Abstract
ContextThe will to live (WTL) is an important indicator of subjective well-being. It may enable a deeper understanding of the well-being of nursing home residents. ObjectivesTo evaluate the intensity of WTL, its association with various factors, and its temporal evolution among residents ≥ 65 years old; we also aimed to compare it with proxy assessments of WTL. MethodsA cross-sectional study was conducted in five nursing homes in Switzerland. Participants with decisional capacity were asked to rate the intensity of their WTL on a single-item numerical rating scale ranging from 0–10. A short-term follow-up was conducted among a sub-sample of 17 participants after three and six weeks. Proxy assessment by residents’ next of kin and professional caregivers was conducted, and inter-rater agreement was calculated. ResultsData from 103 participants (75.7% women, 87.3 ± 8.0 years) was analyzed. The median intensity of WTL was 8. Higher WTL was significantly associated with better physical mobility and shorter duration of daily care but not with age, gender, pre-admission care setting, or prognosis. Significant independent predictors of WTL were physical mobility and provenance from rehabilitative care. In the short-term follow-up assessment, WTL remained highly stable. Intraclass correlation coefficients were moderate for residents’ next of kin and nurse assistants but poor for physicians and nurses; all proxy assessments underestimated the participants’ WTL. ConclusionNursing home residents expressed a very strong WTL and proxy aents underestimated residents’ WTL. It seems pivotal to proactively communicate with residents about their WTL.
Highlights
Offering healthcare that improves older patients’ quality of life (QoL) is challenging, especially for nursing home residents, who often have complex health needs and increased vulnerability.[1,2] Nursing homes is their last place of life and they are accompanied untilAddress correspondence to: Marc-Antoine Bornet, MD, Chair of Geriatric Palliative Care, Palliative and Supportive Care Service and Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University ofÓ 2021 The Authors
Higher will to live (WTL) was significantly associated with better physical mobility and shorter duration of daily care but not with age, gender, pre-admission care setting, or prognosis
Multiple linear regressions revealed that higher physical mobility and pre-admission care in a rehabilitation center were significant independent predictors of WTL (P = 0.054 and P = 0.039, respectively) (Table 2b)
Summary
Offering healthcare that improves older patients’ quality of life (QoL) is challenging, especially for nursing home residents, who often have complex health needs and increased vulnerability.[1,2] Nursing homes is their last place of life and they are accompanied untilAddress correspondence to: Marc-Antoine Bornet, MD, Chair of Geriatric Palliative Care, Palliative and Supportive Care Service and Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University ofÓ 2021 The Authors. Offering healthcare that improves older patients’ quality of life (QoL) is challenging, especially for nursing home residents, who often have complex health needs and increased vulnerability.[1,2] Nursing homes is their last place of life and they are accompanied until. Will to Live in Nursing Home Residents their death: in Switzerland, 35% of the population dies in a nursing home.[3] Providing appropriate care for nursing home residents requires attending to their wishes, needs, and well-being. There are not yet any data available concerning the intensity of older nursing home residents’ WTL.[6]
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