Quality of care, quality of life and the relationship between them in long-term care institutions for the elderly

A stratified randomly selected sample of 28 of all elderly long-term care institutions in the Southampton district was studied including private and local authority residential homes, private nursing homes and NHS geriatric and psychogeriatric wards. The manager was interviewed with a 57-item quality of care questionnaire modified from the methodology of Willcocks et al. (1987) covering aspects of regime and environment. To assess quality of life, 10% of residents were randomly selected for a series of structured quality of life interviews and Barthel Index determination. A life-history approach was used to build rapport and increase the authenticity of resident responses. Systematic significant differences in quality of care and quality of life were found between sectors. The correlation coefficients between quality of care and morale and between quality of care and dependency were significant (r = 0.526, p < 0.01; r = 0.508, p < 0.01 respectively) although the correlation between morale and dependency (r = 0.155, p = 0.2) was insignificant. High-quality care may be more difficult to provide in facilities for more disabled residents. This may affect their morale but the relationship between morale and dependency is complex.