Title

Occupation and Well Being: A Study of the Everyday Experiences of Community-Dwelling Older Adults with Cognitive Loss

Start Time

15-10-2009 10:45 AM

End Time

15-10-2009 11:15 AM

Abstract

A trend in our society has been to overemphasize the value and significance of the biomedical approach to the treatment of Alzheimer’s disease. Our hopes and our resources are deeply invested in the search for a cure. But, the promise of biomedicine to provide a cure for Alzheimer’s disease has been slow to actualize in part, because it subsumes many of the processes of normal brain aging. Despite its inability to effect change in the lives of people with Alzheimer’s disease a biomedical view has been the dominant framework. However, the myth of Alzheimer’s disease as a bounded disease entity is slowly being dispelled. There is a concomitant refocusing of the research agenda to psychosocial aspects and quality of life of the behaving, acting person with Alzheimer’s disease. The purpose of this phenomenological study was to investigate the everyday experiences of four people with cognitive loss due to Alzheimer’s disease who were living in their own homes. The goal was to increase knowledge of quality of life and well being in people with Alzheimer’s disease and explore the importance of occupation to the individual from his/her perspective. The study used multiple data collection methods including; interviews, observations, quality of life assessment and Ecological Momentary Assessment (EMA) to explore the everyday experiences of the participants. EMA required participants to provide a subjective assessment of psychological well being in real time in their typical environment. The use of EMA as a data collection method was particularly germane to this study as it does not rely on recall which can be impaired in people with Alzheimer’s disease. Thus, potential problems with recall-based judgments were avoided. Results of the study revealed a taskscape, or an array of related occupations, which were qualitative and heterogeneous. Furthermore, it demonstrated the importance of engagement in occupation despite level of cognitive impairment. Although, there is a biological basis to Alzheimer’s disease it is also culturally constructed. This research contributes to the development of a new cultural narrative of Alzheimer’s disease. It emphasizes and recognizes the value of occupation in the ordinary, everyday experiences of people with Alzheimer’s disease. It assists with opening a cultural space for the occupational person with Alzheimer’s disease and challenges the hegemony of the current medical category.

References

Ingold, T. (2000). The perception of the environment: Essays in livelihood, dwelling and skill. London: Routledge.

Smith, D., Brown, S., & Ubel, P. (2008). Mispredictions and misrecollections: Challenges for subjective outcome measurement. Disability and Rehabilitation, 30(6), 418-424. DOI: 10.1080/09638280701625237

Whitehouse, P. (2009). The myth of Alzheimer’s: What you aren’t being told about today’s most dreaded diagnosis. New York: St. Martin’s Press.

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Oct 15th, 10:45 AM Oct 15th, 11:15 AM

Occupation and Well Being: A Study of the Everyday Experiences of Community-Dwelling Older Adults with Cognitive Loss

A trend in our society has been to overemphasize the value and significance of the biomedical approach to the treatment of Alzheimer’s disease. Our hopes and our resources are deeply invested in the search for a cure. But, the promise of biomedicine to provide a cure for Alzheimer’s disease has been slow to actualize in part, because it subsumes many of the processes of normal brain aging. Despite its inability to effect change in the lives of people with Alzheimer’s disease a biomedical view has been the dominant framework. However, the myth of Alzheimer’s disease as a bounded disease entity is slowly being dispelled. There is a concomitant refocusing of the research agenda to psychosocial aspects and quality of life of the behaving, acting person with Alzheimer’s disease. The purpose of this phenomenological study was to investigate the everyday experiences of four people with cognitive loss due to Alzheimer’s disease who were living in their own homes. The goal was to increase knowledge of quality of life and well being in people with Alzheimer’s disease and explore the importance of occupation to the individual from his/her perspective. The study used multiple data collection methods including; interviews, observations, quality of life assessment and Ecological Momentary Assessment (EMA) to explore the everyday experiences of the participants. EMA required participants to provide a subjective assessment of psychological well being in real time in their typical environment. The use of EMA as a data collection method was particularly germane to this study as it does not rely on recall which can be impaired in people with Alzheimer’s disease. Thus, potential problems with recall-based judgments were avoided. Results of the study revealed a taskscape, or an array of related occupations, which were qualitative and heterogeneous. Furthermore, it demonstrated the importance of engagement in occupation despite level of cognitive impairment. Although, there is a biological basis to Alzheimer’s disease it is also culturally constructed. This research contributes to the development of a new cultural narrative of Alzheimer’s disease. It emphasizes and recognizes the value of occupation in the ordinary, everyday experiences of people with Alzheimer’s disease. It assists with opening a cultural space for the occupational person with Alzheimer’s disease and challenges the hegemony of the current medical category.