Questions raised about quality of life

Medical and hospice staff in local nursing homes took criticism when researchers at USF asked whether the staff could help residents in their final stages of life.

Lori Roscoe of the College of Medicine and Kathryn Hyer of the School of Aging Studies, with research assistant and student Barry Engh, concluded their USF Collaborative granted research presentation Wednesday with some satisfaction.

“It’s good news, really,” Roscoe said. “Respondents perceive high importance in quality of life and feel empowered to influence it.”

The study divided factors that affect end-of-life patients into 11 domains: pain management, autonomy, privacy, dignity, functional competence, meaningful activities, enjoyment of food, individuality, meaningful relationships, personal safety and spiritual well-being.

Staff members of area nursing homes rated the importance of these domains and their perceived ability to influence them on a 1-10 scale. An emphasis was placed on not only avoiding negative experiences, but also creating enjoyment and positive relationships with the staff. The results showed high ratings for all questions with regard to importance and ambition, but the researchers acknowledge the social desirability factor involved in the study.

One conclusion of a former study was disproved in the presentation; it had suggested that less-educated nursing staff were more hopeful that their work could ease the transition into death than those with higher degrees.

“People were enthusiastic to participate,” said Roscoe. “They said, ‘Nobody ever asks me. I know when people are in pain or unhappy. I think I can do something about it.’ These nurses are treated like they are just there for custodial care.”

End-of-life medical care will affect many people too young to consider it now: 30 percent of people admitted to nursing homes die there, according to Roscoe.

The study was the first research done in this specific area, and it opens the door to many things that have been overlooked in the process of evaluating nursing homes. Many people don’t ask enough questions about death in nursing homes before admitting residents, and most nursing homes try to minimize deaths within their walls because it raises troubling questions, according to Hyers and Roscoe.

“Most nursing homes don’t want to advertise themselves as a good place to die,” Roscoe said.

This type of study could help to bring the facts of death into light. By studying quality of life in its final stages, the researchers hope to improve hospice and nursing care and heighten awareness of the factors that are important to potential patrons of these facilities.