Abstract
In most countries, the prevalence of depression in care homes is substantially higher than among community-dwelling older people. Negative media reports and the stigma associated with long-term care perpetuates the belief that community care is associated with a better quality of life than nursing or residential home care. The aim of this paper is to investigate mental health, quality of life and medication use among a sample of care home residents and community dwelling older people. This cross-sectional study comprised of structured interviews with 75 care home residents and 852 community dwelling older adults in a large health and social care trust within the U.K. Data were collected using an abridged version of the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI). Health-related quality of life was assessed using the SF-6D, derived from responses to the SF-12, which was embedded within the screening section of the WMH-CIDI. Results showed a significantly lower level of mental disorders among older people in the care home sample. Health-related quality of life results indicated that although care home participants were significantly more limited in their physical functioning, they reported better mental health and social functioning than older people living in the community. These results were statistically significant. Prescription rates for mental health medication were higher in the care home sample. This study provides tentative findings about mental health and quality of life in care homes, which should be further explored in future research. The study addresses the negative public perception of quality of life in care homes while contributing to the debate around the health care implications of ‘ageing in place’ for older people. There is a need to address the relationship between mental health, quality of life and medication use among older people across a range of care settings.
Highlights
The ageing population of the world has given rise to a changing philosophy surrounding the provision of health and social care from institutional to community-based care
This paper reports on the comparison of two samples of older people, who were administered the same structured survey instrument, the World Mental HealthComposite International Diagnostic Interview (WMHCIDI) (Kessler and Üstun, 2008)
While 18.0% of individuals living in the community met the criteria for any lifetime mood or anxiety disorder, just 3.0% of those in care homes had a lifetime disorder. panic disorder and panic attacks compared to 2.8% reporting lifetime panic disorder in the Northern Ireland Study of Health and Stress (NISHS)
Summary
The ageing population of the world has given rise to a changing philosophy surrounding the provision of health and social care from institutional to community-based care. This shift is aimed principally at helping people to live in their own homes for as long as possible. While research has focused on the physical well-being of older people, the mental health of older people remains a relatively under-researched topic. Little is known about the mental health and quality of life of older people living in long-term care settings in comparison to their community dwelling peers.
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