Communication and planning are the keys!
By Kathy Bradley
What gives your life quality? Ask 10 people, get 50 different answers. Quality of life can only be measured by the person living that life, even when receiving long-term care.
Both verbal and nonverbal communication are essential to discovering how one in care defines quality: what they say; how they respond to people and 
events; what draws their attention; what makes them smile, frown, back away. Caution — a once-preferred activity may no longer be of interest, and loss of capacity may change feelings about the activity. Meet them where they are, not where they used to be or where you wish they were, when determining what defines quality now.
Autonomy over daily activities is something most of us take for granted — choosing when to wake up, what to wear, what to eat or when to bathe. Yet, these seemingly trivial decisions can significantly impact quality of life. Whether someone is independent or requires assistance, understanding their habits and supporting their choices can enhance their daily life. Long-term care should empower individuals to maintain their daily routines (including on weekends), not disrupt or forego them for the convenience of caregivers.
Quality of life hinges on meaningful activities, social interactions and a structured daily routine. This holds true even when caregiving is involved. Care plans should be individualized, incorporating the person’s choices, routines, preferences and values. The care team should consider factors like the person’s preferred wake-up time, bath schedule and social interactions with friends when creating the care plan. A well-crafted care plan goes beyond a mere checklist of tasks. It should reflect the complete individual, highlighting where assistance is needed to achieve their priorities, goals and preferences. Advocates play a crucial role in ensuring that care plans are comprehensive and aligned with the person’s desires for a meaningful life.
To evaluate the effectiveness of a care plan, it’s essential to ask these questions:
- Does this activity align with the person’s preferences and routine?
- Is this activity meaningful to the person receiving care?
- Does this therapy contribute to the individual’s overall well-being?
Caregivers and advocates should continuously assess and adjust the plan to meet these criteria. Discomfort and dissatisfaction are part of everyone’s life, and will occur in long-term care situations. When a person expresses discontent, it’s crucial to explore the underlying reasons and seek solutions rather than resorting to the right to refuse treatment. Creative strategies — such as breaking treatments into smaller steps, offering positive reinforcement or providing distractions — can help individuals tolerate necessary treatments. If resistance persists, patience and persistence should be the approach, avoiding confrontation while continuing to explore alternatives.
Quality of life in long-term care is a deeply personal matter. It requires effective communication, individualized care plans and a commitment to preserving a person’s autonomy and preferences. Advocates play a vital role in ensuring individuals receive the care that aligns with their definition of quality, allowing them to lead fulfilling lives despite any challenges they may face.
