Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-24T02:46:39.316Z Has data issue: false hasContentIssue false
  • English
  • Français

Quality of life in people with cognitive impairment: nursing homes versus home care

Published online by Cambridge University Press:  11 December 2014

Azlina Wati Nikmat ,
S. Hassan Al-Mashoor  and
Nurul Azreen Hashim
Azlina Wati Nikmat*
Affiliation:
Psychological and Behavioral Medicine Unit, Faculty of Medicine, Universiti Teknologi MARA Malaysia, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia
S. Hassan Al-Mashoor
Affiliation:
Psychological and Behavioral Medicine Unit, Faculty of Medicine, Universiti Teknologi MARA Malaysia, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia
Nurul Azreen Hashim
Affiliation:
Psychological and Behavioral Medicine Unit, Faculty of Medicine, Universiti Teknologi MARA Malaysia, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia
*
Correspondence should be addressed to: Azlina Wati Nikmat, Senior Lecturer, Psychological and Behavioral Medicine Unit, Faculty of Medicine, Universiti Teknologi MARA Malaysia, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia. Phone: +603 61265000; Fax: +603 61265224. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The evaluation of quality of life (QoL) among older adults has become increasingly important, and living arrangements play a pivotal role in determining the QoL of people with cognitive impairment (PWCI). Although informal care (home-based) is favored, transition to formal care (residential care) often becomes necessary, especially in the later stages of cognitive impairment. The primary objective was to compare the QoL of PWCI in the community and nursing homes. Additionally, factors differentiate the QoL of PWCI in these two settings were identified.

Methods:

This is a quasi-experimental study design involving 219 older adults with cognitive impairment, aged 60–89 years old from both nursing home and home care. Participants completed the EUROPE Health Interview Survey-QoL (WHO-8), the Short Mini-Mental State Examination (SMMSE), the Barthel Index (BI), the Geriatric Depression Scale (GDS-15), and the Friendship Scale (FS).

Results:

There were significant differences in QoL, depression, social connectedness (p < 0.01) and cognitive functions (p = 0.01) between home care recipients and nursing home participants. No significant differences were observed with regards to health condition, co morbidities and physical functions between study cohorts.

Conclusions:

Older adults with cognitive impairment living at home experienced higher QoL, had better cognitive function, were less depressed and reported higher social connectedness compared to those living in institutional care. Therefore, support should be provided in enabling home care and empowering caregivers to provide better care for PWCI.

Keywords

agingAlzheimer’s diseasecommunityinstitutional care
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 5 , May 2015 , pp. 815 - 824
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Access Economics (2006). Dementia in the Asia Pacific Region: The Epidemic is here. Melbourne: Access Economics for Asia Pacific Members of Alzheimer's Disease International.Google Scholar
Arlt, S., Hornung, J., Eichenlaub, M., Jahn, H., Bullinger, M. and Petersen, C. (2008). The patient with dementia, the caregiver and the doctor: cognition, depression and quality of life from three perspectives. International Journal of Geriatric Psychiatry, 23, 604–610.CrossRefGoogle ScholarPubMed
Arokiasamy, J. T. (1999). Malaysia's ageing population: challenges in the new millennium. Medical Journal of Malaysia, 54, 429–432.Google ScholarPubMed
Bostrom, F., Jonsson, L., Minthon, L. and Londos, E. (2007). Patients with dementia with lewy bodies have more impaired quality of life than patients with Alzheimer disease. Alzheimer Disease and Associated Disorders, 21, 150–154.Google Scholar
Braekhus, A., Laake, K. and Engedal, K. (1992). The mini-mental state examination: identifying the most efficient variables for detecting cognitive impairment in the elderly. Journal of the American Geriatrics Society, 40, 1139–1145.Google Scholar
Brod, M., Stewart, A. L., Sands, L. and Walton, P. (1999). Conceptualization and measurement of quality of life in dementia: the dementia quality of life instrument (DQoL). Gerontologist, 39, 25–35.Google Scholar
Colbourn, T., Masache, G. and Skordis-Worrall, J. (2012). Development, reliability and validity of the chichewa WHOQOL-BREF in adults in Lilongwe, Malawi. BMC Research Notes, 5, 346–356.Google Scholar
Crespo, M., Bernaldo De Quiros, M., Gomez, M. M. and Hornillos, C. (2012). Quality of life of nursing home residents with dementia: a comparison of perspectives of residents, family, and staff. Gerontologist, 52, 56–65.Google Scholar
Folstein, M., Folstein, S. and Mchugh, P. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Hamid, T. A., Krishnaswamy, S., Abdullah, S. S. and Momtaz, Y. A. (2011). Sociodemographic risk factors and correlates of dementia in older Malaysians. Dementia and Geriatric Cognitive Disorders, 30, 533–539.CrossRefGoogle Scholar
Hawthorne, G. (2005). Measuring Social Isolation Among Older Australians. XVIII World Congress of Gerontology: Active Aging in the XXIst Century – Participation, Health and Security, 2005 Rio de Janeiro, Brazil.Google Scholar
Hawthorne, G. (2006). Measuring social isolation in older adults: development and initial validation of the friendship scale. Social Indicators Research, 77, 521–548.Google Scholar
Hawton, A. et al. (2010). The impact of social isolation on the health status and health-related quality of life of older people. Quality of Life Research, 20, 57–67.Google Scholar
Herrman, H., Hawthorne, G. and Thomas, R. (2002). Quality of life assessment in people living with psychosis. Social Psychiatry and Psychiatric Epidemiology, 37, 510–518.Google Scholar
Hoe, J., Hancock, G., Livingston, G. and Orrell, M. (2006). Quality of life of people with dementia in residential care homes. British Journal of Psychiatry, 188, 460–464.CrossRefGoogle ScholarPubMed
Huang, H. L., Chang, M. Y., Tang, J. S., Chiu, Y. C. and Weng, L. C. (2009). Determinants of the discrepancy in patient- and caregiver-rated quality of life for persons with dementia. Journal of Clinical Nursing, 18, 3107–3118.Google Scholar
Justine, M., Hamid, T. A., Kamalden, T. F. T. and Ahmad, Z. (2010). A multicomponent exercise program's effects on health-related quality of life of institutionalized elderly. Topics in Geriatric Rehabilitation, 26, 70–79.Google Scholar
Leon-Salas, B. (2013). Quality of life (QoL) in community-dwelling and institutionalized Alzheirmer's disease (AD) patients. Archives of Gerontology and Geriatrics, 57, 257–262. doi: http://dx.doi.org/10.1016/j.archger.2013.04.013.CrossRefGoogle Scholar
Logsdon, R. G. and Albert, S. M. (1999). Assessing quality of life in Alzheimer's disease: conceptual and methodological issues. Journal of Mental Health and Aging, 5, 3–6.Google Scholar
Low, G. and Molzahn, A. E. (2007). Predictors of quality of life in old age: a cross-validation study. Research in Nursing and Health, 30, 141–150.Google Scholar
Lucas-Carrasco, R. K. M. J. (2011). Suitability of the WHOQOL-BREF and WHOQOL-OLD for Spanish older adults. Aging & Mental Health, 15, 595–604.Google Scholar
Luppa, M., Luck, T., Weyerer, S., Konig, H. H., Brahler, E. and Riedel-Heller, S. G. (2010). Prediction of institutionalization in the elderly. A systematic review. Age and Ageing, 39, 31–38.Google Scholar
Lynn, P., Beerten, R., Laiho, J. and Martin, J. (2001). Recommended Standard Final Outcome Categories and Standard Definitions of Response Rate for Social Surveys. Working Papers. Colchester: Institute for Social and Economic Research, University of Essex.Google Scholar
Mahoney, F. and Barthel, D. (1965). Functional evaluation: the Barthel index. Maryland State Medical Journal, 14, 61–65.Google ScholarPubMed
Missotten, P. et al. (2008). Relationship between quality of life and cognitive decline in dementia. Dementia and Geriatric Cognitive Disorders, 25, 564–572.Google Scholar
Missotten, P. et al. (2009). Impact of place of residence on relationship between quality of life and cognitive decline in dementia. Alzheimer Disease and Associated Disorders, 23, 395–400.CrossRefGoogle ScholarPubMed
Mougias, A. A., Politis, A., Lyketsos, C. G. and Mavreas, V. G. (2011). Quality of life in dementia patients in Athens, Greece: predictive factors and the role of caregiver-related factors. International Psychogeriatrics, 23, 395–403.Google Scholar
Paskulin, L. M. and Molzahn, A. (2007). Quality of life of older adults in Canada and Brazil. Western Journal of Nursing Research, 29, 10–26; discussion 27–35.Google Scholar
Power, M. (2003). Development of a common instrument for quality of life. In Nosikov, A. and Gudex, C. (eds.), EUROHIS: Developing Common Instruments for Health Surveys (pp. 145–163). Amsterdam: IOS Press.Google Scholar
Prieto-Flores, M. E., Forjaz, M. J., Fernandez-Mayoralas, G., Rojo-Perez, F. and Martinez-Martin, P. (2011). Factors associated with loneliness of noninstitutionalized and institutionalized older adults. Journal of Aging and Health, 23, 177–194.Google Scholar
Rashid, A., Ong, E. K. and Yi Wong, E. S. (2012). The attitude towards ageing among residents of an elderly care institution in Penang Malaysia. International Journal of Collaborative Research on Internal Medicine & Public Health (IJCRIMPH), 4, 1069–1083.Google Scholar
Sansoni, J. et al. (2007). Final Report: Dementia Outcomes Measurement Suite Project. Wollongong: Centre for Health Service Development, University of Wollongong for the Australian Commonwealth Department of Health and Ageing.Google Scholar
Sazlina, S. G., Zaiton, A., Nor Afiah, M. Z. and Hayati, K. S. (2012). Predictors of health related quality of life in older people with non-communicable diseases attending three primary care clinics in Malaysia. The Journal of Nutrition, Health & Aging, 16, 498–502.Google Scholar
Schmidt, S., Muhlan, H. and Power, M. (2006). The EUROHIS-QOL 8-item index: psychometric results of a cross-cultural field study. European Journal of Public Health, 16, 420–428.Google Scholar
Selwood, A., Thorgrimsen, L. and Orrell, M. (2005). Quality of life in dementia–a one-year follow-up study. International Journal of Geriatric Psychiatry, 20, 232–237.Google Scholar
te Boekhorst, S., Depla, M. F., De Lange, J., Pot, A. M. and Eefsting, J. A. (2009). The effects of group living homes on older people with dementia: a comparison with traditional nursing home care. International Journal of Geriatric Psychiatry, 24, 970–978.Google Scholar
Thomopoulou, I., Thomopoulou, D. and Koutsouki, D. (2010). The differences at quality of life and loneliness between elderly people. Biology of Exercise, 6, 13–28.Google Scholar
Wetzels, R. B., Zuidema, S. U., De Jonghe, J. F., Verhey, F. R. and Koopmans, R. T. (2010). Determinants of quality of life in nursing home residents with dementia. Dementia and Geriatric Cognitive Disorders, 29, 189–197.CrossRefGoogle ScholarPubMed
Wolak, A. et al. (2009). Transcultural adaptation and psychometric validation of a French-language version of the QoL-AD. Aging and Mental Health, 13, 593–600.Google Scholar
Yesavage, J. A. et al. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.Google Scholar