Want to Improve Quality of Life for Nursing Home Residents? Focus on These 3 Key Needs

The psychological theory of self-determination suggests that our needs for autonomy, relatedness, and feeling effective (competency) are key elements of human well-being. A recent longitudinal study looked at what role the satisfaction of these needs played in nursing home residents’ quality of life, and whether high satisfaction on one need can compensate for low satisfaction on another.

This study of 138 nursing home residents with an average age of 85 assessed their satisfaction on each of the needs identified by self-determination theory and looked at the association of each need’s satisfaction with residents’ scores on the Geriatric Depression Scale and the Satisfaction with Life Scale five to eight months later. In addition to looking at each need separately, the researchers calculated a “balance score” that looked at how much discrepancy there was between satisfaction scores for autonomy, relatedness, and competence.

Looking at the residents’ scores on the three needs, researchers found that residents overall had significantly higher satisfaction scores for relatedness and autonomy than for feeling effective. Autonomy and connectedness were also found to be highly correlated with each other, while the correlation between competence and the other two needs was only weak to moderate. Balance scores between the needs were highly variable.

Five to eight months later, each of the three needs’ scores were correlated with depression High autonomy scores was most strongly correlated with low depression scores, while the association for competence was moderate and for relatedness was only weakly correlated. As for life satisfaction, higher autonomy scores had a moderate association with higher life satisfaction, whereas relatedness was more weakly associated with life satisfaction. The researchers also found that a bigger discrepancy between autonomy and relatedness scores was associated with worse scores for both depression and satisfaction.

Although autonomy has the strongest association with well-being, professionals serving older adults need to not only find ways to increase or enhance older adults’ autonomy; they should avoid focusing on autonomy at the expense of the other two psychological needs.



Kloos N, Trompetter HR, Bohlmeijer ET, et al. Longitudinal associations of autonomy, relatedness, and competence with the well-being of nursing home residents. The Gerontologist. (2018). DOI: 10.1093/geront/gny005

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