Factors affecting quality of life



Factors affecting quality of life

Factors that affect a person’s quality of life may be physical or emotional. While these factors are important for everyone, it is especially important that care workers ensure that certain factors are present for individuals in their care. These include:

• Physical factors: exercise, diet, physical comfort, safety, hygiene, pain relief

• Intellectual factors: stimulation, engaging in activities

• Emotional factors: privacy, dignity, approval, psychological security, autonomy

• Social factors: social contact, social support.

Physical life quality factors

These include:

• Exercise

• Diet

• Physical comfort

• Safety

• Hygiene

• Pain relief

Physical comfort

By physical comfort we mean the provision of a suitable environment which meets an individual’s needs, i.e not too hot, not too cold, comfortable beds/chairs, the right amount of stimulation, not too noisy.

Ensuring physical comfort may also mean:

• providing the care required to maintain comfort, such as allowing peace to sleep

• having the correct height furniture

• changing a baby’s nappy regularly to prevent nappy rash and so the baby is not uncomfortable

• moving a bedridden individual regularly to prevent soreness.

Diet

All people need food to survive. The amount and types of food they eat can affect their quality of life, particularly if they have a condition such as diabetes or high cholesterol. A balanced diet consisting of varied and appetizing food can contribute to a good quality of life by improving health and well-being in addition to forming a major part of a person’s social and cultural well-being.

Exercise

Regular exercise has important long-term benefits and most people feel better after taking exercise. Different age groups need different types of exercise to improve their quality of life: children need exercise to assist development, older people need exercise to maintain mobility.

Exercise can take many forms, from daily living activities, such as walking or doing housework, to organised activities such as playing sport or attending aerobics or yoga classes.

Safety

Individuals may be at risk from a number of things: their own carelessness, problems caused by age or diasability, incorrect use of equipment or ill treatment from others.

An individual’s quality of life can be improved by preventing the risk of injury, harm and infection. This can be achieved by:

• Use of specialist equipment, eg bath/bed hoists, stair lifts

• Staff training, eg safe lifting techniques

• Safety locks/buzzers on external doors

• Staff reporting methods.

Hygiene

‘Hygiene’ refers to cleanliness and to the use of precautions to guard against infection and prevent unnecessary disease or illness. We use the term ‘hygiene’ to refer to cleanliness within care settings as well as personal hygiene and food hygiene standards.

Individuals who are clean and wear clean clothing generally feel better in themselves and may have a wider circle of friends.

Here are some examples of hygiene in practice:

▪ In a nursery: toys should be washed/sterilized regularly

▪ In hospital: alcohol gel may be used by both staff and visitors

▪ In all care settings: laws relating to food preparation and food safety guidelines must be followed; staff receive basic food hygiene training.

Pain relief

‘Pain relief’ refers to the provision of a number of ways to ensure individuals are free from pain. Some people experience pain on a regular basis and sometimes continuously, usually as the result of a health condition such as arthritis or cancer. If this pain is not controlled it can have a negative effect on a person’s quality of life.

Pain relief may be given by the use of prescribed pain-relieving medication at the prescribed time. Other pain relieving techniques include massage and TENS machines.

Case study 1 / Activity 1: Rita

Press PLAY to watch the animation. As you watch you should consider the physical life quality factors you have learned about and apply your knowledge and understanding to identify those which will have a positive or negative effect on Rita’s quality of life.

Rita has been living in residential care since she became too frail to look after herself properly. Rita has always been active but now due to the pain from her arthritis she does not move much, although she has some help from her carers getting in and out of bed.

Every morning, Rita’s carers help her get up, and then bath and dress her in clean clothes. She is taken to the day room where she sits and watches television all day.

At mealtimes Rita’s food is brought into the day room, where she eats on her own, as she has difficulty walking to the dining room.

She looks forward to visits from her family as they often bring her fresh fruit as a treat.

(Video: Older lady entering the residential home with help.

Carers helping her in and out of bed which has lots of pillows, dressing her and taking her to the day room where a television is on.

Clock on the wall with hands moving to one o’clock.

Other residents leaving the day room and going to the dining room, leaving Rita on her own eating her food from a lap tray/table.

Family arriving carrying a basket of fruit.)

Activity 1: What do you think?

1. Identify the positive and negative physical life quality factors affecting Rita.

2. Discuss how they may affect her quality of life.

Intellectual life quality factors

These include:

• Stimulation

• Engaging in activities

Stimulation

Stimulation refers to the presence of a stimulus to keep the mind active and alert, thus preventing boredom and often depression caused by having nothing interesting to do. Stimulation helps people find life interesting and feel motivated and challenged.

Some ways this may be achieved include:

▪ In the nursery: varying activities each day; engaging children in story time

▪ In hospital/residential care: encouraging visits to the day room; putting individuals of similar age groups in the same ward to encourage conversation; provision of reading books, puzzle books etc.

Engaging in activities

Engaging in activities means having something to do, being occupied. It could be voluntary work, paid work or a hobby such as knitting, sports etc. Certain activities provide individuals with a sense of well-being and make them feel worthwhile; some activities also provide opportunities for social interaction or developing physical fitness.

For example:

• At the nursery: taking part in a Nativity play will improve confidence and children will learn to work with others.

• At the residential home: playing bingo cards provides social interaction, stimulation and a sense of achievement if winning; helping with mealtimes or making tea can give a sense of purpose.

Emotional life quality factors

These include:

• Privacy

• Dignity

• Approval

• Psychological security

• Autonomy

Privacy

All individuals have a right to privacy. This means they should be allowed opportunities to be unobserved or undisturbed as they wish. This could be at times when they may be embarrassed (eg dressing/undressing, receiving treatment of a personal nature, bathing), if they wish to speak to someone confidentially or if they just want some time to themselves away from others.

Lack of privacy may make a person feel devalued.

Dignity

Dignity can be provided by treating people with respect. By not demeaning an individual in any way, we can ensure their self-esteem remains positive.

Dignity can be provided in all care settings. Individuals should be addressed as they wish to be addressed. Some may prefer to be called by their Christian name while other may prefer to be addressed more formally, eg Mrs/Mr. Care workers should not use nicknames or be too familiar (eg calling everyone ‘love’).

Respecting someone’s dignity involves asking for compliance (not giving orders) and observing an individual’s wishes.

This can also relate to physical aspects: eg drawing the curtains around a bed in hospital when changing clothes, dressing wounds or giving a bed bath, so that the patient is not embarrassed in any way.

Activity 2: Approval

Approval means showing affection or praise for someone’s actions. This helps individuals maintain a positive self-esteem and a feeling of achievement and value for their actions.

Can you give examples of how approval can be shown?

Model Answer: Children may be given rewards such as stickers for good work/behaviour. In all settings: verbal praise/thanks/encouragement/a smile or a nod of the head.

Psychological security

We use the term ‘psychological security‘ when individuals are not afraid or anxious about any aspect of their life. Individuals experience times of worry or stress – such as worrying about treatment they may receive, family or financial problems - which may make them feel insecure.

Reassurance and effective communication can help allay fears.

Actions to improve psychological security may include:

• In the nursery: arranging introductory visits to help with separation anxiety

In hospitals/residential care: locking doors so individuals know they are safe.

Autonomy

Autonomy refers to a person’s ability to have control over their own life and the opportunity to make decisions without coercion from others. Autonomy is difficult to achieve in many care settings as individuals receive a lot of care from others. However, people can become more autonomous if they are encouraged to assert themselves and gain confidence.

Nursery: Children are encouraged to go to the toilet by themselves, get their own coats and put them on to go out to play.

Hospital: Patients are allowed to make decisions about their treatment, when and how they wish to dress.

Residential Care: Residents could be allowed to make tea for themselves or others when they wish to.

Social life quality factors

These include:

• Social contact

• Social support

Social contact

This means opportunities to be with other people. Without social contact individuals may become isolated and this can lead to depression. Social contact can be provided by belonging to a range of social groups, depending on age, abilities and interests.

For example, social contact can be achieved:

• In the nursery: by playing with other children

• In hospital: by talking with others on the ward, receiving visits from friends and family

• In residential care: by chatting in the day room, WRVS visitors

Social support

Social support differs from social contact as it is more personal. Individuals receive social support from people they trust, usually family or friends.

Social support provides individuals with emotional security as they can discuss problems and get the help they need to solve them. They may need physical support, ie help with a practical activity, or psychological support, eg having someone to talk to who knows and understands them.

Case study 2 / Activity 3: Reception class

The children in the reception class at school are all given the opportunity to visit the class with their parents before they actually start full-time school. They are able to meet the teacher and other children who will be starting school at the same time.

In the classroom there are a range of activities for the children, such as water play, sand play, a house corner, and puzzles.

In addition to the teacher there is a nursery nurse and a classroom assistant to help out with the children.

The facilities in the school include a canteen (which provides healthy school lunches), an outdoor play area, a sports hall and separate toilets for boys and girls (with small toilets and low hand basins).

What life quality factors are present?

Activity 4: Disability - Think about it

Video clip: Identify the life quality factors present in the video.

Using the post-it notes provided under the headings: physical, intellectual, emotional and social consider:

1) the positive effect on the individual.

2) the negative effect on the individual.

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