Title

Adaptation By Elders to Occupational Disruption

Start Time

16-11-2002 1:45 PM

End Time

16-11-2002 3:00 PM

Abstract

Elders frequently encounter disruptions in their occupational lives due to various circumstances including health crises, hospitalization, or relocation to new living arrangements. The purpose of this presentation is to synthesize findings from five previous studies about elders who have dealt with such disruptions to identify how they adapted to discontinuity in occupations. In three of the studies elders were recruited on a transitional unit following hospitalization in a county hospital-district geriatric program. In two of the studies elders were recruited following relocation to new living arrangements including personal care homes and assisted living facilities. All studies used mixed longitudinal designs incorporating qualitative and quantitative methods. Case studies of a total of 45 elders from these previous studies were separately clustered by two researchers on the basis of similarity in elders' adaptation pathways. Findings were then compared and differences reconciled to increase trustworthiness of the categorization process. The three pathways that emerged from this analysis included (a) maintaining continuity in occupations, (b) establishing new occupational directions, and (c) disconnecting from occupational engagement. Maintaining continuity is exemplified by Mr. Green who resumed walking around the neighborhood and playing dominoes at buddies' homes after a stroke. Establishing new directions is exemplified by Ms. Dobson who began painting in a day program after moving to a personal care home. Disconnecting is exemplified by Ms. Conlon who "likes to participate but now I can't" which she attributes to problems with her medications for congestive heart failure and anxiety. Elders responded in different ways to occupational disruption, with some persons "coming to terms" and others being overwhelmed by change. Personal and environmental factors that influenced adaptation to occupational disruption were identified. Personal factors included past adaptation experience, resilience, and faith. Environmental factors included informal support from family and neighbors, and alternative formal support systems. Implications for practice include the importance of preparing elders at the time of major life disruptions for resuming occupational engagement in the future. It is also important to collaborate with persons after the disruption to explore alternative ways of adapting to changes in their occupational lives. This is particularly significant for persons who appear to be "at risk" for disconnecting from occupational engagement. Implications for future research include the importance of examining the insiders' perspective of elders on factors that influence adaptation, further examining the ability of elders to tell about their experience although they have some cognitive limitations, considering the influence of socioeconomic and cultural factors in shaping adaptation, and tracking the adaptive process over time to capture incremental changes in occupational engagement.

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Nov 16th, 1:45 PM Nov 16th, 3:00 PM

Adaptation By Elders to Occupational Disruption

Elders frequently encounter disruptions in their occupational lives due to various circumstances including health crises, hospitalization, or relocation to new living arrangements. The purpose of this presentation is to synthesize findings from five previous studies about elders who have dealt with such disruptions to identify how they adapted to discontinuity in occupations. In three of the studies elders were recruited on a transitional unit following hospitalization in a county hospital-district geriatric program. In two of the studies elders were recruited following relocation to new living arrangements including personal care homes and assisted living facilities. All studies used mixed longitudinal designs incorporating qualitative and quantitative methods. Case studies of a total of 45 elders from these previous studies were separately clustered by two researchers on the basis of similarity in elders' adaptation pathways. Findings were then compared and differences reconciled to increase trustworthiness of the categorization process. The three pathways that emerged from this analysis included (a) maintaining continuity in occupations, (b) establishing new occupational directions, and (c) disconnecting from occupational engagement. Maintaining continuity is exemplified by Mr. Green who resumed walking around the neighborhood and playing dominoes at buddies' homes after a stroke. Establishing new directions is exemplified by Ms. Dobson who began painting in a day program after moving to a personal care home. Disconnecting is exemplified by Ms. Conlon who "likes to participate but now I can't" which she attributes to problems with her medications for congestive heart failure and anxiety. Elders responded in different ways to occupational disruption, with some persons "coming to terms" and others being overwhelmed by change. Personal and environmental factors that influenced adaptation to occupational disruption were identified. Personal factors included past adaptation experience, resilience, and faith. Environmental factors included informal support from family and neighbors, and alternative formal support systems. Implications for practice include the importance of preparing elders at the time of major life disruptions for resuming occupational engagement in the future. It is also important to collaborate with persons after the disruption to explore alternative ways of adapting to changes in their occupational lives. This is particularly significant for persons who appear to be "at risk" for disconnecting from occupational engagement. Implications for future research include the importance of examining the insiders' perspective of elders on factors that influence adaptation, further examining the ability of elders to tell about their experience although they have some cognitive limitations, considering the influence of socioeconomic and cultural factors in shaping adaptation, and tracking the adaptive process over time to capture incremental changes in occupational engagement.