Factors Affecting Quality of Life in Nursing Homes

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Serious issues in nursing homes

Serious issues often develop in nursing homes because of diverse factors, affecting patients’ quality of life. Some of these issues include negligence, poor sanitation, understaffing, and observance of unhealthy dietary. Negligence in the nursing home usually occurs when nursing staff fails to provide the patients with the recommended standard of care. One of the factors that influence negligence includes understaffing of nurses and job dissatisfaction. The use of a high nurse-patient ratio usually affects the quality of care provided to the patients due to burnout. Similarly, job dissatisfaction influences high turnover rate in addition to poor quality care to the patients. The paper argues that some immediate measures need to be enforced by the government to improve the residents’ quality of life in nursing homes.

Nurse staffing and care quality

Nurse staffing influences the quality of care nurses provide to the patients. Charlene et al. (2) assert that staffing problems are the primary cause of poor care quality in nursing homes. They argue that low staffing levels usually increase the period of hospitalization and impairs with the functional ability of the patients (Charlene et al. 2). According to Charlene et al., high staffing levels among RNs contribute to improved care processes along with the functional ability improvement for the patients. Based on Charlene et al.’s argument, it is apparent that level of nurse staffing influences the quality of care provided to the patients. That is a high patient-nurse ratio as a result of understaffing leads to poor patient outcomes. It is as a result of this that many healthcare facilities record high mortality rate. Thus, the quality of care in the nursing homes can be improved by increases the number of nurses. Apart from increasing patient-nurse interaction, sufficient staff helps will help to uphold healthcare standards.

Higher nursing standards for staffing

One primary measure that can promote nurse staffing levels in nursing homes is the enforcement of higher standards of nursing. According to Charlene et al. (2), use of higher standards of nursing in the US contributed to the rise of staffing levels and decrease in urinary catheters and resident pressure ulcers. Similarly, they note that the introduction of nurse staffing law in California also resulted in the rise of nurses’ number in the nursing homes (Charlene et al. 2). From Charlene et al.’s findings, one can conclude that standards of nursing play a critical role in determining the nurse staffing levels in healthcare facilities. States, through the ministry of health, need to develop higher nurse staffing standards to oblige nursing homes to employ sufficient nurses. They also need to evaluate whether nursing homes comply with the provided standards.

Dietary intake and health outcomes

Similarly, the health outcomes of nursing homes residents are affected by dietary intake. Elderly persons in nursing homes are usually nutritionally vulnerable because of not only consuming insufficient energy but also reduced amounts of macro and micronutrients that are essential for maintaining their health and body function (Keller et al. 1). Keller et al. also indicate that poor intake of food and fluid is the primary reason for the observed long-term care malnutrition that results in falls, depression, and mortality (Keller et al. 2). Similarly, they argue that poor dietary habit impairs with the quality of life for the elderly persons in the nursing homes. From their findings, the majority of the residents in the nursing homes take less than 1500 kcal/day and approximately 70% of the residents consume less than the recommended amount protein, fibre, and other minerals such as magnesium and zinc (Keller et al. 2). The rate of falls and mortality in nursing homes is very high in the US. I noted the severity of the issue falls in one of the nursing homes that I visited recently. In that nursing home, the majority of the residents could manage to walk with the provided walking devices. They depended significantly on other persons to move within the home. Equally, I learned that many elderly persons in nursing homes could not manage to stand for few minutes or peal a fruit. In tandem with Keller et al.’s argument, I can conclude that poor intake of nutrients and foods influence rise of malnutrition in older people.

Improving the quality of meals

The quality of elderly persons’ life can be enhanced by improving the quality of meals they consume (Keller et al. 2). According to Keller et al., quality meal refers to the food and fluid that are culturally appropriate and appealing, served at the recommendable temperature, and meet the nutritional requirements of residents. Similarly, they assert that residents, as well as their families, often prefer the quality meal to nutritional supplements. Therefore, elderly persons usually consume a lot of quality food when compared with food replacements or nutritional supplements. With this understanding, nursing homes need to improve the quality of residents’ lives by providing them with the appropriate food. One measure that can facilitate this is introduction and enforcement of government policies concerning the improvement of foods consumed by residents. Apart from increasing funds for food in nursing homes, the government should enforce the observance of menu planning and feeding time (Keller et al. 3). Nursing homes observe the involvement of the government in ensuring appropriate dietary guidelines will significantly foster consumption of healthier diet by residents and as a result, improve their quality of life.

Job dissatisfaction and its impact

Many elderly persons in nursing homes are also subjected to health care risks because of healthcare providers’ job dissatisfaction. According to Matthew et al. (1), patients’ satisfaction level for the quality of care they receive is shallow when nurses are dissatisfied with their job. Moreover, they argue that approximately one-third of patients claim that they will not recommend friends and relative to the nursing homes they were admitted because of poor quality care. The experience of patients in nursing homes evidences the implacability of the Bill of Rights that advocate quality life. According to the bill, patients are entitled to quality services in nursing homes which they rarely receive (MDH 1). The main contributors to job dissatisfaction according to many nurses include the working conditions that are not appropriate for provision of safe and quality patient-centered care (Matthew et al. 2). Some nurses also cited certain things related to the jobs such as salaries, independence, and professional status as contributors to their job dissatisfaction and burnout (Matthew et al. 5). Also, (Matthew et al. 5) learned that about 60% of nurses working in nursing homes are dissatisfied with their health care as well as retirement benefits.

Assistive living technologies and communication barriers

However, some researchers note in their studies that inadequacy of assistive devices is the primary cause of health issues in nursing homes (Aloulou 2). Majority of the patients in the nursing homes lose their autonomy leading to them becoming excessively dependent on others (Aloulou 2). Within stage 3 and 5, patients experience progressive cognitive decline that reduces their ability to perform activities in their lives. From the argument, it is apparent that deficiency of assistive living technologies impairs with the old persons’ health in the nursing homes. Thus, providing patients with assistive living technologies will improve the quality of healthcare they receive. Similarly, some studies indicate that communication barriers affect the quality of care patients receive from healthcare providers (Hailu, Kassahun, and Kerie 2). Inaccurately communicated in addition to misunderstood information results in tension among staff nurses. It also contributes to provision of low quality care to the patients (Hailu, Kassahun, and Kerie 2). Thus, promoting communication between nurses and reducing communication barriers will promote the quality of healthcare provided to the patients.

Improving nurses' job satisfaction

The satisfaction level of nurses working in the nursing homes can be enhanced by improving their working conditions, reducing the patient-nurse ratio, and providing them with the substantive amount of health care and retirement benefits. According to Matthew et al. (7), nursing homes are likely to lose the services of nurses because of their attraction to other jobs outside the nursing homes. They also argue that nurses in the US constitute mainly the aged because of the low benefits associated with the nursing profession (Matthew et al. 7). Thus, improvement of the nursing benefits will influence retention of nurses in the nursing homes. Equally, it will attract many young people to the nursing profession besides encouraging nurses in the nursing homes to provide quality care to the residents. All these, however, can be achieved through addressing nurses’ concerns.

Using a structured process for quality care

The quality of care in nursing homes can also be improved by using a structured process. According to Minnesota Department of Health (MDH) (7), a structured process will improve both consistency and accuracy of care provided by the nurses to the patients. For instance, Complaint Investigation Process allows the government to identify problems that patients receive while in health care facilities (MDH 8). Similarly, they argue that use of surveys to collect feedback about the kind of care provided by the nurses to the residents will also improve healthcare standards in the nursing homes. Based on these arguments, one can conclude that the government should promote the use of structured processes that are believed to collect information on residents’ experiences in the nursing homes.


In conclusion, various factors related to nursing affects the quality of care nurses provide to the residents in the nursing homes. Understaffing results in burnout of nurses in addition to high turnover. Some nursing homes also provide residents with unhealthy dietary because of economic issues. The facilities fail to provide patients with quality foods because of their cost when compared with supplementary nutrients and alternative foods. Similarly, job dissatisfaction discourages nurses from providing patients with quality care. Some people, however, argue that patients’ Bill of Rights and job satisfaction contribute insignificantly to the quality of care. Despite their argument, it is recommendable for the government to introduce measures that address these problems to promote the quality of care patients receive from nurses. Government intervention will increase nurses’ job satisfaction besides making the working environment suitable for the provision of quality care.

Works Cited

Aloulou, Hamdi et al. Deployment of assistive living technology in a nursing home environment:   methods and lessons learned. BMC Medical Informatics and Decision Making, 2013.

Charlene, Harrington et al.  Nursing Home Staffing Standards and Staffing Levels in Six       Countries. Journal of Nursing Scholarship, 2012: 88-98.

Hailu, Fikadu, Kassahun, Chanyalew, and Kerie, Mirkuzie. Perceived Nurse—            PhysicianCommunication in Patient Care and Associated Factors in Public Hospitals of     Jimma Zone, South West Ethiopia: Cross Sectional Study. PLoS ONE, 2016.

Heather, Keller et al. Making the Most of Mealtimes (M3): protocol of a multi-centre cross-  sectional study of food intake and its determinants in older adults living in long term care         homes. Proquest, 2017.

Matthew, McHugh et al. Nurses' Widespread Job Dissatisfaction, Burnout, And Frustration With         Health Benefits Signal Problems For Patient Care. Health Affairs, 2011: 202-210.

Minnesota Department of Health. Annual Quality Improvement Report: The Nursing Home Survey Process. Health Regulation Division, 2013.

Minnesota Department of Health. Your Rights Under The Combined Federal and Minnesota       Residents Bill of Rights, 2007.

August 21, 2023

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