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

Abstract

Meaningful social engagement in everyday activities can enhance resident quality of life in nursing homes. In this article, we draw on data collected in a multidisciplinary, international study exploring promising practices in long-term care homes across Canada, Norway, and Germany, to investigate conditions that either allow for or create barriers to residents’ social participation. Within a feminist political economy framework using a team-based rapid ethnography approach, observations and in-depth interviews were conducted with management, staff, volunteers, students, families, and residents. We argue that the conditions of work are the conditions of care. Such conditions as care home location, building layout, staffing levels, and work organization, as well as governing regulations, influence if and how residents can and do engage in meaningful everyday social life in/outside the nursing home. The presence of promising conditions that facilitate resident social participation, particularly those promoting flexibility and choice for residents, directly impacts their overall health and well-being.

Everyday Life and Social Contacts of Dementia and Non-Dementia Residents over 80 Years in Long-Term Inpatient Care: A Multi-Level Analysis on the Effect of Staffing

“…The proportion of people suffering from dementia will increase from 1.59 million in 2020 to 2.35 million in 2050 [ 6 ]. Since people suffering from dementia have a high care dependency [ 7 ], this growing proportion is expected to be accompanied by an increase in institutional care in the next years [ 2 , 8 , 9 , 10 , 11 ].…”

“…We did not identify a study directly analyzing the impact of staff on the maintenance of everyday life and social contacts. However, Lowndes et al [ 8 ] identified that staff themselves have little to no time for engaging socially with residents and that staff cannot focus enough on residents’ social needs in Canada, Germany, and Norway. Especially during evening shifts that often are understaffed, it seems impossible to enable residents to be socially active [ 8 ].…”

“…However, Lowndes et al [ 8 ] identified that staff themselves have little to no time for engaging socially with residents and that staff cannot focus enough on residents’ social needs in Canada, Germany, and Norway. Especially during evening shifts that often are understaffed, it seems impossible to enable residents to be socially active [ 8 ]. Lowndes et al [ 8 ] highlight that residents suffering from dementia have less visitors and are less socially connected than people without dementia.…”

“…Especially during evening shifts that often are understaffed, it seems impossible to enable residents to be socially active [ 8 ]. Lowndes et al [ 8 ] highlight that residents suffering from dementia have less visitors and are less socially connected than people without dementia. Many of the needs of residents with dementia for social care, community involvement, company, and daytime activities are not met [ 8 , 42 ].…”

“…Lowndes et al [ 8 ] highlight that residents suffering from dementia have less visitors and are less socially connected than people without dementia. Many of the needs of residents with dementia for social care, community involvement, company, and daytime activities are not met [ 8 , 42 ]. Harmer and Orrell [ 43 ] blamed low staffing levels, as well as staff attitudes of prioritizing physical over social needs and routines within facilities that limit autonomy, for the lack of opportunities for residents with dementia to participate in activities they experience as meaningful.…”