Caring, Quality of Life and Service provision: a perspective

This paper features Quality of Life (QoL) assessment in care provision, including the author’s own research with Alzheimer’s Disease and residential and day care services for adults with Learning Disabilities. Features of epistemology, methodology and methods are examined which may be unchallenged in the rush for objective empirical data. These unquestioned features may impede the development of theory and practice in this field. Questions include: What is meant by QoL in this type of highly artificial socially complex environment? What are the underlying assumptions in the way QoL is measured? Have underlying philosophical assumptions informed theory and aided understanding of QoL? What about the beliefs and attitudes of front line staff, those involved with clients? How do political, policy and other aspects of ‘praxis’ operate in caring environments? Rather than QoL and embedded services being measured in empirical terms, there is space available for a constructionist conceptualization; the latter need not sit uneasily with the former. The reality of, and within, care delivery processes should be challenged. Elements of hermeneutic enquiry and phenomenological psychology could help decipher the manifestations of the above phenomena, via accounts of the lived experiences and personal accounts of staff and carers