Quality of Life in Institutional Care

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.