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Assisted Living Residents with Dementia: Being Out in the World and Negotiating Connections.

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BACKGROUND AND OBJECTIVES Persons living with dementia, including long-term care residents, and their care partners emphasize the importance of meaningful engagement and stress the need for activity and opportunities to… Click to show full abstract

BACKGROUND AND OBJECTIVES Persons living with dementia, including long-term care residents, and their care partners emphasize the importance of meaningful engagement and stress the need for activity and opportunities to go outdoors or offsite. Yet, little is known about getting out in this population. Here, our objectives are to: 1) identify residents' opportunities for, and experiences with, getting out; 2) understand the significance of getting out; and 3) explain influential factors. RESEARCH DESIGN AND METHODS Guided by grounded theory methods, we analyzed qualitative data collected over a one-year period in four diverse assisted living communities. We followed 33 residents with dementia and their care partners. Data include detailed fieldnotes capturing 1,560 observation hours, 114 interviews with residents (where possible), assisted living staff, family members, and other visitors, and record review. RESULTS We identified the centrality of "being out in the world and negotiating connections," which characterizes residents' experiences with the outside world as a process of 'working out' engagement with nature, others, and the community. Being out in the world was consequential to well-being and quality of life. Most residents got out at least occasionally; some lacked opportunities. Among residents who got out, most benefitted from ensuing connections. Yet, not all experiences were positive. Being out in the world varied over time and by individual-, convoy-, AL community-, and neighborhood-level factors. DISCUSSION AND IMPLICATIONS We discuss the implications of our findings for research and practice surrounding meaningful engagement among persons with dementia, including during crises such as the pandemic.

Keywords: negotiating connections; world; living residents; world negotiating; residents dementia; assisted living

Journal Title: The Gerontologist
Year Published: 2021

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