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What does quality of life mean to older adults?

BACKGROUND: Consideration of older adults' quality of life (QoL) is becoming increasingly important in the evaluation, quality improvement and allocation of health and social care services. While numerous definitions and theories of QoL have been proposed, an overall synthesis of the perspective of older adults themselves is lacking.METHODS: Qualitative studies were identified in PubMed, Ebsco/Psycinfo and Ebsco/CINAHL, through a search on 28 November 2018. Articles needed to meet all of the following criteria: (i) focus on perceptions of QoL, (ii) older adults living at home as main participants, (iii) use of qualitative methodology, (iv) conducted in a Western country and (v) published in English (vi) not focused on specific patient groups. A thematic synthesis was conducted of the selected studies, using the complete 'findings/results' sections from the papers.RESULTS: We included 48 qualitative studies representing the views of more than 3,400 older adults living at home in 11 Western countries. The QoL aspects identified in the synthesis were categorized into nine QoL domains: autonomy, role and activity, health perception, relationships, attitude and adaptation, emotional comfort, spirituality, home and neighbourhood, and financial security. The results showed that although different domains can be distinguished, these are also strongly connected.CONCLUSION: QoL can be expressed in a number of domains and related subthemes that are important for older adults living at home. The findings further support that the concept of QoL should be seen as a dynamic web of intertwined domains.

Successful ageing, spirituality and meaning: mulit-disciplinary perspectives

Materializing spirituality – an Interview with Tadao Ando.

Successful ageing and spirituality

Leisure, spirituality and meaning

‘That’s Witchcraft’

This paper theorizes the spiritual processes of community entrepreneuring as navigating tensions that arise when community-based enterprises (CBEs) emerge within communities and generate socio-economic inequality. Grounded on an ethnographic study of a dairy CBE in rural Malawi, findings reveal that intra-community tensions revolve around the occurrence of ‘bad events’ – mysterious tragedies that, among their multiple meanings, are also framed as witchcraft. Community members prepare for, frame, cope and build collective sustenance from ‘bad events’ by intertwining witchcraft and mundane socio-material practices. Together, these practices reflect the mystery and the ambiguity that surround ‘bad events’ and prevent intra-community tensions from overtly erupting. Through witchcraft, intra-community tensions are channelled, amplified and tamed cyclically as this process first destabilizes community social order and then restabilizes it after partial compensation for socio-economic inequality. Generalizing beyond witchcraft, this spiritual view of community entrepreneuring enriches our understanding of entrepreneuring – meant as organization-creation process in an already organized world – in the context of communities. Furthermore, it sheds light on the dynamics of socio-economic inequality surrounding CBEs, and on how spirituality helps community members to cope with inequality and its effects.