Older Adults In Residential Care Research Articles

Environmental mastery and depression in older adults in residential care

ABSTRACTThis study investigated the association between environmental mastery and depression in a sample of 96 older adults (aged 64–98 years) in residential care. The participants completed a scale that assessed depression along with measures for risk factors for depression such as functional capacity, self-evaluated physical health, bereavement experiences and environmental mastery. The results showed that 49 per cent of the variance in participants' scores in depression could be attributed to their self-reported level of environmental mastery. Given the complexity of depression and the likelihood of reduced environmental mastery among older adults in residential care, the construct was further assessed as a mediating variable between the risk factors and depression. With environmental mastery taken as such, the explained variance in depression increased to 56 per cent. It was concluded that environmental mastery may be one of the more important factors affecting the mental health of older adults living in residential care and that strategies for increasing the residents' environmental mastery are important to their psychological wellbeing. The discussion notes that among the questions needing further investigation are whether older adults who experience high environmental mastery make the transition from community living to residential nursing home care more successfully than others, and whether perceived mastery diminishes over time or occurs at the point of transition from community independent living to dependent supported living.

Making Home Work: Theatre-making with Older Adults in Residential Care

The paper reflects on the significance of artistic practice with older adults in residential care settings, asking what ‘home’ means to residents living with dementia. To consider how cultural stereotypes of ageing as narratives of loss and decline might be challenged, this paper draws on a recent production On Ageing that was staged at the Young Vic Theatre in London. This play dramatised gerontologist Tom Kirkwood's view that ageing is not a process of deterioration but accumulation, which determines how the body ages physically. Socially, we also accumulate ‘stuff’ as we grow older and home is often defined by the emotional significance of possessions. So what happens when, in old age, people's physical space shrinks?. The research draws on the principles of person-centred care and non-humanist theories of materiality to debate how home is constructed through the imagination and in the material, spatial and temporal practices of everyday life. In considering how and why creative activity with older adults can help to change a residential care home from an institution to a domestic space, it suggests that the arts have a significant role to play in end of life care.

Social inclusion of older adults in care: Is it just a question of providing activities?

We investigated the experiences of older adults in residential care in relation to social activity and inclusion. We also examined the explored phenomenon of resident's social inclusion from the perspective of those providing care for the residents. Our participants were 25 care providers and 25 residents drawn from five low-level-care residential facilities in metropolitan Melbourne, Australia. We used one-to-one in-depth interviews which were aimed at tapping into themes related to social inclusion. Of special interest to us was residents’ lived experience of social inclusion within the context of their lives in residential care. We found that although participation in activities emerged in our study as being valued and encouraged by care providers, residents were left feeling isolated, compromised, and as though they were not “at home”. We concluded that the difference between caregivers’ understanding and residents’ experiences of social inclusion highlights the need to shift the focus from the provision of activities as an indicator of social inclusion to gaining a deeper understanding of the lived experiences of those in care. We suggest that such a focus would assist in the care of the growing number of older adults who face the transition from their own homes to a residential care facility, and guide us toward a more meaningful understanding of “well-being” in this context.

Mental health problems in the elderly in residential care in Greece—A pilot study

The aim of this study is to examine the mental health problems of older adults living in a residential home in a Greek rural area. A sample of 40 residents was compared with 40 matched controls attending a community open care centre for the elderly (OCCE). The following measures were used: Mini International Neuropsychiatric Interview (MINI), Geriatric Depression Screening Scale (GDSS), and the Mini Mental State Examination (MMSE). The group of the residents had a lower educational level and presented with a higher prevalence of depression and suicidality. Suicidal ideation was not significantly correlated to any of the examined independent social or psychological factors and was persistent during a period of two years follow-up. It is possible that, especially in rural areas, admission in the institution is per se a traumatic event precipitating suicidality. The issues of effective psychological care for older adults in residential care are discussed.

Screening Receptive Communication of Older Adults in Residential Care

Receptive communication of 341 older adults was evaluated in 9 nursing homes. The following assessments were conducted: case history, otoscopic examination, visual perception of facial movements, hearing aid function, sentence identification, and ratings of conversational fluency. The majority of clients reported hearing loss and low vision that interfered with their communication. Otoscopic examination revealed that nearly a third of the ears contained excessive cerumen. Visual perception results indicated that nearly all clients could see the clinician's head movements, but that some clients could not see mouth or eye movements. Fewer than half of the clients owned hearing aids, but not all owners used them. Common problems related to non-use of hearing aids included blocked earmolds and dead batteries. Sentence identification and conversational fluency were improved by the use of amplification, but positive results often depended on application of communication strategies by the partner. Recommendations are provided for training staff and caregivers to increase their awareness of client needs and to modify their own behavior for more effective communication with older people.

Conversation as therapy for older adults in residential care: the case for intervention.

Social isolation resulting from sensory loss tends to reduce life satisfaction in older adults. Residence in a long-term care facility such as a nursing home does little to alleviate their communication needs. Potenial communication partners are available (e.g. other residents, family and friends, nursing staff, volunteers, health-care workers), but many need instruction, counselling and feedback to become therapeutically effective. The speech pathologist's experience as both communication therapist and social facilitator can enhance consultation and staff training in this area.