Date Presented 03/27/20
This qualitative study explored the perceptions and social participation experiences of adults residing in an ALF. Four themes emerged: impressions and social transition, social connections impacting relationships, motivation as key to socialization, and resident-perceived barriers to socialization. Findings implicate the need for change within the ALF setting to best facilitate the social participation and minimize the social isolation of its residents.
Primary Author and Speaker: Nicole Fidanza
Additional Authors and Speakers: Salvador Bondoc, Julia Kowal
PURPOSE: The assisted living facility (ALF) is the fastest growing senior living option nationwide, currently housing over 835,000 Americans (National Center for Assisted Living, 2018). Though active engagement in social activities in an ALF is positively associated with greater life satisfaction, physical and mental health, and quality of life (Horowitz & Vanner, 2010), older adults in ALFs report lower levels of sense of belonging and higher levels of social isolation than those who remain in their homes (McLaren, Turner, Gomez, McLachlan, & Gibbs, 2013). If social participation is linked with health and life satisfaction, and if ALF residents are at risk for social isolation, then the profession needs to better understand what can be done to promote socialization within the ALF setting.
DESIGN: This qualitative study utilized ethnographic immersion and phenomenological interviews to explore the social participation perceptions and experiences of older adults residing in an ALF. Recruitment took place via phone calls to potential participants whose contact information was provided by the facility. Purposive and convenience sampling were used to increase the likelihood of response saturation. To qualify, participants must reside in the ALF, be age 65 and older, and be able to give their own consent.
METHOD: Data was first collected through ethnographic immersion within the ALF. Researchers attended scheduled events and observed natural interactions while taking field notes, journaling, and collecting artifacts. Participants then took part in semi-structured interviews conducted in-person. Interviews were based off a guide organized into three categories: occupational and social history, transition to the ALF, and a typical day in the ALF. Probing, summarizing, amplification, redirection, and reflection were used during the interviews. Each interview was audio recorded and transcribed. Using the Colaizzi process, open and in-vivo coding was used to extract significant statements. From these statements, meanings were formulated and then sorted into categories, subthemes, and overarching themes.
RESULTS: Eight older adults, with time in the ALF ranging from 6 months to 21 years, participated in this study. Four themes emerged that captured their social participation: impressions and social transition, social connections impacting relationships, motivation as key to socialization, and resident-perceived barriers to socialization. Participants reported a lack of ALF-provided social supports upon move-in, resulting in feelings of loneliness and seclusion. They were dismayed to discover a disconnect between social expectations of the ALF and reality. Group activities were neither viewed nor structured as sources of socialization for participants. Observed resident interactions- in and out of groups- were short, spontaneous, and superficial. Despite the challenges to social participation within the ALF, motivated residents developed their own social adaptation strategies and initiated attempts to develop relationships with others.
CONCLUSION: The social participation of older adults in an ALF is captured by the overarching theme of short, spontaneous, and superficial. The findings of this study indicate the need for change within the ALF setting to enable older adults to engage in meaningful social participation. ALF-provided social supports are needed for all residents, especially upon move-in, to facilitate relationship building and limit social isolation. Similarly, occupational therapists in ALFs should develop programs to enhance socialization and connect residents socially.
References
National Center for Assisted Living. (2018). Facts and figures. Retrieved from https://www.ahcancal.org/ncal/facts/Pages/default.aspx.
Horowitz, B. P., & Vanner, E. (2010). Relationships among active engagement in life activities and quality of life for assisted-living residents. Journal of Housing for the Elderly, 24(2), 130- 150. doi: 10.1080/02763891003757056
Mclaren, S., Turner, J., Gomez, R., McLachlan, A. J., & Gibbs, P. M. (2013). Housing type and depressive symptoms among older adults: A test of sense of belonging as a mediating and moderating variable. Aging & Mental Health, 17(8), 1023- 1029. doi:10.1080/13607863.2013.805402
