Quality of life in nursing home residents with advanced dementia
- PMID: 21054329
- PMCID: PMC3057956
- DOI: 10.1111/j.1532-5415.2010.03170.x
Quality of life in nursing home residents with advanced dementia
Abstract
Objectives: To examine quality of life (QOL) in nursing home (NH) residents with advanced dementia and identify correlates of QOL near the end of life.
Design: Cross-sectional data derived from NH records, interviews with residents' surrogate decision-makers, QOL ratings by NH caregivers, and assessment of residents' cognitive function.
Setting: Three NHs in Maryland.
Participants: A cohort of NH residents with dementia (n=119) who were receiving hospice or palliative care or met hospice criteria for dementia and their surrogates.
Measurements: QOL based on the proxy-rated Alzheimer' Disease-Related Quality of Life (ADRQL) scale administered to NH staff and validated against a single-item surrogate-rated measure of QOL, the Severe Impairment Rating Scale, to measure cognitive function and dichotomous indicators of neuropsychiatric symptoms (behavior problems, mood disorders, psychosis, delusions).
Results: Total ADRQL scores, ranging from 12.4 to 95.1 out of 100, were normally distributed and positively correlated (P<.001) with surrogate-rated QOL. Multiple regression analysis of ADRQL scores showed that residents with higher cognitive function (P<.001, 95% confidence interval (CI)=0.97-1.65) and those receiving pain medication (P=.006, 95% CI=3.30-19.59) had higher QOL, whereas residents with behavior problems (P=.01, 95% CI=-11.60 to -1.30) had lower QOL.
Conclusion: The ADRQL is a valid indicator of QOL in NH residents with advanced dementia. QOL in this population may be improved near the end of life using appropriate assessment and treatment of pain and effective management of behavior problems.
© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.
Conflict of interest statement
The following is a disclosure statement for Peter Rabins that is required by the Johns Hopkins University: “Under an agreement between DEMeasure and Dr. Rabins, Dr. Rabins is entitled to a share of income received by DEMeasure from sales of the ADRQL questionnaire and scale used in the study described in this article. Dr. Rabins has an ownership interest in DEMeasure. The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict of interest policies.” In addition, Dr. Rabins has provided expert testimony for Janssen Pharmaceutica and received grant support from the Jewish Community Federation of Baltimore.
The following is a disclosure statement for Betty Black that is required by the Johns Hopkins University: “Under an agreement between DEMeasure and Dr. Black, Dr. Black is entitled to a share of income received by DEMeasure from sales of the ADRQL questionnaire and scale used in the study described in this article. Dr. Black has an ownership interest in DEMeasure. The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict of interest policies.” In addition, Dr. Black has received grant support from the Jewish Community Federation of Baltimore.
Similar articles
-
Quality of Life with Late-Stage Dementia: Exploring Opportunities to Intervene.J Am Geriatr Soc. 2019 Jun;67(6):1189-1196. doi: 10.1111/jgs.15794. Epub 2019 Feb 25. J Am Geriatr Soc. 2019. PMID: 30801671 Free PMC article.
-
Pain, Neuropsychiatric Symptoms, and Quality of Life of Nursing Home Residents With Advanced Dementia in The Netherlands: A Cross-sectional Study.Alzheimer Dis Assoc Disord. 2017 Oct-Dec;31(4):315-321. doi: 10.1097/WAD.0000000000000197. Alzheimer Dis Assoc Disord. 2017. PMID: 28486239
-
A follow-up study of change in quality of life among persons with dementia residing in a long-term care facility.Int J Geriatr Psychiatry. 2003 Apr;18(4):275-81. doi: 10.1002/gps.796. Int J Geriatr Psychiatry. 2003. PMID: 12673600
-
Proxy rated quality of life of care home residents with dementia: a systematic review.Int Psychogeriatr. 2017 Apr;29(4):569-581. doi: 10.1017/S1041610216002167. Epub 2017 Jan 16. Int Psychogeriatr. 2017. PMID: 28088926 Free PMC article. Review.
-
Algorithm-based pain management for people with dementia in nursing homes.Cochrane Database Syst Rev. 2022 Apr 1;4(4):CD013339. doi: 10.1002/14651858.CD013339.pub2. Cochrane Database Syst Rev. 2022. PMID: 35363380 Free PMC article. Review.
Cited by
-
Factors influencing health-related quality of life among long-term care residents experiencing pain: a systematic review protocol.Syst Rev. 2024 Feb 1;13(1):49. doi: 10.1186/s13643-024-02459-7. Syst Rev. 2024. PMID: 38303055 Free PMC article.
-
Person-centred care in nursing homes during the COVID-19 pandemic: a cross sectional study based on nursing staff and first-line managers' self-reported outcomes.BMC Nurs. 2023 Aug 21;22(1):276. doi: 10.1186/s12912-023-01437-z. BMC Nurs. 2023. PMID: 37605177 Free PMC article.
-
Bereaved Family Members' Perceived Care at the End of Life for Patients with Noncancerous Respiratory Diseases.Palliat Med Rep. 2021 Oct 6;2(1):265-271. doi: 10.1089/pmr.2021.0034. eCollection 2021. Palliat Med Rep. 2021. PMID: 34927152 Free PMC article.
-
Multiple imputation to quantify misclassification in observational studies of the cognitively impaired: an application for pain assessment in nursing home residents.BMC Med Res Methodol. 2021 Jun 26;21(1):132. doi: 10.1186/s12874-021-01327-5. BMC Med Res Methodol. 2021. PMID: 34174838 Free PMC article.
-
Impact of the Severity of Alzheimer's Disease on the Quality of Life, Activities of Daily Living, and Caregiving Costs for Institutionalized Patients on Anti-Alzheimer Medications in Japan.J Alzheimers Dis. 2021;81(1):367-374. doi: 10.3233/JAD-201514. J Alzheimers Dis. 2021. PMID: 33780368 Free PMC article.
References
-
- Patrick DL, Erickson P. Concepts of health-related quality of life. In: Patrick DL, Erickson P, editors. Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation. New York: Oxford University Press; 1993. pp. 76–112.
-
- Whitehouse PJ, Rabins PV. Quality of life and dementia. Alzheimer Dis Assoc Disord. 1992;6:135–137. - PubMed
-
- Kane RA. Definition, measurement, and correlates of quality of life in nursing homes: Toward a reasonable practice, research, and policy agenda. Gerontologist. 2003;43(Special Issue):28–36. - PubMed
-
- Rabins PV, Kasper JD, Kleinman L, et al. Concepts and methods in the development of the ADRQL: An instrument for assessing health-related quality of life in persons with Alzheimer disease. J Ment Health Aging. 1999;5:33–48.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous