Quality improvement has always been recognised as an important approach to ensuring improved outcomes for consumers living in residential aged care settings, but the initial factors that providers and policymakers assumed to have the most bearing on the quality of care may have little bearing on what consumers perceive as important to their quality of life.
The winds of change are currently sweeping through the Australian aged care sector, resulting in an intense focus on the recognition of consumer viewpoints and an examination of the correlation between positive customer experience and high-quality care outcomes.
Extensive research with aged care consumers and consultation with industry experts has allowed us to identify seven significant areas of concern for aged care consumers that have the greatest impact on their overall happiness and quality-of-life.
These areas are known as the Happy Life Index.
While other research that has evaluated the happiness of a population often looks at things such as job satisfaction, media consumption, and economic prosperity, we have found that many of these domains are not suitable measurements for older people – as their physical needs, living arrangements, financial control – with many no longer managing their own finances, cognition and freedom has ultimately changed.
To put it simply, it’s the simple pleasures in life that make aged care consumers happy, and the purpose of the Happy Life Index is to give aged care providers the ability to measure and improve the domains that have been found to have a direct impact on the happiness of residents.
Historically, the aged care sector has focused on clinical care as the hallmark of great service, but industry and consumer support for The Happy Life Index is an indication that aged care in Australia is beginning to broaden its horizons in regards to what care actually is.
The seven areas of significant concern for the majority of aged care consumers are:
- Food Quality
- Care Quality
- Staff Friendliness
- Activities & Lifestyle
- Cleanliness & Environment
- Staff Presence
Over the coming weeks, we will examine why each of these seven areas has such a significant impact on the wellbeing of consumers and explore how understanding and gauging these areas of service can allow providers to improve their standard of overall care.
And begin with one of the most frequent themes of concern for aged care residents, food.
Studies of quality of life for aged care residents have consistently identified food as a major domain contributing to well-being.
Research from 2017 that was conducted by the Australiasian Journal on Ageing and recent studies that were cited during recent Royal Commission hearings have found that 50 per cent of residential aged care residents are currently malnourished.
Reasons for malnutrition may include:
- dental issues or ill-fitting dentures
- dementia (because of difficulty swallowing and sensory sensitivities)
- a poorly designed dining environment (such as poor acoustics, uncomfortable furniture, inappropriate crockery, and table settings)
- having too few staff members to help residents eat and drink and/or poor staff training
- not supplying modified cutlery and crockery for those who need extra help
- not offering residents food they want to eat or offering inadequate food choices.
Malnutrition impacts all aspects of care and quality of life, including directly contributing to muscle wasting, reduced strength, heart and lung problems, pressure ulcers, delayed wound healing, increased falls risk and poor response to medications, to name a few.
The link between happiness and eating is well documented, with research conducted in the Netherlands showing a “significant positive correlation between calorie intake and mood improvement was found: the more calories participants ate in the first five minutes of tasting, the better their mood.”
One of our clients that is currently utilising the Happy Life Index has seen a massive improvement in food quality in a particular home after initially identifying that only 68% had positive feedback regarding the quality of food.
After deciding that this score required consultation with consumers, a resident focus group was formed to consult with chefs and kitchen staff and share their opinions on the quality of food.
The provider was pleasantly surprised that consultations revealed that it was the small things like ‘ wanting extra gravy,’ and access to ‘more condiments’ as the reasoning behind the initial low score.
Staff then set about implementing a number of improvement processes based on the direct feedback that they received from the resident focus group, yielding satisfaction scores between 91-100 per cent over the following six month period.