Quality of Life – What Really Matters

Helen is 93 years old and has lived at an assisted living community since she was 90. She has a one-room suite with her own bathroom. It is decorated with her favorite things and whatever furniture that would fit. She has one window that overlooks some trees and a strategically placed bird feeder.

Tom is 84 years old and is living in a long-term care facility as the result of fall and several other medical issues, requiring 24-hour care and support. Due to his finances, he shares a room. He does not mind having a roommate, even though they do not have much in common or converse often. His side of the room has a bed, dresser, small closet, nightstand and a shared bathroom. 

In the healthcare arena, we often hear the phrase “quality of life.” Quality of life is viewed as multidimensional, encompassing emotional, physical, material and social well-being. Quality of life varies from person to person and changes throughout a lifetime. The term or concept is used often with older adults.  

What makes the difference in Helen and Tom’s quality of life? If we listen, really listen, they share the secrets to what makes a good day, regardless of health, finances or their current life circumstances — including long periods of isolation. Whether in a long-term care facility or a brand-new assisted living facility, their answers may surprise you. I rarely hear someone say, “My life would be better today if only: I were  younger, I did not have this disease or condition, my room were bigger/brighter/had more windows, or even if my spouse were alive or family would visit more often.”

What makes the difference in the quality of their days are the interactions with the staff — meaning caregivers, aides, care helpers or whatever name a facility uses for the individuals providing the direct care services and support.

Helen and Tom, like so many older adults residing in various senior communities, often express the same five key factors that, if observed by staff members, would truly make a difference in their day:

  1. Introduce yourself, looking the person in the eyes. Re-introduce yourself every time. Living in a facility with 24-hour care, there are many different faces coming and going each day; add in face masks and often older adults have no idea who may be trying to assist them. It takes a long time to get to know someone, recognize their voice, their face and finally, their name. Most staff are in and out of an older adult’s room or apartment within a matter of minutes. Often, staff will wear name tags, but unless the tag is showing directly in front the older adult with the staff person holding still, and the font size is readable, a name tag is not the answer. Example: Helen was looking out her window when she heard a slight knock on her apartment door and then a voice saying something, but she could not make it out. By the time she turned her wheelchair around to look at the door, it was closing. Helen had no idea who or why someone was just in her room. Later that evening, Helen saw mail on her bed. She had no idea how or when it arrived. The staff caregiver could have turned this quick task into a positive, appreciative interaction that built Helen’s trust, and over time, a sense of belonging. When the caregiver entered the room, she could have waited a moment for Helen to turn around and see her. Then the caregiver would have had the opportunity to look at Helen and say, “Hello Helen, it’s Jennifer. I am stopping by to bring you your mail. Would you like me to give it to you or should I leave it on your bed?” 
  2. Slow down. We live in a fast-paced world where we often multi-task. Older adults dealing with co-morbidities from hearing loss, mobility issues and a range of diseases and conditions move and respond at a much slower pace. Rattling off five commands in a row can be overwhelming. “Dolores, dinner is ready, do you want chicken or fish? Go wash your hands, don’t forget your walker and it is your laundry night.” 
  1. It’s not what you say but how you say it. Tone of voice and the way something is phrased matters; asking versus telling. For example: “Helen, today is Tuesday and you are scheduled for a shower, how does that sound to you?  Instead of, “Come on, you have to take a shower now; it’s on the schedule.” 
  1. Let the individual know what you are doing. The staff caregiver should always tell someone what they are going to do before they do it. Never put hands on someone without letting them know. Example: “John, before they bring your dinner, I am going to help get you ready. I am going to move your walker in front of you, and help you get to the edge of your chair so you can get ready to stand up.” 
  1. Slow Down! Slow Down. Slow Down. Trying to rush older adults to get to the shower, to an appointment, or to dinner can be difficult and counterproductive on the older adult. Example: pushing an older adult quickly in their wheelchair, not realizing how terrifying and out of control the older person feels. We need to respect the pace at which each person functions best and adjust care and supports accordingly. 

What seems like simple common sense often is not so common or simple.  Whether the issue is staff shortages, a need for increased training and/or understanding how fast we move through our day, we need to listen to Helen, Tom and all of our older adults. If we and senior communities care about the quality of life for older adults, we need to focus on the quality of each day and what makes a quality day. 

This post originally appeared here.

About the Author: Jennifer Beach, LSW, MA, C-SWCM established Advocate for Elders in Rocky River in 2010. Jennifer has 25 years of experience in working with and advocating for older adults and their families. Jennifer is a licensed, insured Social Worker and an Advanced Aging Life Care® Professional. She has served as the Midwest Chapter President of the Aging Life Care Association and additionally served 7 years on the Board of Directors. In 2018, Jennifer was honored as the recipient of the ALCA Midwest Chapter Outstanding Member of the Year Award. Learn more at advocate4elders.com.

Jennifer is also a monthly contributor and author of Caregiver Corner for Northeast Ohio Boomer and Beyond blog and magazine.