Factors Affecting Well-Being and Quality of Life From the Perspective of People With Moderate-To-Severe Dementia: A Qualitative Evidence Synthesis.

In 30 seconds

This systematic review and qualitative thematic synthesis examined what people with moderate-to-severe dementia consider important for well-being and quality of life. It included five qualitative studies, all conducted in residential care homes, using face-to-face conversational interviews. Three themes concerned residents’ feelings about their lives in the home, the care home itself, and their sense of self. Across these themes, positive connections with past and present personal identity were central. The review concludes that people with moderate-to-severe dementia can communicate preferences and wishes, and that support for identity, pleasurable activities, and positive reminiscence may help sustain well-being.

Key findings

• The synthesis included five qualitative studies, all conducted in residential care homes.
• Three themes addressed residents’ lives in the home, the care home environment, and their feelings about themselves.
• Positive associations with past and present personal identity were the overarching influence on well-being and quality of life.
• The review found that people with moderate-to-severe dementia can communicate preferences and wishes.

Why it matters

The findings highlight that quality of life in moderate-to-severe dementia is not captured solely by physical or daily care needs. Residents’ own perspectives can inform support that preserves identity and creates opportunities for pleasure and meaningful connection. Recognising that people can express preferences may help care teams and families include them in decisions about everyday life, even when dementia is advanced.

What to keep in mind

The synthesis included only five studies, all from residential care homes, so its findings may not reflect experiences in other settings.