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

Leisure and social occupational choice within nursing home facilities in Ireland: Residents perspectives

BACKGROUND

National standards for nursing homes in Ireland require that residents are offered a choice of recreational and stimulating activities to meet their needs and preferences.

AIMS/OBJECTIVES

To investigate residents' perceptions of leisure and social occupational choice in nursing homes in Ireland to determine if occupational choice is facilitated.

MATERIALS AND METHOD

Qualitative-descriptive design - nursing home residents completed two semi-structured interviews that explored their experiences of leisure and social occupational engagement.

RESULTS

Two overarching themes with six associated sub-themes emerged. From residents' perspectives, social and leisure occupational choice was dependent on: Environmental factors (nursing homes' Cultural, Social, Physical, and Temporal Environments) and Personal factors (residents' Health Status and Personal Attitudes).

CONCLUSION

The cultural environment had the most significant influence on residents' leisure and social occupational choice, highlighting the importance of person-centred care within nursing homes, to promote occupational choice. Resident's health status was also identified as a contributing factor.

SIGNIFICANCE

Occupational therapists could play a critical role in supporting the leisure and social occupational choices of nursing home residents by developing residents' skills, educating staff and adapting tasks and the environment to limit/reduce occupational deprivation.

Social Connectedness Resource Preferences of Older Adults in Assisted Living: A Scoping Review Based on the WHO-ICF Framework

The current scoping review identified emerging evidence on social connectedness resource preferences of older adults in assisted living facilities (ALFs) and the community. A literature search was performed using several databases. We included review articles published between January 2000 and September 2022 in English and related to social connectedness resources in ALFs and the community. Of 134 titles and abstracts, eight studies were included. Study participants comprised 2,482 older adults from 233 ALFs in the United States. Themes were framed using the World Health Organization's International Classification of Functioning, Disability, and Health. For social activities, older adults preferred facility-based recreation and leisure resources. For community social connectedness, residents preferred participation in civic life activities. Participants of older age preferred facility resources, whereas those of younger age preferred more demanding physical activities. Those from larger enrollment facilities preferred facility-based resources compared to community resources. For moderately and less active residents, participation was limited to less demanding activities. Older adults' preferences varied based on age, physical limitations, and size and location of the facility. Findings suggest opportunities for further research on developing ALF- and community-based resources for older adults' social well-being and quality of life. [Journal of Gerontological Nursing, 49(9), 35-42.].

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.

Recreation and Alcohol Consumption in Sub-Saharan Africa: Addressing Gender and Age Differences in Urban Areas-Praia, Cabo Verde

BACKGROUND

Reducing alcohol consumption and improving urban planning in African cities are public health priorities. The aim of this study was to explore gender and age differences in recreational activity participation and its link with self-reported alcohol consumption in three urban areas of Praia.

METHODS

A questionnaire was applied to a probabilistic sample of 1912 adults, with a median age of 35.0 (IQR: 26.0-48.8) years, living in informal, transition, and formal areas of the capital of Cabo Verde.

RESULTS

More than 80% of the participants reported rarely or never participating in recreational activities. Going daily or weekly to the café was the most reported recreational activity, regardless of the urban area. Participation in recreational activities was higher in men than women, decreasing with age in both cases. Alcohol consumption was significantly higher in men than women (72.4% versus 47.4%, p < 0.001). Multiple logistic regression models showed that going at least once to the bar/nightclub (for men and women) and going to the café (for women) were associated with alcohol consumption. Furthermore, age (for women), in a protective way, and having children (for men) appeared to be associated with alcohol consumption.

CONCLUSIONS

This study provides new data on the recreational environment in Praia and can contribute to the development of local and national public health policies and interventions in line with several SDGs to reduce alcohol consumption, enhance healthy leisure/recreation practices, and promote better living conditions for its inhabitants.

Measuring the outcomes for aged care residents' participation in physical activity interventions: A systematic review of randomised controlled trials

OBJECTIVES

Lack of physical activity presents substantial health risks to older adults living in residential aged care facilities. The objective of this review was to examine the suitability of physical activity outcome measurement instruments among cognitively sound residents.

METHODS

Search terms were used to explore health, nursing and social science databases to identify applicable English-language research from January 2000 to July 2020.

RESULTS

Sixteen papers met the inclusion criteria. The findings show that a diverse range of outcome measurement instruments have been used to evaluate physical activity intervention effectiveness. Most were found not to be validated for use specifically with residential aged care populations.

CONCLUSIONS

A range of Outcome Measurement Instruments (OMI) appear to effectively measure physical activity intervention outcomes among residential aged care older adults. Results highlighted the need for greater rigour in study design and selection of valid and population-appropriate instruments for use with this population.

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.

Environment patterns and mental health of older adults in long-term care facilities: the role of activity profiles

Objectives: This study adopts the International Classification of Functioning, Disability and Health (ICF) model to determine extent to which the clustered patterns of long-term care (LTC) environment and activity participation are associated with older residents' mental health. Method: This study enrolled a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis and latent class analysis were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the hypothesized relationships. Results: Three environment profiles (Low-, Moderate-, and High-Support Environment) based on physical, social, and attitudinal environment domains and two activity profiles (Low- and High-Activity Participation) across seven activity domains were identified. Compared to the Low-Support class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in those two classes were more likely to be in the "High Activity Participation" class, which in turn, exhibited better mental health. Conclusion: Environment and activity participation directly relate to older residents' mental health. Activity participation also mediates the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents' mental health.