Rice University
Rice Magazine| The Magazine of Rice University | No. 3 | 2009

Healing vs. Quality of Life

Healing an elderly patient’s physical problems does not automatically improve the patient’s quality of life.

elderlyThat’s what Vikas Mittal of Rice’s Jesse H. Jones Graduate School of Business and co-researchers at the University of Pittsburgh learned from a study of residents in two nonprofit elder-care nursing homes in western Pennsylvania.

“A lot of people look at the care of elderly people in terms of clinical outcomes such as ulcers, depression and pain,” said Mittal, the J. Hugh Liedtke Professor of Management. “The conventional thinking has been that if you heal the patient’s physical condition, their quality of life will automatically improve. We found that this isn’t always the case. While there is an overall connection between physical health and self-reported quality of life, not every finding was consistent.”

The researchers interviewed the patients at six-month intervals over a three-year period to determine the association between changes in clinical health factors and the patients’ perception of their quality of life. They found that patients with improved physical conditions didn’t always feel their quality of life had improved.

“Forty years ago the national focus was on taking care of children. Now we see more and more people struggling to care for elderly family members.”
                                        —Vikas Mittal

The results show the need for incorporating psychological factors into evaluating nursing homes and the care they provide to the elderly, Mittal said. Currently, the U.S. government mandates the data used to monitor the health and quality of life in nursing homes, but all measurements are based on clinical factors. Consequently, when evaluating nursing homes for their elderly relatives, people may not be able to understand the extent to which their loved ones could have a high quality of life there.

“The system is completely devoid of psychological factors,” Mittal said. “This is a very limiting approach because it treats the elderly person as a set of symptoms and not as a whole individual.”
The study also suggests racial and cultural implications for nursing home patients, but the sample was too small for valid conclusions. The researchers plan long-term studies with larger sets of patients across more nursing homes. What they learn could prove extremely useful, especially in culturally diverse states.

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“Forty years ago the national focus was on taking care of children,” Mittal said. “Now we see more and more people struggling to care for elderly family members. It is critical for us to better understand the psychological factors that comprise quality of life for the elderly, as well as physical health of these individuals, so that we can provide them with the best possible care.”