Abstract
An important goal in caring for people with dementia is to sustain or increase their experience of quality of life (QoL). Paying attention to the factors that influence the personal and emotional experiences of having dementia is important in the planning and delivering of care for people with dementia. The overall objective was, in a longitudinal design, to explore the association between organisational, staff and patient characteristics, person-centred care (PCC) and QoL during the disease course of patients with dementia in Norwegian nursing homes, and, by this, contribute to the planning of care and treatment for persons with dementia.
The majority of the patients we followed from admission to NH had good QoL over the observation period of 30 months, and it was mainly the patient characteristics that influenced on the QoL trajectory. Poor patient QoL was associated with more pain, more severe dementia, more affective symptoms, poorer staff job satisfaction, poorer ADL function, and more severe NPS. Even though there was no significant association between the patients’ QoL and PCC, there was an association between the patients’ QoL and the staff’s job satisfaction. The degree of PCC in the unit was associated with several staff characteristica. Three years or more of health-related education, a lower level of quantitative demands and role conflict, a higher level of perception of mastery, empowering leadership, innovative climate and perception of group work, in addition to the type of unit and the physical environment in the NH unit designed for people with dementia. Better job satisfaction among the staff was also associated with a higher degree of PCC in the unit.
As dementia is a chronic disease, focus on symptom relief and QoL is important. To improve the patients’ QoL, efforts should focus on reducing pain, reducing NPS and improving ADL function for the patient, as well as improving the job satisfaction of the staff.