Older People's Views on their Quality of Life
and its Enhancement
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The concept of quality of life spans a wide range
of disciplines and topics (from the quality of the last year of
life to the quality of life in urban environments), and is measured
using an equally wide range of subjective and objective indicators.
Most disciplines, in both the social and medical sciences, have
based their concepts on experts' opinions, rather than those of
lay people. In addition, a pragmatic approach prevails in the
literature, and clarification of the concept of quality of life
is typically by-passed with reference to its abstract nature.
Too often, measurement scales of quality of life, and their scoring
systems, rely too heavily on the literature and on psychometric
properties in their validation process - and lose sight of their
meaning and relevance to the people they will be applied to. More
recently-developed individualised measures which permit respondents
to select their own domains of quality of life, and to weight
these items, are highly complex and unsuitable for use in large
The promotion of quality of life in older age is
attracting increasing policy interests. While for some people
old age will be a time of increasing dependency and loss of control,
for others it will be a period of personal fulfilment. Old age
contains many opportunities for positive change and productive
functioning, and should not be confused with illness. However,
population ageing is regarded as a problem by governments in relation
to increasing burdens on pensions, health and social welfare provisions.
At the same time, the hypothesised future compression of morbidity
and disability into a shorter period of life is leading to more
positive perspectives of healthy ageing as normal. However, most
socio-psychological theory on quality of life has not been underpinned
by empirical data, and there is little data on how the dynamics
of quality of life change with the process of ageing, nor of the
roles of assimilative and accommodative coping behaviour.
This research will address the issues of defining
and measuring quality of life in older age, and is based on the
perspective that people themselves are the best judges of the
quality in their lives, and how it can be extended. The research
will explore older people's perceptions of quality of life, their
views on how their quality of life can be practically improved,
and how it changes over time. This will also contribute to methodological
development in relation to measuring these concepts in evaluations
of multi-agency policy.
The study is based on both quantitative survey and
qualitative interview methods. The survey will generate older
people's conceptual categories of QoL, their priorities in relation
to these, and their views on how quality of life can be extended.
Information will also be collected on people's attitudes and circumstances.
The vehicle for the survey is the national Omnibus Survey mounted
by the Office of National Statistics (ONS). This is a national
population survey, based on interviewing a random sample of adults
in their own homes. A sample of approximately 1760 people aged
65 and over is aimed for, at four stages throughout the year in
four quarterly Omnibus Surveys (to generate enough numbers and
to avoid a seasonal bias). A small sub-sample of eighty of these
survey respondents, and 20 of their carers, will also be selected
for future in-depth follow-up. The qualitative methods will use
an open-ended check list to explore the concepts of interest in
the context of a life history approach.
Aims and Objectives
The research proposed here will investigate older
people's own views of quality of life, the factors that affect
it in both good and bad ways, and how these change over time.
The aims of the proposed study of quality of life
To contribute to the development of a
conceptual framework and body of knowledge on quality of
life and its enhancement in older age.
This will be grounded in older people's
views of factors which constitute and extend quality of
To provide strong, rigorously collected
empirical data which will also be used for a critique of
the content validity of existing measures of quality of
This will contribute to the methodological
development of an improved instrument for use in descriptive
surveys (eg. of the 'social temperature') and in the assessment
of outcomes in multi-agency policy and service evaluation.
To provide rigorously collected data
which will be of value to older people and to public policy
makers by suggesting ways in which the quality of older
people's lives can be improved.
The objectives are:
To obtain population norms of, and rich
insights into, older people's definitions and descriptions
of what QoL means to them, how the different areas are prioritised,
perceptions of what increases and decreases quality in their
lives, how quality can be extended, and to explore the dynamics
of changes in QoL.
To ascertain whether, and to what extent,
these perceptions of QoL are inter-related with other perceptual
domains, social and structural characteristics of people
and their circumstances.
There is international interest in the improvement
of quality of life in old age. This is partly due to the increasing
numbers of older people and higher expectations of society. There
is public policy interest in the potential for reducing public
expenditure by enabling older people to retain their independence,
and to enhance their perceived quality of life, rather than fostering
The information obtained on quality of life will
be used to make practical suggestions for the extension of quality
of life in older age. This will address public policy makers'
concerns about how to prolong independence in older age, how to
empower older people to maintain an active role in society, and
to promote more effectively the well-being of future generations.
The research will also be used for the development of empirically
based measurement scales for measuring the broader QoL outcomes
of multi-agency policy and services.