Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-24T17:37:42.008Z Has data issue: false hasContentIssue false

Engagement with life among the oldest-old in assisted living facilities: enriching activities and developmental adaptation to physical loss

Published online by Cambridge University Press:  26 October 2020

Jordan Boeder*
Affiliation:
School of Social Science, Policy & Evaluation, Division of Behavioural and Organizational Sciences, Claremont Graduate University, Claremont, California, USA
Sarah Hwang
Affiliation:
Health Equity Research and Education Centre, California State University, Northridge, California, USA
Thomas Chan
Affiliation:
Health Equity Research and Education Centre, California State University, Northridge, California, USA
*
*Corresponding author. Email: jordan.boeder@cgu.edu

Abstract

The objective of this study was to examine the activities, motivations, and barriers of activity engagement in the oldest-old residing in assisted living facilities (ALFs). Semi-structured interviews were conducted with 20 participants, aged 80–94 (standard deviation = 4.38), from two ALFs. Thematic analyses were used to identify and corroborate clusters of experiences. All residents stated that they desired enriching activities, most often in the form of productive work or community events. Although engaging in enriching activities was a universal desire, residents who experienced more functional limitations had an increased difficulty satisfying this need. Participants believed that activities offered by the ALF primarily served those who are cognitively impaired. ALF residents with severe mobility issues were not able to access more enriching activities outside the ALF compared to those with fewer physical limitations. However, the more physically impaired residents used a range of adaption methods that fit into the selection, optimisation, and compensation framework to overcome barriers to participate in meaningful activities. ALF residents who are cognitively fit but experience severe mobility limitations may be the most in need of enriching activities. To help these residents maintain a high quality of life, ALFs need to provide activities that appeal to residents of varying cognitive abilities and provide interventions to help aid their adaption to physical loss.

Type
Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Atchley, RC (1989) A continuity theory of normal aging. The Gerontologist 29, 183190.CrossRefGoogle ScholarPubMed
Ball, MM, Perkins, MM, Whittington, FJ, Connell, BR, Hollingsworth, C, King, SV, Elrod, CL and Combs, BL (2004) Managing decline in assisted living: the key to aging in place. Journals of Gerontology: Psychological Sciences and Social Sciences 59B, S202S212.CrossRefGoogle Scholar
Baltes, PB (1997) On the incomplete architecture of human ontogeny: selection, optimization, and compensation as foundation of developmental theory. American Psychologist 52, 366380.CrossRefGoogle ScholarPubMed
Baltes, PB and Baltes, MM (eds) (1993) Successful Aging: Perspectives from the Behavioral Sciences, Vol. 4. Cambridge: Cambridge University Press.Google Scholar
Baltes, PB and Smith, J (2003) New frontiers in the future of aging: from successful aging of the young old to the dilemmas of the fourth age. Gerontology 49, 123135.CrossRefGoogle Scholar
Bandura, A (1997) Self-efficacy: The Exercise of Control. New York, NY: W.H. Freeman.Google Scholar
Banister, D and Bowling, A (2004) Quality of life for the elderly: the transport dimension. Transport Policy 11, 105115.CrossRefGoogle Scholar
Bath, PA and Deeg, D (2005) Social engagement and health outcomes among older people: introduction to a special section. European Journal of Ageing 2, 2430.CrossRefGoogle ScholarPubMed
Bengtsson, M (2016) How to plan and perform a qualitative study using content analysis. NursingPlus Open 2, 814.CrossRefGoogle Scholar
Boyatzis, RE (1998) Transforming Qualitative Information: Thematic Analysis and Code Development. Thousand Oaks, CA: Sage.Google Scholar
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77101.CrossRefGoogle Scholar
Cho, J, Martin, P and Poon, LW (2015) Successful aging and subjective well-being among oldest-old adults. The Gerontologist 55, 132143.CrossRefGoogle ScholarPubMed
Cornwell, EY and Waite, LJ (2009) Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior 50, 3148.CrossRefGoogle ScholarPubMed
Cotton-Bronk, K, Hill, PL, Lapsley, DK, Talib, TL and Finch, H (2009) Purpose, hope, and life satisfaction in three age groups. Journal of Positive Psychology 4, 500510.CrossRefGoogle Scholar
Crews, JE and Campbell, VA (2001) Health conditions, activity limitations, and participation restrictions among older people with visual impairments. Journal of Visual Impairment and Blindness 95, 453467.CrossRefGoogle Scholar
Cummings, SM (2002) Predictors of psychological well-being among assisted-living residents. Health and Social Work 27, 293302.CrossRefGoogle ScholarPubMed
Damon, W, Menon, J and Cotton-Bronk, K (2003) The development of purpose during adolescence. Applied Developmental Science 7, 119128.CrossRefGoogle Scholar
Dattilo, J, Lorek, AE, Mogle, J, Sliwinski, M, Freed, S, Frysinger, M and Schuckers, S (2015) Perceptions of leisure by older adults who attend senior centers. Leisure Sciences 37, 373390.CrossRefGoogle Scholar
Erikson, EH (1982) The Life Cycle Completed. New York, NY: Norton.Google Scholar
Freelove-Charton, J, Bowles, HR and Hooker, S (2007) Health related quality of life by level of physical activity in arthritic older adults with and without activity limitations. Journal of Physical Activity and Health 4, 482495.CrossRefGoogle ScholarPubMed
Freund, AM and Baltes, PB. (1998) Selection, optimization, and compensation as strategies of life management: Correlations with subjective indicators of successful aging. Psychology and Aging 13(4), 531543. http://dx.doi.org/10.1037/0882-7974.13.4.531.CrossRefGoogle ScholarPubMed
Herron, RV, Funk, LM, Spencer, D and Wrathall, M (2020) Assisted living facilities as sites of encounter: implications for older adults’ experiences of inclusion and exclusion. Ageing & Society 40, 15771593.CrossRefGoogle Scholar
Horowitz, BP and Vanner, E (2010) Relationships among active engagement in life activities and quality of life for assisted-living residents. Journal of Housing for the Elderly 24, 130150.CrossRefGoogle Scholar
Hummert, ML. (2011) Age stereotypes and aging. In Schaie, K.W. and Willis, S.L. (eds). Handbook of the Psychology of Aging. San Diego, CA: Academic Press, pp. 249262.CrossRefGoogle Scholar
Hyde, J, Perez, R and Forester, B (2007) Dementia and assisted living. The Gerontologist 47, supplement 1, 5167.CrossRefGoogle ScholarPubMed
Jang, Y, Bergman, E, Schonfeld, L and Molinari, V (2006) Depressive symptoms among older residents in assisted living facilities. International Journal of Aging and Human Development 63, 299315.CrossRefGoogle ScholarPubMed
Jansson, AH, Karisto, A and Pitkälä, KH (2021) Time- and place-dependent experiences of loneliness in assisted living facilities. Ageing & Society 41, 628644.CrossRefGoogle Scholar
Jeste, DV, Depp, CA and Vahia, IV (2010) Successful cognitive and emotional aging. World Psychiatry 9, 7884.CrossRefGoogle ScholarPubMed
Kahn, RL (2002) On ‘Successful aging and well-being: self-rated compared with Rowe and Kahn’. The Gerontologist 42, 725726.CrossRefGoogle Scholar
Kerstetter, DL, Yarnal, CM, Son, JS, Yen, IY and Baker, BS (2008) Functional support associated with belonging to the Red Hat Society®, a leisure-based social network. Journal of Leisure Research 40, 531555.CrossRefGoogle Scholar
Krippendorff, K (2004) Content Analysis: An Introduction to Its Methodology. Thousand Oaks, CA: Sage.Google Scholar
Lees, FD, Clark, PG, Nigg, CR and Newman, P (2005) Barriers to exercise behavior among older adults: a focus-group study. Journal of Aging and Physical Activity 13, 2333.CrossRefGoogle ScholarPubMed
Luo, Y, Hawkley, LC, Waite, LJ and Cacioppo, JT (2012) Loneliness, health, and mortality in old age: a national longitudinal study. Social Science & Medicine 74, 907914.CrossRefGoogle ScholarPubMed
Lyons, K and Dionigi, R (2007) Transcending emotional community: a qualitative examination of older adults and masters’ sports participation. Leisure Sciences 29, 375389.CrossRefGoogle Scholar
Matz-Costa, C, Besen, E, Boone James, J and Pitt-Catsouphes, M (2012) Differential impact of multiple levels of productive activity engagement on psychological well-being in middle and later life. The Gerontologist 54, 277289.CrossRefGoogle ScholarPubMed
Menec, VH (2003) The relation between everyday activities and successful aging: a 6-year longitudinal study. Journals of Gerontology: Psychological Sciences and Social Sciences 58B, S74S82.CrossRefGoogle Scholar
Michael, YL, Green, MK and Farquhar, SA (2006) Neighborhood design and active aging. Health & Place 12, 734740.CrossRefGoogle ScholarPubMed
Nakamura, J (2001) The nature of vital engagement in adulthood. New Directions for Child and Adolescent Development 93, 518.CrossRefGoogle Scholar
National Center for Assisted Living (2009) 2009 Overview of Assisted Living. Washington, DC: American Health Care Association. https://www.ahcancal.org/ncal/facts/Documents/09%202009%20Overview%20of%20Assisted%20Living%20FINAL.pdf.Google Scholar
National Center for Education Statistics (2018) The Condition of Education 2018 (NCES 2018-144). Washington, DC: US Department of Education, National Center for Education Statistics. Available at https://nces.ed.gov/programs/coe/indicator_caa.asp.Google Scholar
National Center for Health Statistics (2019) Long-term Care Providers and Services Users in the United States, 2015–2016 (Series 10, No. 2019-1427). Hyattsville, MD: DHHS. Available at https://www.cdc.gov/nchs/fastats/residential-care-communities.htm.Google Scholar
Perkins, MM, Ball, MM, Whittington, FJ and Hollingsworth, C (2012) Relational autonomy in assisted living: a focus on diverse care settings for older adults. Journal of Aging Studies 26, 214225.CrossRefGoogle ScholarPubMed
Petriwskyj, A, Gibson, A and Webby, G (2018) What does client ‘engagement’ mean in aged care? An analysis of practice. Ageing & Society 38, 13501376.CrossRefGoogle Scholar
Reed, AE and Carstensen, LL (2012) The theory behind the age-related positivity effect. Frontiers in Psychology 3, 339.CrossRefGoogle ScholarPubMed
Riley, MW and Riley, JW (1986) Longevity and social structure: the added years. Daedalus 115, 5175.Google Scholar
Rowe, JW and Kahn, RL (1997) Successful aging. The Gerontologist 37, 433440.CrossRefGoogle ScholarPubMed
Ryan, RM and Deci, EL (2000) Intrinsic and extrinsic motivations: classic definitions and new directions. Contemporary Educational Psychology 25, 5467.CrossRefGoogle ScholarPubMed
Shankar, A, McMunn, A, Demakakos, P, Hamer, M and Steptoe, A (2017) Social isolation and loneliness: prospective associations with functional status in older adults. Health Psychology 36, 179187.CrossRefGoogle ScholarPubMed
Silverstein, M and Parker, MG (2002) Leisure activities and quality of life among the oldest old in Sweden. Research on Aging 24, 528547.CrossRefGoogle Scholar
Stevenson, DG and Grabowski, DC (2010) Sizing up the market for assisted living. Health Affairs 29, 3543.CrossRefGoogle ScholarPubMed
Strauss, A and Corbin, J (1990) Basics of Qualitative Research. Thousand Oaks, CA: Sage.Google Scholar
Sugarhood, P, Eakin, P and Summerfield-Mann, L (2017) Participation in advanced age: enacting values, an adaptive process. Ageing & Society 37, 16541680.CrossRefGoogle Scholar
Van den Bogaard, L, Henkens, K and Kalmijn, M (2014) So now what? Effects of retirement on civic engagement. Ageing & Society 34, 11701192.CrossRefGoogle Scholar
Watson, LC, Garrett, JM, Sloane, PD, Gruber-Baldini, AL, and Zimmerman, S (2003) Depression in assisted living: results from a four-state study. American Journal of Geriatric Psychiatry 11, 534542.CrossRefGoogle ScholarPubMed
White, RW (1959) Motivation reconsidered: the concept of competence. Psychological Review 66, 297333.CrossRefGoogle ScholarPubMed