What can local authorities do to improve the social care-related quality of life of older adults living at home? Evidence from the Adult Social Care Survey

Abstract

Access to information, design of home and access to local area explain variance in SCRQoL  They are equally strongly associated with SCRQoL as health indicators  The associations are stronger for older adults with higher needs and less assistance AbstractLocal authorities spend considerable resources on social care at home for older adults. Given the expected growth in the population of older adults and budget cuts on local government, it is important to find efficient ways of maintaining and improving the quality of life of older adults. The ageing in place literature suggests that policies in other functions of local authorities may have a significant role to play. This study aims to examine the associations between social care-related quality of life (SCRQoL) in older adults and three potential policy targets for local authorities: (i) accessibility of information and advice, (ii) design of the home and (iii) accessibility of the local area. We used cross-sectional data from the English national Adult Social Care Survey (ASCS) 2010/2011 on service users aged 65 years and older and living at home (n=29,935). To examine the association between SCRQoL, as measured by the ASCOT, and three single-item questions about accessibility of information, design of the home and accessibility of the local area, we estimate linear and quantile regression models. After adjusting for physical and mental health factors and other confounders our findings indicate that SCRQoL is significantly lower for older adults who find it more difficult to find information and advice, for those who report that their home design is inappropriate for their needs and for those who find it more difficult to get around their local area. In addition, these three variables are as strongly associated with SCRQoL as physical and mental health factors. We conclude that in seeking to find ways to maintain and improve the quality of life of social care users living at home, local authorities could look more broadly across their responsibilities. Further research is required to explore the cost-effectiveness of these options compared to standard social care services.

Improving early detection initiatives: a qualitative study exploring perspectives of older people and professionals

“…Having a home appropriate for their needs and being able to get around in the community are important aspects of older people’s quality of life [46, 58]. Physical and social neighbourhood characteristics, such as safety, accessibility of facilities and social cohesion and the availability of social support, may be crucial in enabling people to age in their own preferred environments [59].…”

“…A more explicit focus of early detection initiatives on stimulating or enhancing the ability to adapt and self-manage is in line with emerging concepts such as positive health [62], reablement [63, 64] and function focused care [65], in which the ability to live a meaningful life is central. As a supportive environment could reinforce this ability [46, 58], there is a call for action to a varied group of stakeholders (including municipalities, project developers and housing corporations) to support the availability of appropriate homes in older people’s communities. Second, as our results suggest that people value autonomy and feeling in control, we further recommend that decisions with regard to care and support are made in dialogue with older people and/or their informal caregivers, and are based on the older person’s priorities [66].…”

“…listening, motivational interviewing) [67]. In addition, transparent and comprehensive information about the available options for care and support should be available and accessible for different groups of older people, as this will be necessary for informed decision-making [67] and will improve older people’s experience of the care and support they receive [58]. …”

The factors associated with care-related quality of life of adults with intellectual disabilities in England: implications for policy and practice

“…As survey administration factors have been found to affect responses among older adults with physical and sensory impairment (van Leeuwen et al . ), these were also considered. Dummy variables for the survey year and local authorities were included to capture changes by geographical location or over time.…”

“…Although this particular study did not explore survey‐related factors, such as the effect of help to complete questions, these are also known to influence self‐reported care‐related QoL (van Leeuwen et al . ). The relatively small contribution of social care to QoL found in the Dutch sample highlights the importance of developing a better understanding of the relationship between non‐care‐related factors and QoL to support the interpretation and application of QoL to policy and practice in the English and other contexts.…”