Quality of life in residential care homes : older disabled persons’ and allied health professionals’ perspectives

Abstract

The global trend of the ageing population presents significant social, economic and infrastructural challenges, particularly as older persons experience higher rates of disability, compounded by societal and environmental barriers. Locally, the demand for residential care homes is increasing, with Maltese individuals more than twice as likely as their European counterparts to view residential care as the preferred option for older persons needing assistance. This underscores the urgent need for research to address the challenges of supporting an ageing population with disabilities through more inclusive policies and sustainable solutions. This study aimed to explore the perspectives of older disabled persons and allied health professionals regarding the quality of life in residential care homes, focusing on the factors that either enhance or diminish the quality of life for older disabled persons living in these settings. A qualitative research design was adopted within the interpretive tradition to gain an in-depth understanding of their perspectives. A conceptual framework combining the social-relational model of disability and intersectionality theory guided this study, keeping emancipatory principles in mind. Using purposive sampling, 10 participants were selected, including five older disabled persons and five allied health professionals. Data was gathered through semi-structured face-to-face interviews, supplemented by two pilot studies and an advisory group. Thematic analysis of the generated data revealed five key themes: Autonomy, Quality of Care and Staff Interaction, Physical and Emotional Well-being, Environment and Living Conditions, and Engagement in Daily Life Activities. These factors can either enhance or hinder quality of life, depending on how they are addressed. This study is valuable given the limited local and international literature. A key issue identified in other studies is the lack of clarity in distinguishing whether older persons living in residential care homes are explicitly recognised as having disabilities. Many studies make this assumption, failing to differentiate between ageing and disability. While the findings align with previous research on the factors influencing the quality of life in residential care homes, this study highlights the compounded effects these factors have on persons who are both older and disabled. Based on these findings, recommendations have been made for policymakers, governmental institutions, authorities and allied health professionals, aiming to improve the quality of life for older disabled persons living in residential care homes.