Individual and interpersonal factors associated with care-related quality of life in older adults: a comparison of home-based services, nursing homes and sheltered housing

Background: Understanding how long-term care (LTC) services affect care-related quality of life (CRQoL) and potential differences between LTC services is important, especially considering ageing in place policies. However, data on CRQoL is lacking. This study aims to investigate characteristics associated with CRQoL and compare CRQoL across service types.

Methods: From October 2022 to January 2024, older adults in Norway were interviewed using ASCOT (Adult social care outcomes toolkit): 151 in nursing homes, 129 in sheltered housing and 134 in home-based services. Mixed effects models investigated associations between individual-, interpersonal- and care service characteristics and CRQoL, including specific domains.

Results: Age was positively associated with CRQoL, and men had lower cumulative odds of better CRQoL for social participation and control. Cognitive decline was associated with worse CRQoL for safety, social participation and control, while physical decline was associated with better CRQoL for safety. Frequent contact with friends was associated with better CRQoL for activity and social participation, and frequent contact with family was associated with better CRQoL for safety. However, frequent contact with friends was associated with worse CRQoL for safety, and frequent contact with family was associated with worse CRQoL for accommodation cleanliness and dignity. Home-based care recipients had significantly poorer control, safety and activity than sheltered housing residents, and had significantly poorer control than nursing home residents.

Conclusions: The present study revealed significant associations with individual and interpersonal characteristics and clear differences between service types. This information can help target quality improvement strategies toward groups with the lowest CRQoL.