“We Get to Decide”: The Role of Collective Engagement in Counteracting Feelings of Confinement and Lack of Autonomy in Residential Care

A latent profile analysis of the nature of social group memberships and their contribution to retirement outcomes

Positive experiences of groups (e.g., the extent to which groups are important and supportive) tend to be associated with better retirement adjustment outcomes. However, group experiences are not always positive, and we know little about their varied contribution to adjustment outcomes. We addressed this gap by exploring the nature of social group memberships - in terms of varying positive and negative experiences of groups - to better understand how social group memberships shape retirement adjustment, life satisfaction and mental health. A latent profile analysis (using data from 489 retirees and their membership of 1887 groups) identified four profiles of social group memberships: optimal (63%), slightly straining (13%), low-supportive (18%) and ambivalent (6%). Subsequent regression analysis showed that these different profiles of group membership were differentially associated with retirement adjustment outcomes: belonging to more optimal groups was associated with better perceived adjustment, higher life satisfaction and better mental health, while belonging to slightly straining and ambivalent groups contributed to poorer adjustment, lower life satisfaction and greater depression. These findings have implications for theory and practice, not least because they advance our understanding of the diversity of people's group memberships and their contribution to retirement and health outcomes.

Associations between social networks, cognitive function, and quality of life among older adults in long-term care

BACKGROUND

Having rich social networks is associated with better physical and cognitive health, however older adults entering long-term care may experience an increased risk of social isolation and consequent negative impacts on cognitive function. Our study aimed to identify if there is an association between accessing specific types of services or activities within long-term care on social networks and cognition.

METHODS

A cross-sectional study of 96 residents from 2 aged care providers in New South Wales, Australia. Residents were given a battery of assessments measuring social network structure (Lubben Social Network Scale, LSNS-12), quality of life (EuroQol 5D, Eq. 5D5L) and cognitive function (Montreal Cognitive Assessment, MoCA). Demographic factors and service use factors were also collected from aged care providers' electronic records. Independent sample t-test, ANOVA and linear regression analyses were used to explore associated factors for cognition.

RESULTS

Residents had a mean age of 82.7 ± 9.4 years (median = 81) and 64.6% were women. Most residents had cognitive impairment (70.8%) and reported moderate sized social networks (26.7/60) (Lubben Social Network Scale, LSNS-12). Residents who had larger social networks of both family and friends had significantly better cognitive performance. Service type and frequency of attendance were not associated with cognitive function.

CONCLUSIONS

Among individuals most at risk of social isolation, having supportive and fulfilling social networks was associated with preserved cognitive function. The relationship between service provision and social interactions that offer psychosocial support within long-term facilities and its impact over time on cognitive function requires further exploration.

Development of the Music Therapy in Transition to Long-Term Care Model

Transition to long-term care can be a challenging period for older adults, with high risk for negative outcomes, including depression, anxiety, and fear. However, music therapy has the potential to enhance related protective factors because it emphasizes individual strengths by leveraging culture-specific resources, facilitates relationships and a sense of belonging through joint music-making, and provides opportunities to process and make sense of one's experiences in the "new normal" through sharing of music-related emotions. The purpose of this study was to explore the perspectives of older adult long-term care residents, their care team staff, and their music therapists to develop a conceptual framework for the role of music therapy in older adults' transition and adjustment to long-term care. A grounded theory approach was used to conceptualize this process. Interviews with 17 participants were transcribed and analyzed using open, axial, and selective coding. The resulting theoretical model describes a progression of qualities and benefits of music therapy that leads to residents "feeling their best self." Related categories include: Music therapy is accessible and engaging; Music therapy is personal and meaningful; Music therapy acts as a bridge to other resources; Music therapy facilitates transformation; and Music therapy facilitates community integration. This initial theoretical model provides a foundation for clinical assessment and interventions. Future research is needed for continued testing and refining this theory.

Expressions of masculine identity through sports-based reminiscence: An ethnographic study with community-dwelling men with dementia

BACKGROUND

Despite increasing numbers of men living in isolation with dementia in the community, uptake of supportive interventions remains low. This may be because of limited availability of activities suited to men's interests. One organisation reporting higher attendance from men is Sporting Memories, offering inclusive sports-based reminiscence and physical activities for men living with dementia. This study aimed to explore the impact of the Sporting Memories intervention on men living with dementia.

METHOD

This study was an ethnography employing techniques of participant observation, informal conversations and semi-structured interviews with group participants. Data were woven into a series of narratives using creative non-fiction, to bring life to the first-hand accounts of participants and experiences within a typical group setting.

FINDINGS

The groups provided an environment for men with dementia to explore, reflect upon and reinforce their masculine identities through the subject of sport. Physical activities further facilitated this embodied demonstration for some, although this was not a feature of all sessions.

CONCLUSIONS

The content of Sporting Memories group sessions provides a vehicle for men to retain an important aspect of personhood. They also hold the potential to present opportunities for men to feel a sense of value by contributing to sessions in varied ways. Facilitators and volunteers require support and training to ensure this benefit is maintained.

How do residents of aged care homes perceive physical activity and functional independence? A qualitative study

Limited evidence exists concerning knowledge and understanding of how to optimally support residents' physical activity, mobility and functional independence in residential aged care homes. An interpretive qualitative study was conducted to explore residents' perceptions and experiences of opportunities for physical activity and functional independence, and how physical activity and functional independence are challenged in their care home environment. Purposefully sampled 24 participants (male = 13) from five not-for-profit residential aged care homes in the outskirts of a metropolitan area in Australia, were interviewed between August and September 2017. Maintaining independence was found to be the utmost priority for nearly all participants in this study. Yet, many did not make the connection between physical activity and independence, and regarded 'exercise' as an inappropriate activity for them, perceiving it as high-impact, high-intensity activity in commercial gyms that was only appropriate for the young. Walking and gardening were found to be most popular. Walking could be a physical activity, social activity, solo recreational activity and a means of maintaining mobility and functional independence-all of which residents considered to be appropriate to them and achievable. The study identified key factors influencing physical activity and functional independence of residents: levels of activity prior to living in residential aged care, ageism, social capital and loss of a loved one, pain and staff support. Findings highlight the need for a 'flexible and inclusive' approach in facilitating the resident's physical activity, and a greater role for staff in encouraging residents' engagement in, and communicating the benefits and requirements of, physical activity, through, for example, motivational interviewing.