Background To assess health-related quality of life (QoL) of nursing home residents with dementia using the nursing staff and the residents' family members as proxy raters, to determine the level of agreement between both groups, and to analyze how functional independence, the number of challenging behaviors, nursing home suitability, and the rater group influence QoL assessments.Methods Nursing staff and family members assessed residents' QoL using the short version of the Quality of Life in

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... mentia (QUALIDEM) instrument. The nursing staff also assessed functional independence and the number of challenging behaviors, while nursing home suitability was assessed by the nursing staff and family members. Multiple linear regressions were run with each QoL dimension as the dependent variable.Results The agreement between nursing staff and family members on the QoL dimensions, for n=53 residents with dementia, was relatively poor, and for each QoL dimension, the reported scores were higher among the nursing staff. Residents' functional independence and the nursing home suitability were associated with a higher QoL, and more challenging behaviors were associated with a lower QoL, particularly according to the assessments of the nursing staff.Conclusion Including family members as an additional rater group is recommended as a valuable way to discuss and possibly improve quality of care and QoL. Keywords: nursing homes, health-related quality of life, proxy ratings