Quality of life in residential care

While some of the changes in life that accompany increasing age may promote higher quality of life, the increased prevalence of disease and other negative life events presumably operate in the opposite direction. Among the most salient negative life events in later life is the development of physical or mental disability sufficiently severe 10 justify moving from an independent life in the community to a residential care facility. This chapter first reviews the current state of knowledge concerning quality of life with increasing age. Most studies note changes. but the distinction of age effects from cohort effects is not often made. Illness in later life has a major impact upon quality of life, especially if disability is one outcome. As illness and disability often lead to a move into a residential care facility, the quality of life in residential care becomes of broader interest. Such interest is enhanced by the strong contrast in views expressed by people when contemplating life in residential care and when actually experiencing it. Various models of this apparent "disability paradox" are described, followed by an analysis of the conceptual difficulties underlying research into quality of life because of the varied definitions in current use