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    Comparing proxy rated quality of life of people living with dementia in care homes

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    Lord_Psychological_Medicine (379.8Kb)
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    Publication date
    2020-01
    Author
    Robertson, S.
    Cooper, C.
    Hoe, J.
    Lord, Kathryn
    Rapaport, P.
    Marston, L.
    Cousins, S.
    Lyketsos, C.G.
    Livingston, G.
    Keyword
    Care home
    Carer
    Dementia
    Family carer
    Institution
    Paid carer
    Proxy
    Quality of life
    Rights
    © Cambridge University Press 2019. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/ by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Peer-Reviewed
    Yes
    
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    Abstract
    Background. Improving quality of life (QOL) for people with dementia is a priority. In care homes, we often rely on proxy ratings from staff and family but we do not know if, or how, they differ in care homes. Methods. We compared 1056 pairs of staff and family DEMQOL-Proxy ratings from 86 care homes across England. We explored factors associated with ratings quantitatively using multilevel modelling and, qualitatively, through thematic analysis of 12 staff and 12 relative interviews. Results. Staff and family ratings were weakly correlated (ρs = 0.35). Median staff scores were higher than family’s (104 v. 101; p < 0.001). Family were more likely than staff to rate resident QOL as ‘Poor’ (χ2 = 55.91, p < 0.001). Staff and family rated QOL higher when residents had fewer neuropsychiatric symptoms and severe dementia. Staff rated QOL higher in homes with lower staff:resident ratios and when staff were native English speakers. Family rated QOL higher when the resident had spent longer living in the care home and was a native English. Spouses rated residents’ QOL higher than other relatives. Qualitative results suggest differences arise because staff felt good care provided high QOL but families compared the present to the past. Family judgements centre on loss and are complicated by decisions about care home placement and their understandings of dementia. Conclusion. Proxy reports differ systematically between staff and family. Reports are influenced by the rater:staff and family may conceptualise QOL differently
    URI
    http://hdl.handle.net/10454/18153
    Version
    Published version
    Citation
    Robertson S, Cooper C, Hoe J et al (2020) Comparing proxy rated quality of life of people living with dementia in care homes. Psychological Medicine. 50(1): 86-95.
    Link to publisher’s version
    https://doi.org/10.1017/S0033291718003987
    Type
    Article
    Collections
    Health Studies Publications

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