Aged care services are usually assessed on health outcomes and sometimes measures of satisfaction. Both are important to reflect the way that services are delivered (satisfaction) and a specific, important, set of outcomes (health). However, as per the Australian Royal Commission into Aged Care Quality 2021 [final report], we need broader measures of wellbeing and quality of life that more broadly assess the overall impact of the services on individuals and evaluate the $40bn per annum investment in aged care services from government and individuals.
Consistent with the advice given to the Royal Commission (Ratcliffe et al 2020), our research supports the argument that such soft measures are important measures of success for ageing consumers and their stakeholders, for industry, for government and for us as a society. It is time for the broad resident-centered care voice to be heard (Royal Commission, 2021), we must ask those who ‘live’ the experience to describe that experience for us.
Measuring wellbeing is usually subjective although can include objective behavioral measures and can take quite a health (physical or mental) oriented perspective, but what we are advocating here is for broader ‘whole of life’ wellbeing measures such as the WHO-5 or Satisfaction with Life or emotional balance (e.g. the dominant PANAS). These measures reflect evaluations of life that are much broader than aged care services but a key argument is that aged care services should contribute rather than detract.
Consistent with the existing research, subjective well-being is ‘a person’s cognitive and affective evaluations of his or her life’ (Diener, Lucas and Oshi, 2002 p63)
This approach seems consistent with the Australian government’s instalment of consumer experience interviews (CEI) into residential care starting April 2022. The CEI measure focuses mostly on the service elements intrinsic to residential care but also points to broader evaluations of life. This is a good starting point to invite all participants of aged care (including family) to regularly feedback on their personal wellbeing and to then be able to link those outcomes to changes in services over time.
Check back in the next chapter of the series to discuss measures of subjective well-being in aged care.
1. Diener, E., Lucas, R. E., & Oishi, S. (2002). Subjective well-being: The science of happiness and life satisfaction. Handbook of positive psychology, 2, 63-73.
2. Ratcliffe J, Chen G, Khadka J, Kumaran S, Hutchinson C, Milte R, Savvas S, Batchelor F (2020). Australia’s aged care system: the quality of care experience and community expectations. Caring Futures Institute, Flinders University, South Australia.