Being occupied: supporting ‘meaningful activity’ in care homes for older people in England

Abstract

The benefits of meaningful activity in later life are well documented. Studies show that being occupied contributes to both physical and mental health as well as quality of life. Research also suggests that activity may be beneficial to people residing in care homes, including people living with dementia. This paper presents findings from a study which used the Adult Social Care Outcomes Toolkit (ASCOT) to measure quality of life in six care homes located in the south-east of England. The racterised by a lack of activity. Drawing on observations, interviews and focus groups with residents and staff from these homes, this paper attempts to understand why care homes residents do not engage in meaningful activities. We reject the idea that these low levels of activity are a natural part of the ageing process or that they can be explained by notions of resident choice. Instead the findings point to both insufficient funding and working practices within care homes as more substantive explanations.These explanations inform a discussion of how the low levels of engagement in meaningful activity

Social Participation in Long-term Residential Care: Case Studies from Canada, Norway, and Germany

“…In high-income countries, long-term care homes have historically been known as under-funded institutions where residents spend their remaining days away from larger society, subjected to routinized, task-oriented care practices (Baum, 1977;Diamond, 1992;Johnson, Rolph, & Smith, 2010;Smith, Towers, Palmer, Beecham, & Welch, 2018). More recently, through the culture change movement (Rahman & Schnelle, 2008), attention is being paid to quality of life and person-centred care in these settings (Koren, 2010;Rahman & Schnelle, 2008).…”

“…This is a far cry from an afternoon of bingo or a bus trip to the local shops. (Knight & Mellor, 2007, p. 84) A more recent analysis of "meaningful activity" in six English care homes, based on interviews with 72 residents, argues persuasively that the limited choices of what activities or occupations were on offer strongly constrained residents' quality of life, and contributed to widespread feelings of loneliness and boredom (Smith et al, 2018).…”

“…"These accounts provide a challenge to the notion that older people living in care homes are choosing not to engage in activities … [T]hey show residents talking of their unhappiness about doing nothing and their desire to engage in activities of their choice" (Smith et al, 2018(Smith et al, , p. 2228.…”

Quality of Life in Older Adult Care Homes: Comparing Office Hours with Out-of-Office Hours

“…This seems to reflect the staffing patterns we found in the few homes we have data for. Care staff often focus on ensuring that basic needs, such as being kept clean and fed, are met and in their working practices place less emphasis on meeting needs in the higher order domains (Smith et al, 2018). This might be particularly true at times when there are high needs for basic care support such as getting up, mealtimes or going to bed (Eyers et al, 2012).…”

Meaningful Activities During COVID-19 and Association With Mental Health in Belgian Adults.

“…Indeed, activity engagement contributes strongly to humans' sense of purpose in life and ful lment of psychological basic needs (e.g. need for autonomy, need to belong, and need for competence) leading to better health [41], well-being [42,43], and aging successfully [44][45][46]. This suggests that the COVID-19 lockdown and the implied immediate and unprecedented impact on multiple facets of life might in uence one's mental health due to a diminished sense of purpose and/or frustration of these psychological needs.…”