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Soc Sci Med. 1990;30(11):1201-10.

Quality of everyday life in long stay institutions for the elderly. An observational study of long stay hospital and nursing home care.

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Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, England.


The observational study reported here was part of a wider evaluation of long stay care for elderly people. The observational study showed that it was essential not to rely on interview material alone. Qualitative techniques provided insights into behaviours, moods and interactions which would have been difficult to measure using traditional survey techniques. The data collected was analysed in relation to the theory of the total institution and disengagement theory. Although the survey data presented evidence of block treatment of individuals in both long stay hospital wards and smaller nursing homes for the elderly, the observational study showed that only the ward setting conformed closely to Goffman's concept of the total institution. In addition, the study indicated that involvement in activities and interaction with others promotes positive feelings among elderly people, and questions the validity of disengagement theory.

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