Care Keys Survey of Care and QoL of People with Dementia

One of the aims of the CareKeys survey approach (see Chapter 1) was to ensure that the instrumentation and procedures for people with dementia matched as closely as possible those for people without dementia in both homecare and institutional care settings. The general approach was identical with data collected using the CLINT, InDEX and ManDEX instrumentation. A key initial task at the beginning of the CLINT was to record the CPS score or the SMMSE score. Respondents were then categorised into...

Selecting the Instrumentation to Evaluate the QoL in Clients with Dementia

A key aim of the client interview (CLINT) in Care Keys is to provide a client perspective on QoL and satisfaction with services. However, people with communication difficulties, including people with cognitive impairment, are a significant group of clients who are often unable to respond to the interview format of instruments such as the PGCMS and the WHOQOL-Bref. In a study by Balcombe, Ferry, and Saweirs (2001), 46 of patients admitted to an acute care of the elderly hospital ward were...

Veenhovens Model of Four Qualities of Life

A system theoretic perspective is provided by Veenhoven (1996, 2000), who outlines a general conceptual and structural model of QoL to organise the various concepts and measures in various disciplines that are commonly associated with individual well-being or the quality of individual human lives. Veenhoven presents a fourfold taxonomy of QoL, based on two dimensions (i) life chances and life results and (ii) outer and inner qualities (Table 4.1). Veenhoven's framework has been applied to the...

Browns Model of Quality of Life as Being Belonging Becoming

A model of QoL proposed by Ivan Brown provides a link between QoL theory and the issue of care-related QoL referring to communication and negotiation of order in care relations. The model distinguishes between three main domains of life being-belonging-becoming. It further differentiates these domains into three sub-dimensions, yielding nine (sub-) domains of life (Brown & Brown, 2003, pp. 127-128, Renwick & Brown, 1996) 1. Physical being body and health 2. Psychological being thoughts...

Care of Older Persons with Dementia

A key issue to consider in the quality of care for older people is the care and services provided to people with dementia. Care concepts have an impact on the way a person's needs are conceptualised and the kind of care that is provided. In the biomedical model, dementia is characterised primarily in terms of the deterioration of the brain, which in turn results in deterioration of cognitive ability and attendant decline in the person's social and personal skills. This concept of dementia has...

QoL in Older Persons with Dementia

A very important result of the Care Keys research certainly is that it proved to be possible and practical to include persons with dementia in the study, as demonstrated by Sixsmith, Hammond and Gibson (Chapter 10). Although severe cases were often excluded from the study by care managers and, therefore, the sample may not be representative, the study still rendered some interesting results. And it drew a lot of interest from professional carers, since this group of clients increases, and poses...

References

C., & Hadlow, J. (2002). Self-talk versus needs-talk An exploration of the priorities of housebound older people. Quality in Ageing, 3(1), 42-48. Baltes, P. B., & Baltes, M. M. (1990). Psychological perspectives on successful aging The model of selective optimization with compensation. In P. B. Baltes, & M. Baltes (Eds.), Successful aging. Perspectives from the behavioural sciences. Cambridge Cambridge University Press. Baltes, P. B., & Mayer, K. K. (Eds.). (1999). The...

The Group Level TEFF Model

The group-level TEFF has its focus on the match between the need, supply and equity of care at aggregated client group levels. The initial TEFF model developed by Vaarama et al. (1997) was developed using the Finnish RAVA-dependency scoring, which is an ADL-based dependency scoring system with little attention to cognitive or psycho-social needs and no attention to the IADL needs. The RAVA classification was originally developed for monitoring of the correctness of allocation of clients on...

Data and Methods

The data were collected in the five Care Keys countries in late 2004 to early 2005, using the data collection instruments described earlier in this book client interview instrument CLINT-HC, documentation extraction form InDEX-HC and management survey instrument ManDEX (see Chapter 2). The homecare data consist of the complete database of five countries (Estonia, Finland, Germany, Sweden, UK), where only clients with reasonable cognitive function (MMSE > 15) were included. Almost all data...

The Three Models of Carerelated QoL

Theoretical frameworks prove their validity by guiding and structuring research, and it should be emphasized that the PoW framework even though the framework was not subjected to test in a strict sense provided a very fruitful base focusing on the different objectives and tasks of the project. As a meta model it gave a systematic place to issues of crQoL as final outcome of care, and to issues of professional care and care management as intermediate outcomes (or outputs), as well as to...

Revisiting Three Models of Quality of Life Lawtons Model of Four Sectors of Good Life

Quality Models Different Person

A basic concept in Lawton's theory of QoL (Lawton & Nahemow, 1973) is the idea of a person-environment fit, which assumes that increasing frailty in old age causes significant losses of competence, affecting the ability to perform activities of daily living (I ADLs), and that the more vulnerable a person is the more supportive the environment should be. The concept reflects the insight that it is not the capabilities of a person or the affordances of the environment as such which determine...

Wellbeing in the Different Countries

There were 394 people in the total survey group for whom QUALID and CSDD data were collected. Of these, 292 (72.1 ) were women and 89 (22.6 ) were men (cognitive score data were missing for 13 (3.3 ) respondents). The mean age of the respondents was 83.86 (SD 8.37), mode 84 years (minimum age 49, maximum 101 years). Three hundred and twenty were living in residential care (81.2 ) and 74 (18.8 ) were living in their own homes. Of the 313 (79.45 ) classified as having moderate or severe cognitive...

The Instruments CLINT

CLINT is the client interview instrument for use with the clients in homecare (CLINT-HC) and in institutional settings (CLINT-IC) to (i) gain or to confirm background information that is typically contained in most care documentation systems (ii) collect self-reports on the need and supply of care in Client Quality Instrument CLINT RELINFO Professional Care Quality Instrument InDEX Management Quality Instrument ManDEX Key Indicators Quality of Life, Quality of Care, Quality of Management Key...

Discussion

One of the goals in the Care Keys project was to specify reliable and valid measures for evaluation of the efficiency of the long-term care of older people, which would be based not only on the criteria of conventional economy but also takes the social and ethical objectives of care into account. The project adopted the concept of TEFF as the measure to be used, and took the earlier developed pilot model of TEFF as a starting point from which to proceed further. The testing and expert...

The Target Efficiency of Care

The concept of target efficiency (TEFF) and basic algorithms for calculating the set of TEFF indicators (Vaarama, Mattila, Laaksonen, & Valtonen, 1997) were already available at the beginning of the project, and in Care Keys, they were subjected to further testing and development as described in Chapter 11. Basically, target efficiency measures the responsiveness of care to needs of the clients, the efficiency of allocation of resources against the priority needs (Bebbington & Davies,...

Communicatoin In Old Age As

Communication and interaction within dementia care triads. Developing a theory for relationship-centred care. Dementia, 4, 185-205. Beckmann, Ch., Otto, H.-U., Richter, M., amp Schr dter, M. Eds. 2004 . Qualit t in der Sozialen Arbeit. Wiesbaden Verlag f r Sozialwissenschaften. Beresford, P. 2004 . Qualit t sozialer Dienstleistungen. Zur zunehmenden Bedeutung von Nutzerbeteiligung. In Beckmann et al. Eds. . 2004 . Qualit t in der Sozialen Arbeit. Wiesbaden...

Measuring QoL and its Determinants

To provide an overview of the available validated instruments for use in the interviews with older persons who regularly use care services, we examined the instrumentation used in a number of major projects on QoL in old age that also involved aspects of care in the study design 1. OASIS Old Age and Autonomy the Role of Service Systems and Intergenerational Family Solidarity L wenstein, 2001 L wenstein, Katz, Mehlhausen-Hassoen, amp Prilutzky, 2002 . 2. norLAG The Norwegian Life Course, Ageing...