal-directed activities,” said Shippee. “Greater staff capacity may be vital not only in meeting physical needs, but also in providing a nurturing social environment in an otherwise potentially distressing time of life.”