All the difference in the world. One way of looking at it is that
"quality of care" is largely external and quantitative. "Quality of
life" is largely internal (specific to the individual) and
qualitative. Just speaking from personal experience (I work for a
health care organization and my mom's in an asisted living facility),
"quality of care" might be measured in such things as number of
attendants per individual, number of times a week one is bathed, and
so forth. One government agency (HHS, I think; maybe CMS) has begun
posting such statistics on its Web site.
Quality of life is the patient's perception. And, in the same
facility, receiving the same quality of care, one patient's quality of
life may be perceived (by that patient) as very good; another may
perceive it as poor. One patient might have been an avid golfer all
his life and because he now is unable to golf, he might rate the
physical activity performance of his life as poor. Another patient may
have had a stroke and now is learning to walk with a walker. That
patient may be delighted at the progress she's making, and rate her
ability to perform physical activities as good and improving. The
first patient, objectively, is able to perform far more physical
activities than the second. However, the second, subjectively, is far
more pleased with that aspect of her life than the first.
One other thought, slightly off-topic but perhaps still relevant. Many
long-term care facilities seem designed more for the children of the
patients--to impress the children--than for the patients themselves.
My sister and I recently transferred my mom from a nice, fancy, really
impressive facility to an adquate but much more plain facility. No
soaring ceilings, no elaborate window treatments...things that
initially impressed us about the first facility. But it turned out our
mom didn't really notice those things. She noticed that her room
didn't have a light in the ceiling, making it difficult for her to
read. The first facility had some beautiful grounds...but residents
couldn't go outside unaccompanied. The second facility has adequate
grounds, but residents can go outside whenever they want. And the
second facility has waist-high planters for residents who want to
plant flowers or vegetables...whereas the first one didn't. Both
facilities have good "quality of care" but the second is far more
likely to contribute to a higher "quality of life."
Hope that helps.