Family Involvement in the Nursing Home and Perceived Resident Quality of Life

Purpose of Study: This study focuses on the relationship between family involvement and family perceptions of nursing home residents' quality of life (QOL). Design and Methods: Resident and family variables from the 2012 Ohio Family Satisfaction Survey were merged with facility information from the Certification and Survey Enhanced Reports (CASPER). Hierarchical linear modeling was used to examine the association between family involvement and other predictors with perceived resident QOL. Results: Although most of the variability in family member perceptions of resident QOL was observed at the individual level (residents and families), characteristics of the facilities were also significantly associated with perceived resident QOL. Family involvement was a strong predictor of perceived resident QOL: Families who visited frequently and provided more help with personal care perceived lower resident QOL, while those who communicated frequently with facility staff had higher perceptions of resident QOL. Interestingly, the negative association between helping with more personal care and perceiving lower resident QOL was attenuated when family members communicated more regularly with facility staff. However, as family member age increased, the positive association between communication with facility staff and resident QOL diminished. Family members who are spouses, older, non-White, and highly educated perceived resident QOL as lower. Implications: Meaningful family involvement is a modifiable factor that can potentially enhance resident QOL. Facilities can become more family-oriented through encouraging communication between staff and families, helping spouses and other family members fulfill their desired caregiving role, and discussing the family's motivations for providing personal care during visits.