Quality and Quality of Life

There have been numerous efforts to measure quality of health care, especially among the elderly.  For instance, Nursing Home Compare measures of quality of care for nursing homes.  However, these quality measures focus on health and safety.  They do not measure quality of life.  Atul Gawande’s book Being Mortal describes why nursing homes focus more on patient safety and less on quality of life.

Compounding matters, we have no good metrics for a [nursing home’s] success in assisting people to live.  By contrast, we have very precise ratings for health and safety.  So you can guess what gets the attention from the people who run places for the elderly: whether Dad loses weight, skills his medications, or has a fall, not whether he’s lonely…assisted living isn’t really built for the sake of older people so much as for the sake of their children.

Children of the elderly focus more on safety than their parents’ satisfaction; they will do anything to avoid a fall from their parents, whereas elderly parents often are willing to tradeoff more autonomy for a higher risk of a fall.

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