Adults who are older or living with disabilities that require long-term care and support interventions, can access services in a range of locations.
Around 10% of Australians aged 70+ years choose residential care and receive institutional services designed around their assessed needs. The rest of them live at home or in a village community where services are provided by practitioners who visit them at home. The standard of long-term care and support received in any of these contexts needs to be measurable in terms of what is done for them and the results of interventions.
For instance, how can we know if these services preserve health and promote the person's experience of quality of life? The monitoring of health care services and indicators of quality is well established in institutional care and hospitals, but measuring if and how interventions by family and visiting practitioners are improving the person's life quality is a neglected area of quality monitoring.
An older or frail person may have to move between home, living with relatives, hospital, residential care and assisted living in order to get the support they need and, with each move, their quality of life could be affected.
A reliable way to consistently monitor the continuity of services and the outcomes of interventions and changes of residence on the person's perception of their quality of life, is to use an assessment scale validated for people who have a wide range of health and other issues and living in these situations.
In 2005, when this research commenced, it was difficult to find a Quality of Life assessment that is easy to use, reliable and emphasises person's views on the quality of their lives in reporting, care planning and interventions.
Research behind the development of the Long-term Care Quality of Life Scale (LTC-QoL) identified certain fundamental elements or pillars that need to be present for a person to have a chance at experiencing a reasonable quality of life. These are: social capacity and well-being, self-efficacy, supportive relationships, outlook or mood and whether they feel safe and well (all things considered). The LTC-QoL scale is consistent with general systems models and is a unique assessment scale for estimating a person's general well-being (in their view) regardless of age, debilitating disease or disability.
The LTC-QoL contains nine questions about how the person responds to their circumstances. It was developed to address the lack of available quality of life assessment tools suitable for adults of both genders, at any age over 55 years, with any combination of medical diagnoses and brain function issues.
The assessment scale specifically addresses the outcomes of care, support, treatment and protection interventions supporting the quality of life of people needing long term care at home, living with relatives or in long-term care facilities or villages. The simplicity of design and scoring in the LTC-QoL allows the assessment to be completed by the person themselves (self report) or applied by people who are in a care and trust relationship with the person, who know them well and can detect changes in their behaviour (proxy report).
For best results, the assessment is conducted every 12 weeks (applied twice, 7-10 days apart, within a two-week period). The total score and the chart show summary information on the recent life quality experienced by the older adult doing the assessment. The results provide insights on aspects of their life that require attention. For those providing support services, information on the strength or weakness of quality of life pillars can guide further interventions to improve areas of weakness and support the pillars essential to quality of life.
The LTC-QoL is a valid, easy-to-use scale for monitoring the quality of life experienced by this group of people. Family members, carers and health practitioners will be better able to design interventions to fit with and complement aspects of the person's life.