Characterizing Social and Recreational Programming in Assisted Living

The effect of corrective exercises on musculoskeletal disorders among the older adults residing in a nursing home in Rasht, Guilan, Iran

BACKGROUND

Ageing causes changes in the function of musculoskeletal systems and disability, and injury among older adults. This study aimed to determine the effect of corrective exercises on musculoskeletal disorders among older adults residing in a nursing home in Iran.

METHOD

This controlled clinical trial study was conducted on 58 older adults (29 samples in each group). The intervention group performed corrective exercises for 8 weeks and three sessions per week and each session lasted for one hour. The pre-test was performed one week before intervention and the post-test one week after the 8-week intervention. The research instruments included Nordic Musculoskeletal Questionnaire (NMQ), and the pain visual analog scale (VAS). Descriptive and inferential (Chi-square, Mann-Whitney, Wilcoxon, and McNemar test) statistics were used to analyze the data using SPSS software version 19.

RESULTS

the majority of the participants were males (67.2%) and in the age range of 60-74 years (82.8%). The mean age of samples in intervention and control groups was 68.45 (SD = 5.38) and 69.17 (SD = 5.86), respectively. The results showed that the prevalence of musculoskeletal disorders (MSDs) was decreased in the intervention group after the intervention (%Δ = -34.68, p < .05). The results also showed a statistically significant decrease in pain intensity of musculoskeletal in the intervention group, after the intervention (%Δ = -68.34, p < .001).

CONCLUSIONS

Corrective exercises reduce the prevalence of MSDs and the pain intensity among older adults. It is recommended to pay attention to these exercises to improve physical health and reduce the prevalence of MSDs among older adults.

How Does Community-Based Housing Foster Social Participation in Older Adults: Importance of Well-Designed Common Space, Proximity to Resources, Flexible Rules and Policies, and Benevolent Communities

As supporting active and healthy aging calls for different community-based housing alternatives, integrated knowledge of their impacts on older adults' social participation is required. This study aimed to explore how community-based housing fostered social participation in older adults. A scoping review was used to systematically identify relevant studies according to 32 keywords in 8 electronic databases. Published during 2000-2021, the 46 studies were carried out in North America, Europe, Oceania, and Asia, documenting older adults' social participation in six community-based housing models. Targeting different clienteles, these models mainly promote older adults' social participation by providing: 1) accessible common space in a design favorable to social interactions; 2) proximity to resources; 3) flexible rules and policies that facilitate residents' interactions with not only co-residents but community neighbors; and 4) benevolent communities. These results highlight the interactions between the physical and social environments; they suggest the importance of building benevolent communities as well as of sharing resources among residences and local communities to create a supportive living and neighborhood environment for active and healthy aging. Future studies should further explore the role of different stakeholders in developing benevolent communities by considering the dynamics between the person and the environment.

Programmed Activity Attendance in Assisted Living: An Application of the Theory of Planned Behavior with Additional Health Factors

Objectives: Programmed activities contribute to the quality of life of assisted living (AL) residents, but attendance rates are often quite low. Using the theory of planned behavior (TPB), this study explores relationships among social cognitive variables, multidimensional health factors, and programmed activity attendance in AL.Methods: In a cross-sectional survey, 185 AL residents (Mage = 83.64, SD = 9.64) self-reported physical and mental health; TPB constructs (i.e., attitudes, subjective norms, behavioral control, and behavioral intention); and the percentage of programmed activities attended in the previous week.Results: Structural modeling showed that TPB was a good fit for the data (χ2/DF = 1.67; CFI = .97; TLI = .96; RMSEA = .06), explaining 82% of variance in behavioral intention and 44% of variance in activity attendance. After adding health factors to the model, only mental health yielded a significant indirect effect on activity attendance.Conclusion: Results provide preliminary support for the viability of TPB as a framework to explain resident activity attendance in AL. Thus, the decision to attend programmed activities in AL may represent a social cognitive process, influenced by mental health.Clinical Implications: Interventions may consider targeting TPB constructs and mental health to increase activity behaviors amongst AL residents.

Network Modeling of Assisted Living Facility Residents' Attendance at Programmed Group Activities: Proximity and Social Contextual Correlates of Attendance

BACKGROUND AND OBJECTIVES

Social engagement, including participation in group activities, supports older adults' mental and physical health. However, many residents of assisted living facilities do not participate in their facility's programmed group activities. Explaining residents' attendance at group activities is complex; attendance is associated with a confluence of individual-level and contextual factors. The aim of this study was to assess the effects of multilevel factors on attendance, including residents' proximity to activity location and the potential for one resident's attendance to depend on other residents' attendance.

RESEARCH DESIGN AND METHODS

We used bipartite exponential random graph models to examine the attendance of 35 residents at 563 programmed group activities. We simultaneously modeled the effects of the geospatial distance from a resident's apartment to the activity and the tendency for residents to attend activities with similar groups of other residents (i.e., shared attendance) on the likelihood of attendance, while controlling for individual-level factors (demographic and health indicators) and activity popularity.

RESULTS

Greater distance was associated with a reduced likelihood of attendance (p < .001) and residents tended to attend activities with similar subsets of other residents (p < .001).

DISCUSSION AND IMPLICATIONS

Findings suggest that greater distance to group activities may be a barrier to attendance. Implications include facility design, placement of activities and apartments, and mobility-related strategies to increase activity participation. It is also important to recognize that participation in activities is dependent on social context. We recommend that proximity to activities and social contextual factors be considered in future examinations of attendance at group activities.

Programmed Activity Offerings and Attendance Patterns in Assisted Living

The scope of programmed activity offerings and attendance rates for specific activities are not thoroughly captured in the assisted living (AL) literature. The purpose of this study is to report activity offerings and associated attendance rates, as well as relationships between individual factors and activity attendance patterns in a sample of 202 residents of 21 ALs. Sampled communities offered 50 different types of programmed activities. Each AL offered exercise and religious services, most offered BINGO (n = 19, 91%) and socials (n = 18, 86%). BINGO was the most frequently attended activity (n = 83; 47%), followed by religious services (n = 75; 38%), socials (n = 67; 40%), and musical performances (n = 62, 37%). Additional findings provide insight into the features of frequently attended activities, and the relationships between attendance and resident characteristics. The authors conclude with a discussion of implications for service delivery and future research.

Perceptions of older adults living in long-term care institutions regarding recreational physiotherapy: a qualitative study

Background: Long-term care institutions (LTCIs) present a limiting environment. Physiotherapy through recreational exercises can stimulate older adults.Objective: To explore LTCIs residents' perceptions regarding recreational physiotherapy.Method: This is a descriptive qualitative study. Participants included older adults living in two LTCIs, who took part in recreational physiotherapy and did not display severe communication problems or cognitive deficits. The activity was regularly offered in both LTCIs. Semi-structured interviews were audio-recorded to analyze the participants' perceptions of physiotherapy. We also observed video footage of the participants' behaviors during one session of the recreational activity. The audio recordings were transcribed, and content analysis was conducted with MAXQDA 12®.Results: Nine older adults participated, the majority women (n = 6), with a mean age of 83.8 ± 7.4 years. The interviews' average duration was about 30 minutes. The reports revealed three themes. In the "activity for myself" theme, participants discussed issues related to their own old age. In the "activity with others" theme, participants reported physiotherapy's value for providing sense of collectivity. In the "activity itself" theme, the components of physiotherapy and their benefits were evaluated. Observation of the video recording revealed that each resident engaged in the activity at their own pace and within their capabilities.Conclusions: The experience of older adults living in LTCIs showed that the regularly practicing physical exercises in recreational group, strengthens social bonds and provides physical and emotional well-being. When formulating and executing physiotherapy in the context of LTCIs, professionals should consider the residents' perceptions of the practice.

It’s Not Just Physical: Exercise Physiologist-Led Exercise Program Promotes Functional and Psychosocial Health Outcomes in Aged Care

Regular physical activity has multiple benefits for older adults, including improved physical, cognitive, and psychosocial health. This exploratory study investigated the benefits of a 12-week exercise program for older adults (n = 11 control and n = 13 intervention) living in a residential aged care facility in Perth, Western Australia. The program, prescribed and delivered by an accredited exercise physiologist, aimed to maintain or improve participants’ physical capacity. It comprised one-on-one exercise sessions (1 hr × 2 days/week × 12 weeks), involving a components-approach intervention. Physical performance measures (balance, strength, flexibility, and mobility) were assessed preintervention and postintervention. Qualitative interviews postintervention with residents participating in the exercise intervention, and with family members, staff, and research team members, explored barriers and enablers to participation and perceived psychosocial outcomes. Findings indicate the program provided physical benefits and enhanced social engagement for participants, illustrating the value of providing exercise physiology services in the aged care sector.

Reducing Sedentary Time among Older Adults in Assisted Living: Perceptions, Barriers, and Motivators

Older adults accumulate more sedentary time (ST) than any other age group, especially those in assisted living residences (ALRs). Reducing prolonged ST could help maintain function among older adults. However, to develop effective intervention strategies, it is important to understand the factors that influence sedentary behavior. The purpose of this study was to explore perceptions of ST as well as barriers and motivators to reducing ST among older adults in assisted living, in the context of the Social Ecological Model (SEM). Using a qualitative description approach, we sought to learn about participants’ perceptions of sedentary time in their daily lives. Semi-structured focus groups were held at six ALRs with 31 participants (84% women, 83.5 ± 6.5 years). Data were transcribed and coded using an inductive thematic approach. Themes were categorized based on four levels of the SEM: individual, social, physical environment, and organization. Many reported barriers were at the individual level (e.g., lack of motivation, pain, fatigue) while others were associated with the organization or social environment (e.g., safety concerns, lack of activities outside of business hours, and social norms). These findings suggest that there are unique challenges and opportunities to consider when designing ST interventions for assisted living.

Recreational Activity in Assisted Living Communities: A Critical Review and Theoretical Model

BACKGROUND AND OBJECTIVES

This paper critically reviewed the scientific literature on recreational activity (RA) behaviors in assisted living (AL) communities.

RESEARCH DESIGN AND METHODS

A search of three databases yielded 70 quantitative, qualitative, and observational articles that met criteria for inclusion.

RESULTS

AL residents participated in various types of RA, however, did so infrequently. Individual, interindividual, environmental, and relocation factors influenced RA behaviors, and participation may relate to positive consequences for residents and AL communities. This review identified multiple limitations in the literature related to construct definitions, measurement protocols, and incomplete or absent theoretical frameworks.

DISCUSSION AND IMPLICATIONS

To address these limitations, the current review proposes a multivariate measurement model and an interdisciplinary theoretical model of factors relating to RA, consistent with an ecological framework. The proposed models appreciate individual psychological factors that influence the multiple facets of human choice and behavior, as well as the interaction between individuals and the unique sociophysical environment of AL. This paper concludes with recommendations for future research, emphasizing studies that have applied implications for practice and policy.

Physical Activity and Function in Assisted Living Residents

The purpose of this study was to consider the feasibility, reliability, and validity of MotionWatch 8. A total of 249 residents were recruited from 26 assisted living settings. Data collection included demographics, comorbidities, function (Barthel Index), physical activity (MotionWatch 8), and falls. The mean age of participants was 86.86 ( SD = 7.0), the majority were women 179 (74%) and White ( N = 232, 96%). A total of 86% of participants wore the MotionWatch 8. There were no significant differences in physical activity over 3 days of testing. The MotionWatch 8 findings were significantly associated with activities of daily living (ADL) function. There were no significant differences in ADL function or physical activity between those who did and did not fall. The study provides additional support for the feasibility, reliability, and validity of the MotionWatch 8 and confirms that older adults living in assisted living settings spend the majority of their time in sedentary activity.

Factors that Influence Physical Activity among Residents in Assisted Living

The purpose of this study was to examine factors that influence physical activity among residents in assisted living. This was a secondary data analysis using baseline data from a function-focused care intervention study including 171 residents from 4 assisted living facilities. Using structural equation modeling, we found that mood, satisfaction with staff and activities, and social support for exercise were directly associated with time spent in physical activity. Gender, cognition, depression, and comorbidities were indirectly associated with physical activity and accounted for 13% of the total variance in physical activity. Implications for future research and social work practice are presented.