Quality of Life in Norwegian Long-Term Care Services for Older Adults: An Interview Study Using the Adult Social Care Outcomes Toolkit (ASCOT)

Context: Increased knowledge on the quality of long-term care services from the care recipient’s perspective is needed to inform quality improvement, service development and priority setting. Objectives: The aim of the study was to describe care-related quality of life (CRQoL) in three types of Norwegian long-term care services using the Adult Social Care Outcomes Toolkit (ASCOT) and assess the contribution of these services to CRQoL. Methods: Data were collected in three municipalities from October 2022 to January 2024. We interviewed 185 people in nursing homes, 138 people in sheltered housing, and 148 people receiving home-based services with the ASCOT. Data were analysed with descriptive statistics, and ANOVA investigated differences between service types. Findings: The summed score for CRQoL was 18.6 (SD: 3.5, possible range 0–24) in nursing homes, 19.6 (SD: 3.3) in sheltered housing, and 19.0 (SD: 3.7) in home-based services. Care recipients reported higher CRQoL for the basic domains of food and drink, personal cleanliness and comfort, accommodation cleanliness and comfort, safety, and the dignity domain than for the higher-order domains of social participation, activity, and control over daily life. All services significantly improved CRQoL for all domains, and the contribution of care services to CRQoL increased with increasing service intensity. Limitations: Generalizability of results to small municipalities and home-dwelling care recipients with cognitive disabilities may be limited. Implications: Future research should investigate the causes behind differences between domains and service types.