Care Partner Wednesday–What is Quality of Life?



What makes life worth living?

(If you answered “coffee in the morning” I’m with you on that, but we’re going a little deeper here.)

What are the essential elements that make you feel complete, fulfilled, contented, whole?

Do you need to have full mental capacity to have quality of life? Does it disappear after a certain age?

The Eden Alternative identifies seven domains of well-being that are universal. Anyone of any age could relate to these, but several of them can be absent in the elderly, especially those who are living in institutions. People with dementia are often not able to communicate their feelings as well as they used to.  If they are missing some of the domains of well-being, they may communicate that loss through actions.  In an institutional setting, we call these actions “behaviours.” Aggression, anxiety, wandering are part of a long list of (undesirable) behaviours, and often the solution is psychotropic medication. While there is a place for medications when dealing with depression, anxiety and other issues, there is also a place for looking at root causes. 

Perhaps we need to ask the question, “Why?” It’s not always apparent, but sometimes it’s possible to find out why a person is acting a certain way. Essential emotions may be missing from their lives, causing them to act out.
Here are the seven domains of well being:

* Identity
* Growth
* Autonomy
* Security
* Connectedness
*Meaning
* Joy 1

What do they mean? What does it look like (or feel like) when they are present and what might happen, especially to someone with dementia, when one or more is missing?

We’re going to explore these in the coming weeks.

Think about this. What would happen, if every time an elderly person displayed a difficult action, we asked, “what domain of well-being is missing?” And when we identified what was missing, what would happen if we asked, “how can we restore (identity, security etc.) to that person?

I’m not claiming magic here. All aggression, anxiety, wandering, depression and other symptoms don’t always suddenly disappear. But often, they do. Often the only “medication” needed is to feel known as a valuable person, to have meaningful connection to another , or to have the ability to make independent choices.

We’re going to examine the domains of well-being in the coming weeks. We’ll look at what they mean, and what it means in an elder’s life if one or many of them are missing. 

We’ll ask a vital question: how do I return this domain to my loved one’s life?


1. http://edenalt.org/wordpress/wp-content/uploads/2009/06/EdenWell-BeingWhitePaperv5.pdf

CONTINUE THE CONVERSATION: What does quality of life, or well-being, mean to you?