Subjective Quality of Life of Care-Dependent Older People in Five European Union Countries

Ageing Europe faces a challenge of providing good care for older persons. Until recently there have been no universal standards for long-term care in the European Union (EU). Many national and European surveys indicate that health and social care for older people is primarily biomedically oriented and evaluates quality of care using health-related outcome measures (Carver, Chapman, Thomas, Stadnyk, & Rockwood, 1999; Garratt, Ruta, Abdalla, Buckingham, & Russell, 1993; Smit, 2000). Alternatively, recent research in the field of long-term care has clearly shown that quality of life (QoL) is a primary and meaningful outcome marker of care (Kane et al., 2003; Noelker & Harel, 2001). QoL can be evaluated using objective or subjective variables and indices (Lawton, 1991), but there is a growing consensus that the conceptualization and measurement of QoL in long-term care should be based primarily or exclusively on the resident’s subjective assessment of his or her QoL (Kane et al., 2003). It is now recognized that QoL extends beyond a strict medical discourse into areas as psychology, environmental studies, social work and so on (Smith, 2000). For people who need help in everyday life, the quality of care can significantly influence their QoL (see Chapter 5).

Research of QoL in long-term care is usually limited to one country, one care type or even one institution, and there is lack of comparative studies in this field. The main aim of the present study was to compare QoL of older people receiving long-term care—clients of home-based or institutional care-in different regions of EU: Estonia, United Kingdom, Sweden, Finland and Germany. Estonia is a “new” EU member and other four countries are “old” members. During the study Estonia had been a member of EU less than 2 years while others more than 10 years. Estonia differed from other project countries in several socio-economic areas. The mean life expectancy in Estonia was significantly lower (Estonia 71.8, UK 84.1, Sweden 86.3, Finland 81.4, Germany 82.3 years) (List of countries by life expectancy, 2005), general life satisfaction and happiness were poorer, security and state of repair of houses were more problematic and people were less satisfied with their homes, social life and health services (InfobaseEUROPE Database Record No. 7530, 2004).