Quality of Life with Change and Deterioration
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Tips for Nurses:
Quality of Life with Change and Deterioration

What it is: Quality of Life (QoL) is a person’s perception of their life in the context of their health, culture, and values and in relation to their goals, hopes, fears, values, and beliefs. So, QoL will mean different things to different people. It often includes:

  • feeling valued and respected
  • being comfortable and pain free
  • being able to socialise or spend time with loved ones
  • having as much independence as possible
  • not feeling like a burden
  • feeling emotionally well and supported.

Why it matters: QoL is central to palliative care. Across the course of life-limiting illness, support to live well while adapting to functional decline is about QoL.

Standards 1 and 4 of the Aged Care Quality Standards also emphasise QoL.

What I need to know: To assess QoL, you need to know what issues are of most concern to the person at the time. Where possible, the older person should rate their own experiences. Family and health professionals may not always rate these the same.

Older people can experience deterioration in QoL as their disease progresses. Often this reflects changes in their ability to complete daily activities or to socialise and form relationships with others. Changes in QoL may be slow with diseases like dementia that progress slowly (over a long period).

Others may not register a change in QoL. Their goals and expectations may adapt to what is currently possible.

Actions

 


Regularly ask what is currently important to the older person and their family.

Use ongoing assessment with a validated tool for QoL.

Engage with the older person to set individual goals and support them with activities that are meaningful to them.

Provide families with information about changes.

Help the older person to stay connected with family and friends.

If language is a barrier try to match them with staff who speak their language.

Assist them to maintain their spiritual perspectives and spiritual connections.

Encourage them to remain active with tasks that they can manage. Adapt personal interests and activities as functional abilities change.

If tasks become more difficult, help rather than doing it for them.

 

Tools

Tools that may be useful include:

ICEpop CAPability Index for Older people (ICECAP-O) measures five dimensions (attachment, security, role, enjoyment, and control)

Quality of Life - Aged Care Consumers (QOL-ACC) instrument

 

My reflections:

 

What tools are used in my organisation to measure QoL?

 

How often do I re-assess what is important to the people I care for?

See related palliAGED Practice Tip Sheets:

People with Specific Needs

Person-Centred Care

Recognising Deterioration


 

For references and the latest version of all the Tip Sheets visit www.palliaged.com.au/PracticeTipSheets

 

CareSearch is funded by the Australian Government Department of Health and Aged Care.
Updated July 2022

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