Quality of life (QoL) in dementia: a comparison of the perceptions of people with dementia and care staff in residential homes.

Evaluating quality of life (QoL) in people with dementia has become increasingly valued, for example in assessing the effectiveness of interventions or making treatment decisions. This study compared the QoL of people with dementia as assessed by the individuals and their care staff, and possible factors associated with the discrepancy between ratings. Seventy-six dyads of people with dementia and care staff in 9 residential homes were recruited. People with dementia were interviewed, using the "quality of life-Alzheimer disease" (QoL-AD) and assessed for severity of cognitive impairment. Staff completed the QoL-AD with respect to the person with dementia, and measures assessing their job satisfaction, level of hope, and person-centeredness. Results showed that people with dementia and care staff rated QoL differently. Some items on the QoL-AD ("physical health," "family," and "friends") were rated similarly between the 2 groups and others differently ("ability to do chores," "marriage/closest relationship," "memory," and "life as a whole"). Neither staff factors (hope, person-centeredness, or job satisfaction) nor the severity of cognitive impairment in the people with dementia explained the discrepancy between ratings. However, when data were aggregated within residential settings, a correlation between increased hope in staff and better resident assessed QoL emerged. Care homes should be aware that low staff hope may be linked to lower resident QoL. Effective training and support for care staff may impact on residents' QoL.