Quality of Life in Institutional Care

  • Kai Saks
  • Ene-Margit Tiit
  • Seija Muurinen
  • Susanna Mukkila
  • Mona Frommelt
  • Margaret Hammond

It is generally accepted that most old people prefer to live independently in their own homes. However, institutional care in nursing or residential homes is often the only option available for frail and dependent people, who require higher levels of support. Moreover, social and demographic changes throughout Europe show a weakening of family and community networks, resulting in a reduction in informal support from family and friends to allow frail old people to remain at home.

Care institutions provide adapted and safe environments and provide a range of care, such as support in everyday activities and medical procedures. In addition to these instrumental issues, increasing attention has also been paid to the general quality of life (QoL) of clients through facilitating social participation, leisure activities and, supporting clients’ lifestyles, while trying to preserve individuals’ autonomy and control. At the same time however, the individual has to conform to the social roles and rules prevalent in the institution. Among older people, this process can lead to “induced dependency” whereby the person undergoes psychological changes, loss of personal competence and even physical deterioration.

Residents of care institutions commonly have serious limitations in their abilities to take care of themselves because of the illnesses or frailties of advanced age. These conditions and associated functional decline inevitably have an impact on QoL. As well as physical functioning, other factors such as psychological, social and emotional changes can have an impact on wellbeing and satisfaction with life.


Nursing Home Resident Environmental Domain Psychological Domain Description Rate Care Documentation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Boumans, N., Berkhou, A., & Landeweerd, A. (2005). Effects of resident-oriented care on quality of care, well-being and satisfaction with care. Scandinavian Journal of Caring Sciences, 19, 240–250.CrossRefPubMedGoogle Scholar
  2. Bowers, B. J., Lauring, C., & Jacobson, N. (2001). How nurses manage time and work in long-term care. Journal of Advanced Nursing, 33, 484–491.CrossRefPubMedGoogle Scholar
  3. Caris-Verhallen, W., Kerkstra, A., & Bensing, J. (1997). The role of communication in nursing care for elderly people: a review of the literature. Journal of Advanced Nursing, 25, 915–933.CrossRefPubMedGoogle Scholar
  4. Currie, V., Harvey, G., West, E., McKenna, H., & Keeney, S. (2005). Relationships between quality of care, staffing levels, skill mix and nurse autonomy: literature review. Journal of Advanced Nursing, 51, 73–82.CrossRefPubMedGoogle Scholar
  5. DePorter, C. H. (2005). Regulating food service in North Carolina’s long-term care facilities. North Carolina Medical Journal, 66, 4, 300–303.PubMedGoogle Scholar
  6. Donabedian, A. (1969). Some issues in evaluation the quality of nursing care. American Journal of Public Health, 59, 1833–36.CrossRefPubMedGoogle Scholar
  7. Faulk, L. E. (1988). Quality of life factors in board and care homes for the elderly: A hierarchical model. Adult Foster Care Journal, 2, 100–117.Google Scholar
  8. Gilloran, A., McGlew, T., McKee, K., Robertson, A., & Wight, D. (1993). Measuring the quality of care in psychogeriatric wards. Journal of Advanced Nursing, 18, 269–275.CrossRefPubMedGoogle Scholar
  9. Hughes, B. (1990). Quality of life. In S. M. Peace (Ed.), Researching social gerontology: concepts, methods and Issues (pp. 46–58). London: SAGE.Google Scholar
  10. Kane, R. A., Kling, K. C., Bershadsky, B., Kane, R. L., Giles, K., Degenholtz, H. B., Liu, J., & Cutler, L. J. (2003). Quality of life measures for nursing home residents. Journals of Gerontology Series A-Biological Sciences & Medical Sciences, 58, 3, 240–248.Google Scholar
  11. Kane, R. L., Rockwood, T., Hyer, K., Desjardins, K., Brassard, A., Gessert, C., & Kane, R. (2005). Rating the importance of nursing home residents’ quality of life. Journal of American Geriatric Society, 53, 2076–2082.CrossRefGoogle Scholar
  12. Lawton, M. P. (1975). The Philadelphia Geriatric Centre Morale Scale: a revision. Journal of Gerontology, 30, 85–89.PubMedGoogle Scholar
  13. Lawton, M. P. (1991). A multidimensional view of quality of life in frail elders. In J. E. Birren, J. E. Lubben, J. C. Rowe, & D. E. Deutchman (Eds.), The concept and measurement of quality of life in frail elders (pp. 3–27). San Diego: Academic Press.Google Scholar
  14. Muurinen, S., Nuutinen, H.-L., & Peiponen, A. (2002). Omaisten mielipiteitä vanhusten hoidosta Helsingin ympärivuorokautisen hoidon yksiköissä 2002. (Relatives perspectives in long-term care in the City of Helsinki 2002.) Tutkimuksia 2002:2. Helsingin kaupungin sosiaalivirasto, Helsinki.Google Scholar
  15. Muurinen, S., Raatikainen, R., Silander, E., Tolvanen, A., Turtainen, K., Peiponen, A., & Valvanne, J. (2001). Asukkaiden tyytyväisyys hoitoon Helsingin vanhustenhoidon yksiköissä 2001. (Client satisfaction in long-term care in the City of Helsinki in 2001.) Tutkimuksia 2001:2. Helsinki: Helsingin kaupungin sosiaalivirasto.Google Scholar
  16. Muurinen, S., Valvanne, J., & Mukkila, S. (2004). Performance indicators for the long term care of older people. Indicators for professional quality. http://www.carekeys.net.
  17. Nagatomo, I. Kita, K., Takigawa, M., Nomaguchi, M., & Sameshima, K. (1997). A study of the quality of life in elderly people using psychological testing. International Journal of Geriatric Psychiatry, 12(6), 599–608.CrossRefPubMedGoogle Scholar
  18. Øvretveit, J. (1998). Evaluating health interventions. An introduction to evaluation of health treatments, services, policies and organizational interventions. Buckingham: Open University Press.Google Scholar
  19. Raatikainen, R. (1995). Hoitotyön kehitysvaiheiden luokitus. Sairaanhoitaja, 68(9), 31–34. (The model of phases in patient care).Google Scholar
  20. Rantz, M., Jensóttir, A. B., Hjaltadóttir, I., Gudmundsdóttir, H., Sigurveig Gudjónsdóttir, J., Brunton, B., & Rook, M. (2002). International field test results of the Observable Indicators of Nursing Home Care Quality instrument. International Nursing Review, 49, 234–242.CrossRefPubMedGoogle Scholar
  21. Schroll, M., Jonsson, P. V., Mor, V., Berg, K., & Sherwood, S. (1997). An international study of social engagement among nursing home residents, Age & Aging, 26, (Suppl. 2), 55–59.Google Scholar
  22. Subasi, F., & Hayran, O. (2005). Evaluation of life satisfaction index of the elderly people living in nursing homes. Archives of Gerontology & Geriatrics, 41(1), 23–29.CrossRefGoogle Scholar
  23. Veenhoven, R. (2000). The four qualities of Life. Ordering concept and measures of the good life. Journal of Happiness Studies, 1, 1–39.CrossRefGoogle Scholar
  24. Voutilainen, P., Isola, A., & Muurinen, S. (2004). Nursing documentation in nursing homes—state-of-the-art and implications for quality improvement. Scandinavian Journal of Caring Sciences, 18, 72–81.CrossRefPubMedGoogle Scholar
  25. Weman, K., Kihlgren, M., & Fagerberg, I. (2004). Older people living in nursing homes or other community care facilities: Registered Nurses’ views of their working situation and co-operation with family members. Journal of Clinical Nursing, 3, 617–626.CrossRefGoogle Scholar
  26. World Health Organization (WHO) (1995). WHOQOL-100. Facet Definitions and Questions (WHO Division of Mental Health and Prevention of Substance Abuse, Geneva, Switzerland).Google Scholar
  27. WHOQOL group (1998) Development of the World Health Organization WHOQOL-BFER quality of life assessment. Psychological Medicine, 28, 551–558.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Kai Saks
  • Ene-Margit Tiit
  • Seija Muurinen
  • Susanna Mukkila
  • Mona Frommelt
  • Margaret Hammond

There are no affiliations available

Personalised recommendations