Lay theories of quality of life in older age

This paper presents findings from a national survey of quality of life (QoL) in older age. The main aim of the analyses was to examine the definitions of quality of life given by people aged 65 or more years and the underlying reasons. Open-ended questions were used to elicit their perceptions of QoL. These were followed by structured measures of self-rated QoL overall, and of domains of QoL commonly reported in the literature. The main things said by the respondents to give their lives quality were categorised into 'themes'. These were: social relationships; social roles and activities; leisure activities enjoyed alone; health; psychological outlook and wellbeing; home and neighbourhood; financial circumstances; and independence. The reasons people gave to explain why these things were important to their QoL focused on: the freedom to do the things they wanted to do without restriction (whether in the home or socially); pleasure, enjoyment and satisfaction with life; mental harmony; social attachment and having access to companionship, intimacy, love, social contact and involvement, help; social roles; and feeling secure. This paper also presents data that demonstrates the ability of theoretically informed, structured survey indicators of QoL to predict respondents' self-rated overall QoL. Logistic regression analyses showed that most of these indicators were strong, independent predictors of self-ratings of QoL, although those that were not significant in the model did not fully incorporate lay reasons of QoL in their measurement scales. In conclusion, the indicators which were not significant in the model did not fully incorporate lay values in their measurement properties. It is also likely that those indicators that were significant could have been improved.