Care home residents on the move: the significance of cultural context for physical activity

Alison Bowes,Louise Mccabe,Ruth Jepson,Alison Dawson,Corinne Greasley-Adams

doi:10.1017/s0144686x20001920

Abstract

AbstractIncreased physical activity is widely promoted as beneficial for older people, but previous research indicates this may be difficult to implement in care homes, especially for people with dementia who form an increasing proportion of residents. Care home cultures can mitigate against physical activity for residents, but there is also scope for them to embed personalised physical activity. They are under-researched, but significant in terms of outcomes and quality of life for residents. This paper builds understanding of care home cultures of physical activity through qualitative, empirical research in five care homes. Key findings are that culturally framed views about physical activity, sometimes reflecting stereotypical views of dependency, can be seen in care homes. Managers, staff and residents may be invested in or resistant to physical activity and dominant managerial or societal views may be reflected or contested. The relatively closed boundaries of care homes reinforce sedentariness, and resident involvement in either chosen or enforced physical activity is varied. Interactions demonstrate potential to negotiate physical activity more or less effectively in any given care home. Rigid routines, external regulations and pressure on staffing can be negative, but management commitment has positive potential. In conclusion, the paper identifies that to increase physical activity in a sustainable manner, any intervention needs to address issues of culture change and individual needs and preferences.

Highlights

Physical activity has been promoted as a means of improving cognition, mood, behaviour and physical condition for care home residents, notably those living with dementia
Our presentation of the findings reflects the core themes that emerged from the data analysis. They build a description and understanding of how movement is played out in care home cultures, that is, how it is underpinned by values, facilitated or constrained by boundaries, performed in everyday actions and interactions, and contextualised in the organisation
Beliefs and values Beliefs and values about movement in older age were expressed in all five care homes

Summary

Introduction

Physical activity has been promoted as a means of improving cognition, mood, behaviour and physical condition for care home residents, notably those living with dementia. The present paper develops discussion of care home cultures into the particular area of physical activity In doing so, it draws on the theoretical work of classic anthropologists such as Geertz (2017), who saw culture as fundamental to social life, providing ways of seeing the world that guide actions, including interpersonal interactions and the workings of organisations. Phoenix and Tulle (2017) have argued, that physical activity is increasingly considered both a cultural and a personal dimension of ageing They reference multi-disciplinary research focusing on the contexts of physical activity, what people do and their experiences of it. Contextualised in societal attitudes to ageing, experiences and expressions of physical activity emerge as profoundly culturally influenced

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