Factors that affect quality of life for older persons with life limiting illness in long term care homes : a literature review

Abstract: Dying is a normal life process. Palliative care is the means in which health care professionals care for individuals with either life limiting or terminal illness at or near the end of life. It is important to deliver palliative care across all health care contexts - from acute care to residential care. Nurses within the specialty of palliative care or who have had palliative care education consider all aspects of caring for individuals - physical, psychological, social, and spiritual. Quality of life (QoL) is important at all stages of life. Older persons with life limiting illness residing in long term care homes may have different factors that influence their QoL than younger persons in good health. The purpose of this study was to describe factors affecting quality of life for older persons with life limiting illness who reside in long term care (LTC) homes. It was also of interest to discover what nursing strategies are used to promote quality of life for this population. A literature review of sixteen articles was carried out. Articles which were relevant to the literature review’s aim were retrieved from CINAHL and PubMed databases. Twelve articles were retrieved from the databases and four articles were found using a manual search. A systematic process of reviewing each article, reading and re-reading them to analyze the method and results was undertaken. Deductive reasoning was used to develop themes with inspiration from the World Health Organization’s domains of quality of life. Results were categorized into categories of sociodemographic characteristics, psychological/spiritual, physical health/independence, environment, and nursing strategies. It was found that being female and married positively affected one’s quality of life. Visits from family and friends positively affected QoL. Of interest was that having a higher education negatively affected one’s quality of life. Having a lower cognitive function and more comorbidities negatively affected one’s quality of life. Living in a smaller long term care home and also long term care homes with more leisure activities positively affected one’s quality of life. Nursing strategies to positively affect quality of life in long term care homes included education of staff in palliative care by a palliative care consult team, and assessment and treatment of older persons’ pain. In conclusion, QoL must be emphasized in LTC homes since the world’s population is aging and more complex symptoms within an increase in co-morbidities require expert nursing. QoL is affected by social factors such as visits from family and friends. It is affected by nurses’ attention to pain management and their caring nature in supporting residents’ dignity. QoL is also affected by demographic characteristics which staff and managers must be aware of in order to support the resident in optimizing QoL in a LTC home. Nurses, nurse specialists and managers at LTC homes need to prioritize their work in order to positively affect QoL for older persons with life limiting illness.