The association between quality of care and quality of life in long-stay nursing home residents with preserved cognition

J Am Med Dir Assoc. 2014 Mar;15(3):220-225. doi: 10.1016/j.jamda.2013.10.012. Epub 2013 Dec 17.

Abstract

Objectives: To assess the overall quality of life of long-stay nursing home residents with preserved cognition, to examine whether the Centers for Medicare and Medicaid Service's Nursing Home Compare 5-star quality rating system reflects the overall quality of life of such residents, and to examine whether residents' demographics and clinical characteristics affect their quality of life.

Design/measurements: Quality of life was measured using the Participant Outcomes and Status Measures-Nursing Facility survey, which has 10 sections and 63 items. Total scores range from 20 (lowest possible quality of life) to 100 (highest).

Setting/participants: Long-stay nursing home residents with preserved cognition (n = 316) were interviewed.

Results: The average quality- of-life score was 71.4 (SD: 7.6; range: 45.1-93.0). Multilevel regression models revealed that quality of life was associated with physical impairment (parameter estimate = -0.728; P = .04) and depression (parameter estimate = -3.015; P = .01) but not Nursing Home Compare's overall star rating (parameter estimate = 0.683; P = .12) and not pain (parameter estimate = -0.705; P = .47).

Conclusion: The 5-star quality rating system did not reflect the quality of life of long-stay nursing home residents with preserved cognition. Notably, pain was not associated with quality of life, but physical impairment and depression were.

Keywords: Activity of daily living; cognition; nursing home; quality of health care; quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Centers for Medicare and Medicaid Services, U.S.
  • Cognition
  • Humans
  • Long-Term Care
  • Michigan
  • Middle Aged
  • Nursing Homes*
  • Qualitative Research
  • Quality Indicators, Health Care
  • Quality of Health Care*
  • Quality of Life*
  • Regression Analysis
  • Surveys and Questionnaires
  • United States
  • Urban Health Services