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

Abstract

Maintenance of well-being is recognized as important for well-being in residential care, but the particular contribution that social groups and group activities make in this context is rarely considered. To understand how we can foster well-being in care, this study explores (a) older adults' general experiences of life in long-term residential care and (b) their particular experiences of participation in this group intervention. Ten semi-structured interviews were conducted with long-term care home residents and interview transcripts were analyzed thematically. Thematic analysis revealed two overriding themes that illustrated participants' general experiences of life in care. The first theme, "care home as home," suggests that adjustment and positive social relations with carers play a role in enhancing well-being. The second theme, "being stuck," describes a general sense of confinement and a lack of control associated with living in long-term care. The significance of collective engagement became evident in relation to this second theme. Specifically, participants' involvement in the group activity considered here was experienced as making a positive contribution to building social relations with other residents and, in doing so, as reducing residents' sense of confinement and lack of control. Engagement in the group intervention and the resulting positive social relationships were thus experienced as a means of counteracting participants' sense of being stuck. Overall, the findings point to the importance of group activities in fostering older adults' autonomy and control-and thus well-being-in care. Increased life expectancy, changes in family structure, and families living apart are contributing factors to the growing need for residential care support (Ice, 2002; Office for National Statistics [ONS], 2011). Moving into residential care is often perceived as a negative life transition:

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