Factors influencing the proxy-rated quality of life of residents with dementia in long-term care units

Abstract

Quality of life (QoL) is slowly becoming one of the most important outcomes in older persons with dementia. Up to two-thirds of residents in long-term care facilities have some type of dementia. Understanding the QoL of a person living with dementia in long-term care (LTC) will ensure that the care being provided is person-centered. The study aimed to measure the proxy-rated QoL of older persons with dementia living in dementia-friendly units in a long-term care facility in Malta as perceived by nurses taking care of them. A quantitative cross-sectional survey design was adopted. The proxy-rated QoL of the participants was measured using the QUALID scale. Moreover, the presence of behavioural and psychological symptoms of dementia (BPSD) of residents with dementia was measured using BEHAVE-AD scale. This was done through questionnaires administered as interviews with nurses who work with dementia residents. Additional data was gathered from the patients’ personal files such as their age, gender, mini-mental state examination score and Barthel Index score. This is the first local study that sought to measure the QoL of residents with dementia in LTC units. The mean QoL score of the participants was 22.14. Sociodemographic characteristics such as age and gender, were not found to be significantly associated with the QoL. A higher level of functional dependency and higher presence of BPSD were associated with a lower QoL. The participants’ cognitive abilities were found to be negatively associated with their QoL when analysed on their own. However, no significant association was found when they were analysed with other factors. The presence of BPSD and the functional dependency of the participants were the most important predictors of their QoL. Therefore, LTC facilities should focus more on improving and maintaining the functional status of persons with dementia as well as reducing the presence of BPSD, in order to maintain their QoL.