Quality of life in nursing homes and home settings equally high

The quality of life among people with dementia in a nursing home is just as high as for those still living at home. The mood of people with dementia appears most important for a good quality of life, more than physical well-being or cognitive abilities, for example. This and more was the result of doctoral research by Hanneke Beerens conducted at Maastricht University, with which she hopes to earn her doctoral degree on 29 April. “The Netherlands is the all-round champion when it comes to dementia care”, says the researcher, who also worked as a nurse in elderly care and performed her research at the Academic Collaborative Centre on Care for Older People in South Limburg.

There are two central studies in Hanneke Beerens's research. The first was conducted in eight European countries (the Netherlands, Germany, England, Estonia, Finland, France, Sweden and Spain) and surveyed people with dementia and their caregivers in nursing homes as well as people with family caregivers at home about their quality of life. The participants were also observed by researchers.

According to previous research, the quality of life for people with dementia is based on four pillars:

  • psychological well-being (the own subjective assessment of the quality of life)
  • behaviour (including physical health, cognitive functioning, social behaviour and dependence)
  • objective social environment (material status, social network)
  • experienced quality of life (the assessment of all aspects considered important for a person's own life)
  • Quality equally good in home settings and nursing home

This study included 1123 people with dementia who were still living at home but would probably soon be admitted to a nursing home, as well as 791 people with dementia who had been living in a nursing home for three months or less. Their scores for quality of life were almost the same; from a scientific point of view the differences are negligible. On average, people with dementia in Sweden, the Netherlands and England scored higher on quality of life than in the other countries.

Quality of care high in the Netherlands
In addition to quality of life, quality of care was also scored in the eight countries. This revealed that in an objective sense the Netherlands is the ‘champion in dementia care’. In the rest of the EU, for example, people with dementia living at home encounter measures that restrain their freedom 10% of the time, compared to only 3% of the time in the Netherlands. Also, whereas 7% of people in EU nursing homes develop pressure ulcers, only 4% of nursing home residents do in the Netherlands. "Of course, there are always incidents or concerns in the care for people with dementia that you need to take seriously, but the one-sided negative images you often see in the Netherlands about nursing home care does not seem to be supported by research," says Hanneke Beerens.

Positive impact of mood
The second study is based on the observation of the quality of life among 115 nursing home residents predominantly in the Dutch province of Limburg. This showed that a positive mood is associated with a higher quality of life (and vice versa that a negative mood is associated with a lower quality of life). A positive mood was found in particular among those involved in activities, preferably outdoors, and social interactions.

The PhD researcher argues for better equipping caregivers to learn what daily activities are most meaningful for each individual client. She also calls for more focus in healthcare education on psychosocial and elderly care.

Hanneke Beerens will be defending her dissertation ‘Adding life to years – Quality of life of people with dementia receiving long-term care’ on 29 April at 16.00.

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