Engagement In Meaningful Activities Research Articles

Examining Meaningful Activity Engagement for Residents in Assisted Living (MAC-4-BSD)

Examining Meaningful Activity Engagement for Residents in Assisted Living (MAC-4-BSD)

"I Want to Do Something" - Exploring What Makes Activities Meaningful for Community-Dwelling People Living With Dementia: A Focused Ethnographic Study.

Supporting ageing in place, quality of life, and activity engagement are public health priorities for people with dementia. The importance of maintaining opportunities for meaningful activities has been widely acknowledged for those with dementia in long-term care, but little is known about what makes activities meaningful for, and how they are experienced by, people with different types of dementia in their own homes. This study used focussed ethnographic methods to explore the motivations and meanings of everyday activity engagement within the homes of 10 people with memory-led Alzheimer's disease and 10 people with posterior cortical atrophy. While participants' interactions with their everyday environments were challenged by their diagnoses, they were all finding ways to continue meaning-making via various activities. The main findings are encapsulated in three themes: (1) The fun and the function of activities; (2) Reciprocities of care, and (3) The constitution and continuity of (a changing) self. Ongoing engagement with both fun and functional activities offered participants living with different dementias opportunities to connect with others, to offer care and support (as well as receive it), and to maintain a sense of self and identity. Implications are discussed regarding the development and delivery of tailored interventions and support to enable continued engagement in meaningful activities for people with different types of dementia living in the community.

Examining pain, function, behavioral symptoms and associations with engagement in meaningful activity for residents with dementia in assisted living

Objectives The purpose of this study was to examine factors associated with engagement in meaningful activity among residents with dementia in assisted living. We hypothesized that greater functional independence, less pain, and lower behavioral and psychological symptom severity would be associated with higher engagement in meaningful activity after controlling for residents’ age, gender, comorbidities, and cognition. Understanding factors associated with engagement in meaningful activity can help to inform strategies for optimizing engagement among residents with dementia in assisted living. Method This descriptive study used baseline data from a randomized controlled trial, Meaningful Activity for Managing Behavioral Symptoms of Distress (MAC-4-BSD). Linear regression was used to examine factors associated with engagement in meaningful activity. Results A total of 71 residents from 5 assisted living settings were included in the sample. Most participants were female (n = 52, 73%), White (n = 62, 87%), and mean age was 85 years old (SD = 8.2). Controlling for age, gender, comorbidities, and cognition, pain was significantly associated with engagement in meaningful activity (b= −2.09, p < 0.05). There were no associations found between function and behavioral symptoms with engagement in meaningful activity. Conclusion Findings from this study show that pain is a significant factor that is negatively associated with residents’ engagement in meaningful activity. Ongoing research is needed to help improve pain management for residents with dementia in assisted living and support their engagement in meaningful activity.

Engagement in Meaningful Activity Mediates the Relationship Between Stressful Life Events and Functional Resilience.

Resilience during stressful life events is a priority for administering the most client-centered care as possible. Occupational therapy practitioners have the unique opportunity to support resilience through promoting meaningful participation. The current study aims to understand the associations between meaningful activity engagement, resilience, and stressful life events. We specifically focused on answering if meaningful participation mediates the relationship between stressful life events and resilience. 492 participants from a non-clinical convenience sample of Amazon's MTurk completed the study. Participants completed an online survey and reported their experiences of stressful life events, resilience, well-being, and meaningful participation. We used SPSS and PROCESS to analyze our data. Stressful event severity and resilience were inversely related. When accounting for the effect of meaningful participation, the relationship became non-significant, indicating evidence of mediation. Implications: Focusing on measuring meaningful participation may be worth studying in further research.

Effectiveness of Interventions for Meaningful Activity Participation in Homelessness: A Systematic Review.

Background. Meaningful activity participation has been identified as a key outcome of services designed to support individuals during and following homelessness. Little is known about the effectiveness of interventions for promoting this outcome. Purpose. To identify the range and effectiveness of interventions on promoting meaningful activity participation among persons with experiences of homelessness. Method. We conducted a systematic review using the Joanna Briggs Institute methodology following PRISMA guidelines including a critical appraisal and narrative synthesis. Findings. Of 12,343 titles and abstracts screened, we included 12 studies. The authors of the included studies primarily used standardized measures of meaningful activity engagement. Critical appraisal scores ranged from 50.0 to 77.8. The most common interventions evaluated in the included studies were psychosocial interventions (n = 6; 50.0%), followed by case management and housing support interventions (n = 4; 33.3%) and Housing First (n = 2; 16.7%). While several interventions demonstrated effectiveness in promoting meaningful activity participation including psychosocial and case management interventions, Housing First, Critical Time Intervention, and a peer support intervention were found to be ineffective for promoting engagement in meaningful activity. Conclusion. Few intervention studies have been conducted that demonstrate effectiveness for promoting participation in meaningful activity for individuals during and following homelessness. Occupational therapy researchers and practitioners can build on existing evidence by developing and evaluating novel approaches by co-designing interventions in collaboration with persons with experiences of homelessness and service providers.

Engagement in meaningful activities post suicide loss: A scoping review protocol.

Each day, more than 10 Canadians die by suicide. Each suicide leaves entire communities to manage the traumatic aftermath of this loss. Individuals bereaved by suicide loss are at a higher risk of experiencing negative mental health outcomes. Current research suggests that engagement in meaningful activities may be an avenue to protecting mental health. It is important to understand if this is also the case for those experiencing bereavement post suicide loss. To date, there has not been a synthesis of the literature examining suicide loss and the nature and extent of engagement in meaningful activities post loss. 1) To describe the nature and extent of the peer-reviewed suicide loss and bereavement literature related to engagement in meaningful activities; and 2) to identify facilitators and barriers that may impact engagement in meaningful activities post loss. This paper describes a scoping review protocol that will be completed using stages identified by Arksey and O'Malley and updated by Levac and colleagues. Joanna Briggs Institute framework will also guide this review. Four electronic databases will be searched for suicide bereavement/loss concepts. Two reviewers will apply inclusion and exclusion criteria to identify articles discussing engagement in meaningful activities of everyday living post loss. Data will be descriptively summarized and analyzed using inductive content analysis. Results will be reported following PRISMA Extension for Scoping Reviews. A descriptive summary and conceptual map describing the current state of the peer-reviewed literature will be constructed. Experiencing a suicide loss increases the risk of negative mental health outcomes. A synthesis of literature is required to map the current available evidence related to suicide bereavement and engagement in meaningful activities, with potential implications for improving supports and services for those bereaved. This protocol is register with Open Science Framework Registries (10.17605/OSF.IO/M2NES).

A Systematic Review of Occupational Therapy Care Programs for Dementia Patients: Accomplishments and Suggestions for Improvement

The primary goal of the present study was to critically review previous research on an increasingly important role that occupational therapy (OT) plays in dementia care. OT interventions such as cognitive training, memory strategies, and engagement in meaningful activities have been shown to improve cognitive function in individuals with dementia. The present study found that (1) strength based, (2) patient-centered, and (3) caregiver-collaborative OT interventions were significantly more effective in helping dementia patients maintain and/or improve their cognitive abilities (e.g., attention, memory, problem-solving, and decision-making skills) as well as their functional ability to perform instrumental activities of daily living including bathing, dressing, grooming, meal preparation, and managing finances. On the contrary, there is a growing need for providing occupational therapists with tailored training and education programs designed specifically for their intervention services for clients with dementia. Evidence-based interventions also need to be applied to address the specific needs of individuals with dementia. Given an exponentially growing number of dementia patients each year worldwide, it is imperative to have affordable and effective OT intervention services. The current study suggests a holistic OT intervention approach based on the biopsychosocial theoretical framework as the future of OT in dementia care.

Designing technology to support greater participation of people living with dementia in daily and meaningful activities.

People living with dementia should be at the center of decision-making regarding their plans and goals for daily living and meaningful activities that help promote health and mental well-being. The human-computer interaction community has recently begun to recognize the need to design technologies where the person living with dementia is an active rather than a passive user of technology in the management of their care. Data collection comprised semi-structured interviews and focus groups held with dyads of people with early-stage dementia (n = 5) and their informal carers (n = 4), as well as health professionals (n = 5). This article discusses findings from the thematic analysis of this qualitative data. Analysis resulted in the construction of three main themes: (1) maintaining a sense of purpose and identity, (2) learning helplessness and (3) shared decision-making and collaboration. Within each of the three main themes, related sub-themes were also constructed. There is a need to design technologies for persons living with dementia/carer dyads that can support collaborative care planning and engagement in meaningful activities while also balancing persons living with dementia empowerment and active engagement in self-management with carer support.

Clinical impact of a multifaceted intervention aimed at decreasing distress in people living with dementia: evaluating the Reconnect program.

To better meet the needs of people living with advanced dementia, Orchard Care Homes, United Kingdom have established an enhanced person focused program, namely the Reconnect program, which provides an enriched psycho-social care to enhance peoples' quality of life and well-being. Here we aimed to review the impact of this program on people living with dementia. In this study the implementation of the Reconnect program was evaluated for two six-month periods (April-September 2020 and April-September 2021). The focus of this evaluation was on three key interventions: increasing meaningful occupation and engagement; improving pain identification and management, and reducing constipation. The Reconnect program was conducted in a single for-profit care home. It involved residents with complex dementia needs who previously not responded to support in alternative settings or found previous care ineffective in relieving their distress and reducing risks they pose to themselves or others. A total of 24 people participated in the program during this evaluation. We observed a substantial increase in engagement in meaningful activity per person, including an increase of outdoor access to fresh air. Pain management improved as evidenced by more standardized pain assessments using the PainChek system and coverage of people with either regular and/or "when required" pain management. Constipation relief also improved. For the two comparison periods, distress responses per resident reduced from 14.5 to 10.6 events and use of regular pain relief increased from 21.7 to 48.1%. Use of "when required" benzodiazepine halved from 6 months average of 46 to 23.2 doses given. Benzodiazepine dose reductions increased from 13.3 to 31.8%, while cessations increased from 20 to 50%. We also observed a reduction from 76.3 to 56.3% in antipsychotic use. Their dose reductions increased from 8.3 to 40% and drug cessation was made in 30% of people using antipsychotics (compared to the first period in which no medication cessation was observed). A 91.7% reduction (i.e., from 36 to 3 events) in safeguarding events related to behaviors was also observed. Introduction of the Reconnect program, through its interventions focused on meaningful activity engagement, pain management and constipation relief resulted in substantial improvements related to people's distress, safeguarding and psychotropic use.

Engagement in Meaningful Activities Among Residents with Dementia in Assisted Living

AbstractBackgroundEngagement in meaningful activities is beneficial for the physical and psychological well‐being of persons with Alzheimer’s disease or related dementia (ADRD). Meaningful activities are a critical dimension of person‐centered care, although challenges exist in providing them for persons with ADRD in long‐term care settings. The purpose of this study was to describe engagement in meaningful activities among residents with ADRD in assisted living.MethodThis study included baseline data collected from the first cohort of the randomized controlled trial, Meaningful Activities for Managing Behavioral Symptoms of Distress (MAC‐4‐BSD). Assisted living residents were eligible if they were ≥55 years old, live in a participating setting, and screen positive for dementia based on the Saint Louis University Mental Status exam (SLUMS) and AD8 Dementia Screening Interview. Residents were excluded if they were enrolled in hospice, admitted for short term respite, or had a significant neurological condition not related to ADRD. Residents’ engagement in meaningful activities was evaluated based on the Engagement in Meaningful Activities Survey (EMAS). Descriptive statistics were used to summarize sample characteristics and describe engagement in meaningful activities.ResultA total of 38 residents from 3 assisted living communities were included in the sample. Most participants were female (71%), White (82%), and mean age was 81 years old (SD = 7.9). Average score on the SLUMS was 4.5 (SD = 4.9). The EMAS mean score was 43.57 (SD = 10.9) with a range of 25 to 60. Participation was endorsed most frequently for activities that give them pleasure (60.7%) and a sense of satisfaction (64.3%). Participation was endorsed least frequently for activities that help other people (35.7%), contribute to feeling competent (42.9%), and have the right amount of challenge (42.8%).ConclusionFindings from this study offer preliminary insights into residents’ engagement in meaningful activities in assisted living and suggest there is limited participation in activities that help others, help with feeling competent, and have the right challenge level for those with ADRD. Although limited by small sample size, this study highlights the need for increasing engagement in meaningful volunteer activities to help others which recent research demonstrates could positively impact physical and cognitive health outcomes.

The impacts of language decoding and literacy of adults in the cognition of elderly people and its occupational engagement

AbstractBackgroundBrazil has a population of 11 million illiterate individuals. This percentage among Brazilians over 60 equals 18%. In view of this, researchers from the Colleges of Medicine and Education from Federal University of Minas Gerais, Brazil, created Alfabetização e Memória (PROAME) – a project that investigates the relations of late literacy with adults’ psychosocial health. The analysis carried out associated the variables of mental and social health to the literacy process, taking into account memory and language aspects.MethodThis study evaluated 130 illiterate adults living in the city of Belo Horizonte, Brazil. 108 participants fitted all criteria and agreed to undergo this survey. There were 31 men (28,4%) and 78 women (71,5%); their average age was 58,5 (±9,6). Regarding race, 91% were black/brown (83,4%), 11 were white (10,1%) and 1 was indigenous (0,1%). 80 of those participants completed all clinical evaluations, interviews and pedagogical diagnoses before and after our intervention through a period of 7 months. The goal was to qualitatively analyze the participants’ discourse, focusing on evidence of the improvement of their autonomy. This was done by associating aspects from occupational engagement to the so‐called social literacy, which consist in the practical application of reading and writing on previously illiterate adults.ResultThe average age of the participants who completed the evaluations was 58,9 (±9,1), and 64 of them were women (80,0%). Both the interviews (made before and after our intervention) and the pedagogic report of 15 random individuals were analyzed. The results show progress in: their engagement in meaningful activities of daily life; their autonomy, sociability and self esteem; their use of technological applications; their occupational repertoire and their reading and writing abilities.ConclusionA pedagogical intervention made up by specific reading and writing activities, carried out with illiterate adults during 6 months, resulted in benefits for the participants. However, in face of the high illiteracy levels in Brazil, it is necessary a broader engagement in developing studies and literacy programs for adults as political, educational and health goals. By raising the literacy levels, we expect to guarantee the rights of marginalized individuals in Brazilian society.

“It’s not often that people want to hear me talk about my life”: Storytelling experiences of people with aphasia in an interdisciplinary songwriting project

Purpose Storytelling is an integral part of human life, providing opportunities for social closeness, relationship development, and identity exploration. Having aphasia can disrupt the ability to convey stories across a variety of settings. Structured songwriting frameworks may provide people with aphasia an opportunity to successfully engage in this medium for storytelling. Method Three individuals with aphasia participated in a structured songwriting intervention modified to support individuals with aphasia. Each participant-songwriter co-constructed three songs about their life in collaboration with an interdisciplinary team. Data about the songwriting process were collected via individual semi-structured qualitative interview and analysed using interpretative phenomenological analysis to identify superordinate themes and subthemes. Result The overarching superordinate theme related to the process itself as a catalyst that occurred as a result of participating in a songwriting intervention modified for individuals with aphasia. Three subthemes were identified: (a) relationship-centred experience, (b) engagement in meaningful activities, and (c) identity exploration. Conclusion Songwriting may provide meaningful opportunities for people with aphasia to experience the power of sharing stories about themselves. Key components of this experience aligned with the core elements of the positive psychology PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishments) framework. Findings support incorporating storytelling through songwriting into the rehabilitation journey for individuals with aphasia.

MEANINGFUL ACTIVITIES AND MEANING IN LIFE IN SOUTH KOREA: BASIC PSYCHOLOGICAL NEEDS SATISFACTION AS AN EXPLANATORY MECHANISM

Introduction – The self-determination theory implies that autonomy, relatedness, and competence might influence the extent to which one perceives his/her life is meaningful. In addition, we examined whether the level of engagement in meaningful activities is subject to the satisfaction of basic psychological needs, which in turn is likely to form perceptions on a meaning in life. Methods – To address these questions, we analyzed survey data that is collected from South Korean adults at the individual level in March of 2023 (N=36). I conducted t-tests and a zero-order correlation before working on the serial mediation analysis. PROCESS macro model 80 is used to analyze serial meditation mechanisms including exposures to meaningful activities, basic psychological needs satisfaction, engagements in meaningful activities, and meaning in life. Results – The serial mediation model discovers two significant paths involving that higher levels of sense of autonomy have increased perceptions on a meaningful life. Also, once individuals regularly participate in meaningful activities, a sense of relatedness is shown to be enhanced. Discussion – This research can contribute to the study of public health by suggesting that beneficial psychological effects of engagement in meaningful activities have subsequent social implications through an increased sense of belongingness. More one senses autonomy, the more likely hold meaningful life perceptions. Participation in meaningful activities has to do with an increase in a sense of relatedness. Conclusion – Autonomy has a significant direct effect on meaningful life perception, which corroborates satisfaction with autonomy plays an important role in the South Korean population’s well-being. By designing initiatives is likely to enjoy greater levels of satisfaction in a sense of relatedness, implying an improved sense of belongingness to one’s network, including their neighborhood and society. Keywords: meaningful activities, autonomy, relatedness, competence, meaning in life.

Worry Intervention in an Older Adult With a Persecutory Delusion: A Single Case Experimental Design.

This report presents the single case of Jack, a 67-year-old referred to our Older Adult Community Mental Health Team (OA CMHT) for his distressing persecutory delusion and high levels of worry. Jack also reported learning difficulties and autistic traits, although neither were formally diagnosed. Ten sessions of worry intervention taken from The Feeling Safe Programme worry module were used to reduce Jack's time spent worrying and increase his engagement in meaningful activity. Weekly face-to-face sessions were held, with Jack's brother acting as a co-therapist. Adaptations to the intervention were made based on Jack's learning preferences. An AB single case experimental design was adopted to compare Jack's scores on measures of worry, paranoia and delusional conviction, and wellbeing and daily functioning before and after intervention. Results demonstrate the worry intervention improved Jack's scores on all measures to a clinically significant degree. This is the first known report of applying the worry intervention to an older adult. The results show the intervention can be of considerable benefit in terms of reducing worry and paranoia, in the context of both older age and suspected neurodiversity.

Sequential multiple assignment randomised controlled trial protocol for developing an adaptive intervention to improve depressive symptoms among family caregivers of people with dementia

ObjectivesFamily caregivers of people with dementia (FC-of-PWD) suffer from a high level of stress and depressive symptoms, which usually require different interventions at different stages. Although some standalone interventions such...

Impact of Volunteer Transportation on Older Adults’ Engagement in Meaningful Activities

Abstract Date Presented 04/21/2023 Community mobility is vital for promoting engagement in meaningful activities and occupations outside the home. This study compared engagement levels among older adults, with and without access to volunteer transportation, during the COVID-19 pandemic. Primary Author and Speaker: Belinda D. Alexander Contributing Authors: Casey Humphrey, Allen Keener

Results of the Healthy GOALS Efficacy Study of a Life Management Intervention on Engagement in Meaningful Activities &amp; Quality of Life Poststroke

Abstract Date Presented 04/21/2023 The purpose of this poster is to present the results of the efficacy of a life management intervention for stroke survivors on meaningful activity, occupational performance, and quality of life outcomes. This study adds an efficacious intervention for OT. Primary Author and Speaker: Valerie Ann Hill Additional Authors and Speakers: Valerie Miller Contributing Authors: Rebecca Leugers, Erin Wagner

פרויקט שילוב טיפול באמצעות בובות לאנשים עם דמנציה בבית אבות - קידום מעורבות בפעילות משמעותית

Occupational therapy treatment for people with dementia in nursing homes faces two major issues: Coping with challenging behaviors, such as shouting and wandering, and finding activities residents can engage in over time. There is preliminary evidence that doll therapy can address these issues. The article describes a project, led by occupational therapists, of integrating doll therapy in a nursing home in Jerusalem. The project aimed to improve the quality of life of residents living with dementia by reducing challenging behaviors and encouraging engagement in meaningful activities. There were two phases to the project: A preparation phase during which the management was recruited to support the project and staff members were trained, and an execution phase during which the treatment was administered. The article provides guidelines for implementing the project in nursing homes. Our experience from this project suggests that the treatment resulted in a reduction in challenging behaviors. In addition, it improved communication and facilitated engagement in activities. As doll therapy might raise objections among staff and family members, it is imperative that the issue be addressed when this treatment is implemented as part of the implementation. In the discussion, we addressed the ethical issues related to the use of a doll as a mean of treating people living with dementia. In addition, we discussed possible explanations for the treatment's beneficial effects from an occupational therapy perspective. The importance of the project is in providing an additional tool for occupational therapists and nursing home staff that can also be used in cases of advanced dementia. Doll therapy is an accessible, affordable, and easy-to-implement method for improving quality of life for people living with dementia.

Hot Instantaneous Temperature and Affect: Meaningful Activities as a Buffer for Older Adults With Low Socioeconomic Status.

Extremely hot temperature affects psychological well-being negatively, especially for older adults with lower socioeconomic status (SES). The objectives of this study are to examine: (a) the impact of hot instantaneous temperature on older adults' emotional well-being and (b) whether meaningful engagement could reduce the above impact, particularly for those of lower SES. We conducted a quantitative time-sampling study during hot-weather months (May-September) in 2021 and 2022. The sample comprises 344 participants aged 60 years or older (Mage = 67.15, SDage = 5.26) living in urban areas of Hong Kong, where hot days (daily maximum temperature ≥33°C) accounted for 23% of the study days. Participants reported positive and negative affect, and engagement in meaningful activities, three times a day over a 10-day period, and wore sensors that tracked the instantaneous temperature of their immediate environment. Multilevel modeling was employed to examine the impacts on affect from temperature, SES, and meaningful activity engagement. Hotter instantaneous temperature predicted greater momentary negative affect and less positive affect immediately afterwards. Meaningful engagement significantly buffered against the affective impacts of hotter temperature, and this buffering effect was more salient among older adults of lower SES. This study highlights the role of meaningful engagement in reducing the impact of hotter instantaneous temperature on older adults' emotional well-being, particularly for those of lower SES. Meaningful activity engagement may be capitalized on, as a strategy, to reduce climate-related social inequality.

Effect of the COVID-19 pandemic on meaningful activity engagement in racially and ethnically diverse older adults.

Participation and active engagement in meaningful activities support the emotional and physical well-being of older adults. In 2020, the onset of the COVID-19 pandemic altered lives, including the ability to participate in meaningful activities. This study compared meaningful activity engagement before and at the beginning of the COVID-19 pandemic in a nationally representative, diverse sample >65 years between 2015 and 2020. We described the proportions and characteristics of National Health and Aging Trends Study participants and their engagement in four activities: visiting friends or family, attending religious services, participating in clubs/classes/other organized activities, and going out for enjoyment. We used mixed effects logistic regressions to compare probabilities of activity engagement before 2020 and in 2020, adjusting for age, sex, functional status, income, geographic region, anxiety-depression, and transportation issues. Of 6815 participants in 2015, the mean age was 77.7 (7.6) years; 57% of participants were female; 22% were Black, 5% Hispanic, 2% were American Indian, and 1% were Asian; 20% had disability; and median income was $33,000. Participation in all four activities remained consistent between 2015 and 2019 and declined in 2020. Significant differences existed in attending religious services (p < 0.01) and going out for enjoyment (p < 0.001) by race and ethnicity, before and after the start of COVID-19. Black and Hispanic participants experienced the largest decline in attending religious services (-32%, -28%) while Asian and White participants experienced the largest decline in going out for enjoyment (-49%, -56%). Potential quality of life tradeoffs should be considered to a greater extent in future pandemic emergencies.