Despite Symptom Severity, do Nursing Home Residents Experience Joy-of-Life? The Associations Between Joy-of-Life and Symptom Severity in Norwegian Nursing Home Residents

Abstract

Background: Finding new approaches to increase health and well-being among nursing home (NH) residents is highly warranted. From a holistic perspective, several Norwegian municipalities have implemented the certification scheme framed “Joy-of-Life Nursing Home” Aims: In a holistic perspective on NH care, this study investigated if NH residents despite potential symptom severity experience joy-of-life (JoL). Therefore, we examined the frequency of common symptoms and the association between common symptoms and JoL in cognitively intact NH residents. Methods: A cross-sectional design was employed. Using the QLQ-C15–PAL quality-of-life questionnaire, hospital anxiety and depression scale, and JoL scale, a total of 188 cognitively intact NH residents participated. Results: Symptom severity was high; 54% reported fatigue, 52% reported constipation, 45% reported pain, 43% reported dyspnea, 32% reported insomnia, 22% reported appetite loss, and 20% reported nausea, while 20% reported anxiety and 23% reported depressive symptoms. Nevertheless, 59% of the NH residents reported high JoL, which was significantly positively related to the quality of life and negatively associated with anxiety and depression.

Quality of life and nurse–patient interaction among NH residents: Loneliness is detrimental, while nurse–patient interaction is fundamental

“…Moving to a NH result from numerous losses, illnesses, disabilities, loss of functions and social relations and facing an end‐of‐life situation. Accordingly, the long‐term NH population is characterised by a high incidence of chronic illness and functional impairments (Hoben et al, 2016), multiple simultaneous and complex diagnoses with a severe symptom burden, impaired functioning, various losses and fewer social relationships (Haugan, 2014b; Rinnan et al, 2022; Söderbacka et al, 2017). All of these increase an individual's vulnerability and distress.…”

“…Furthermore, symptom severity seems constantly high; in 2009 (Haugan, 2014d) and 2018 (Rinnan et al, 2022) symptom severity was reported respectively as: 57% and 54% fatigue, 43% and 52% constipation, 49% and 45% pain, 41% and 43% dyspnoea, 38% and 32% insomnia, 25% and 22% appetite loss, 18% and 20% nausea, 12% and 20% anxiety and 30% and 23% reported depressive symptoms. Nevertheless, a recent study demonstrates that despite these ailments, about 50% of residents in Norwegian NHs report a high joy‐of‐life (Rinnan et al, 2022). Globally, anxiety and depression are commonly reported among NH residents (Beutel et al, 2017; Drageset & Haugan, 2021; Hawkley & Cacioppo, 2010); compared to older people living in their own homes NH residents report higher levels of depression and anxiety (Šare et al, 2021).…”

“…In Norway, about 86% of long‐term NH residents have extensive assistance needs; the mean residential stay is about one to two years, and annual mortality is about 40% (Norwegian Directorate of Health, 2020). Furthermore, symptom severity seems constantly high; in 2009 (Haugan, 2014d) and 2018 (Rinnan et al, 2022) symptom severity was reported respectively as: 57% and 54% fatigue, 43% and 52% constipation, 49% and 45% pain, 41% and 43% dyspnoea, 38% and 32% insomnia, 25% and 22% appetite loss, 18% and 20% nausea, 12% and 20% anxiety and 30% and 23% reported depressive symptoms. Nevertheless, a recent study demonstrates that despite these ailments, about 50% of residents in Norwegian NHs report a high joy‐of‐life (Rinnan et al, 2022).…”

Spiritual and existential care in nursing homes

“…V literaturi sta osamljenost in depresija opredeljeni kot faktorja tveganja, ki lahko ogrozita čustveno počutje starejših (Routsaldo et al, 2006;Savikko, 2008). Populacija DSO se sooča z visoko starostjo, šibkostjo, pridruženimi boleznimi, umrljivostjo, invalidnostjo, nemočjo, odvisnostjo, ranljivostjo, slabšim splošnim zdravjem in visokim simptomatskim bremenom (Haugan, 2014a;Rinnan et al, 2022), kar vodi v bivanje na zgolj preživetveni ravni (Hoben et al, 2016). Eksistencialno trpljenje stanovalcev DSO se odraža tudi v prisotnosti eksistencialnih vprašanj, kot so dokončnost življenja, socialna izolacija, osamljenost in pomanjkanje smisla (Sanderson & Scherbov, 2010;Drageset & Haugan, 2021).…”

“…Loneliness and depression have been identified as risks to the emotional well-being of older people (Routsaldo et al, 2006;Savikko, 2008). the NH population is characterised by advanced age, frailty, concurrent diagnoses, mortality, disability, powerlessness, dependency, vulnerability, poor general health and high symptom burden (Haugan, 2014a;Rinnan et al, 2022), which implies a highly existential state of living (Hoben et al, 2016). Consequently, existential issues such as the finality of life, social isolation, loneliness and meaninglessness are indicative of existential suffering among NH residents (Sanderson & Scherbov, 2010;Drageset & Haugan, 2021).…”