Measuring and Improving Quality of Life in Older Adults with Special Needs

By Crystal McGaha

Quality of life is defined by personal feelings, details, outlook, and day-to-day experiences—how happy and positive one feels, how comfortable and secure, how productive and desired, how healthy and free an individual considers themselves, etc. Professionals in aging must seek to assess quality of life through determination of individual meaning associated with various elements of quality of life, as best as possible. Positive outlook and quality of life in older adults may not always mean an individual is healthy mentally or physically, although positive outlook and presence of hope often encourages improved outcomes.

Useful website recommendations:

Debra Sheets—Aging with Physical Disability.

Nutrition Australia—Physical Activity for Older Adults.

Rakesh Tripathi—Quality of Life: An Important Issue in Geriatric Research.

Physical and mental impairments have been known to significantly decrease quality of life in older adults, as many lose hope, become isolated or depressed, lose faith, and struggle to feel joy in everyday life. When care professionals identify factors such as depression, social isolation, or chronic medical illness in a client, immediate measures should be taken to address what can be done to improve quality of life; interventions to improve comfort level, happiness, social immersion, access to care, resources, support systems, etc., need to be explored.

Absence of hope, loneliness, lack of desire, negative reflection upon life, pessimistic personality, lack of control, and lack of satisfaction often dramatically decrease quality of life. Factors that negatively impact quality of life may include: chronic mental and physical diseases, physical, mental or spiritual decline, emotional setbacks, physical setbacks, inability, loss, negative affectivity, negative or debilitating symptoms, absence of successful intervention, fatigue, pain, fear, depression, absence of attention, absence of love, feeling unwanted, feeling inadequate, feeling unsuccessful, general insecurity, poor self-esteem, obesity, weight loss, etc.

Minute details can make major differences in quality of life and comfort level, such as: food selections to meet personal preference and to encourage comfort and well-being; décor to meet personal preference and to encourage happiness and relaxation; spa accessibility (such as hair, skin, nails, and massage) to improve outward appearance, sense of well-being, and happiness; and improvements to overall living environment to promote comfort, healing, and well-being. Professionals in aging can use results from quality of life assessments to identify and target problem areas that damage quality of life, create positive interventions, sustain and encourage positive contributing factors to quality of life, further develop individual sense of purpose, stimulate learning and self-expression, promote dignity, build connection with others, and encourage overall health and well-being.

Beyond formal quality of life assessment, quality of life can be measured through identification of what the “ideal life” consists of in the hearts and minds of the clients you are caring for and making decisions for. Guiding conversation to discover what matters and is important to your clients, identifying what is fulfilling to them, and recognizing areas in which you can build individual self-esteem is important for quality of life improvement. Just as important, if not more important than written questionnaires, verbal communication is a wonderful, effective way to assess quality of life and to determine areas that can be improved upon; the approach to quality of life assessment can and should be individualized, according to personality, ability, and preference.

In assessing quality of life, seek to determine whether or not your client is afraid of anything and attempt to work through their fears with them. Some older adults regularly struggle with feelings of impending doom or fear of the unknown; encouraging communication and exploration of fears while seeking to address fears can improve quality of life. While older adults with physical and mental limitations, chronic illness or disease and disabilities may not have the same possibilities as other individuals with full capacity, help them to identify what is possible—possibilities beyond their imagination that they are capable of. Extending life seems to be a common goal for researchers and medical providers, although just as important, if not more so, researchers and care providers should seek to improve the “life” in those years. Sadly, when quality of life is rapidly declining, many older adults—especially those suffering from chronic pain, physical and mental illness and disability—do not have the desire to live longer.

Further elements to consider when assessing and seeking to improve quality of life in older adults include: sexual health and activity, sleep patterns, dietary habits and nutritional needs, exercise levels and capability, hearing, vision, retirement status, and financial grounding. Dealing with gradual loss of hearing or vision that may occur with age or trauma, for example, can be a very difficult process both physically and emotionally. As an individual experiences gradual loss of ability or sensation in any aspect, regular communication and assistance from loved ones can make a world of difference. Those who experience loss of ability or sensation (in any form) may feel embarrassment, confusion, anxiety, fear, loneliness, etc. Professionals in aging can encourage methods of coping and connect clients with others who are going through some of the same experiences. Equipping clients with stress management tactics and guided techniques for handling stress and coping with depression is important for improved quality of life in older age—in particular, for clients dealing with mentally, emotionally, and physically altering conditions.

Professionals in aging must attempt to recognize unspoken signals, read body language, relate to, and understand client’s as they assess quality of life and seek to make positive interventions. For example, not all responses in conversation or through written questionnaires will be truthful and accurate due to uncomfortable subject matter, feelings of embarrassment, hurt, fear, or denial. Professionals in aging must demonstrate sensitivity and the ability to identify specific, individual areas of emotional pain, hurt, fear, discomfort, avoidance, etc. Individual quality of life can be significantly improved when a care professional can effectively identify unspoken, unaddressed areas of need. While older adults with physical and mental limitations, chronic illness or disease, and disabilities may not have the same possibilities as other individuals with full capacity, professionals in aging can help clients to identify what is possible and how purpose, meaning, dignity, and fulfillment can be found.


Crystal McGaha is working towards her MA in Gerontology with a concentration in Professional Geriatric Care Management through Nova Southeastern University. She has a BA in Complementary and Alternative Health with a minor in Human Resources Management. Her goal is to combine her knowledge in Alternative Health and Human Resources Management with Gerontology to offer the aging population unique, yet very important care initiatives, life planning, and health promotion opportunities. Crystal can be contacted via email or on LinkedIn.