Quality of life in nursing home residents with advanced dementia: a 2-year follow-up.
Quality of life (QOL) in dementia has become increasingly recognized as an important clinical and policy concern, but little is known about the progression of QOL in patients with advanced dementia on psychogeriatric units of nursing homes. Therefore, the primary goal of the current study was to assess the evolution of QOL in advanced dementia patients on a psychogeriatric unit. The QUALIDEM scale, a reliable and validated QOL instrument developed for patients with advanced dementia in residential settings who are unable to self-report, was assessed at baseline and 2 years later. Of the 75 patients with advanced dementia included at baseline, 32 patients participated at follow-up. Average QUALIDEM QOL scores did show a trend towards a significant improvement over a 2-year period. For 61.8% of the subjects at follow-up, the average scores improved. On the subscales that assessed 'feeling at home', 'social isolation' and 'negative affect', improvement was significant. Although it could be expected that QOL would decline over time in advanced dementia patients, results of the current study suggest that QOL is stable or improves despite the global cognitive deterioration, particularly in the more advanced stages of dementia. QOL is a distinctive domain of disease severity that should receive more attention in the advanced stages of dementia.