The term “quality of life” has many definitions. The definitions vary and are determined in a broad range, depending on the interpreter. A good understanding of this concept would be a measure that considers both the components and determinants of health and well being. This includes an emphasis on an individuals' physical, psychological, and spiritual functioning, their connections with their environment, and opportunities for maintaining and enhancing skills.
There are three major areas to consider when dealing with this concept: a person’s spiritual, physical, and psychological well-being. At the lowest level, physical comfort should be considered. This includes physical health, personal hygiene, nutrition, exercise, grooming, clothing, and general physical appearance. In addition to having these needs met, the ability to perform them without assistance is just as important. A person could have all of these needs met with assistance, but not feel the quality of life. Independence is the key to fulfilling this area of need. If a person is not self-sufficient in this area, the quality may not be met. A person’s ability to take care of their basic needs without assistance is tied into the physical, as well as the psychological aspects of well-being.
Psychological well-being is the next level of importance of the overall health of an individual. Psychological aspects include health and adjustment, cognitions, feelings, self-esteem, self-concept, and self-control and they are an all-encompassing part of the psychological area. If the individual is able to perceive a decline in any of these areas, the well-being in this area will be affected. For example, in the early stages of Alzheimer’s disease, a gradual decline in memory is perceived and the individual, knowing that this situation will only decline, is affected in the psychological sense. “Up to 70 percent of people who have Alzheimer's disease also have symptoms of depression. They gradually lose the ability to participate in activities they once enjoyed and may eventually withdraw from all activities” (www.mayoclinic.com). Knowledge of any existing disease can have a major psychological effect on an individual’s need to continue their normal activities of daily living. Understandibly, as stated, knowledge of any existing disease may cause an individual to “give up” life and, consequently, a decrease in their normal activities will also decrease.
Last, but not least, the spiritual side of an individual’s well-being is an important aspect of the individual as a whole. Depending on the individual, this may be the most important, but this varies from person to person. Any individual with a sense of higher purpose will consider this aspect to be the most important and least affected by physical ailments. Although, a life-threatening ailment may alter the significance or enhance this area of need. When any person encounters an illness that may suggest an end to life, spirituality is often an area that is in focus. Questions of the afterlife and what happens to a person’s spirit are often on a person’s mind in this scenario. Many ask the question, “Where will I go when I die?”
If a person is secure enough in their faith at the time then, normally, they are secure in the answer to this question. But, if they are not secure in this area of question, then more questions than answers arise and their spiritual well-being is in chaos. At this point, professional clergy is sought and, hopefully, some of the dilemmas are put to rest.
When a person becomes dependant on another, many aspects of a relationship come into play. First and foremost is trust. Depending on the relationship of one another, the aspects may be mostly trust issues, if any. Often, family members take on the care giving that is needed, but with this comes family dynamics. Dynamics also differs from one relationship to another, but without trust, dependency with always be an issue. With professional dependency, however, in a case of home health nursing, for example, the trust is based on professionalism rather than family cohesiveness.
This is a perfect time to consider what “quality of life” means to our aging population. The “Baby Boomers” of this country are aging rapidly at this point and this will be an issue for all of them, eventually. With the busy lifestyle that we have created in this country, we need to reevaluate whether we are worrying about the “important” things in life. If we don’t take care of our loved ones and set a good example for our youth, who will take care of us when we are in need? No one considers a nursing home lifestyle to be the ultimate goal. Most agree that the nursing home is not the favorable destination, due to its quality. But, most agree that having family incorporated into a daily schedule is conducive to a “well-being” lifestyle.