Title

Dozing, dreaming, searching, being together and doing in another way – occupational engagement patterns of nursing home residents with dementia

Location

Hiawatha 3

Start Time

17-10-2014 10:30 AM

End Time

17-10-2014 11:00 AM

Session Type

Research Paper

Abstract

Occupational engagement refers to doing occupations and a sense of being involved in occupations (Christiansen & Townsend, 2011). Patterns of occupations are mostly conceptualized in the way of what Meyer (1922) called the big four: Work, Play, Rest and Sleep. These gradations of occupation neglect individual experiences and the social dimensions of occupations. Hammel (2009) suggests conceptualizing occupations in experienced-based categories as an alternative. In case of nursing home residents with dementia, their occupational engagement is affected by disease-specific losses of capacities and abilities as well as the conditions, procedures and care routines in nursing homes. Previous research on nursing home residents’ occupations often included interviews with persons with mild dementia; there is a lack of knowledge concerning the occupational engagement of residents with middle- and late-stage dementia.

Analyzing and conceptualizing unknown aspects of the occupational engagement of specific groups are important issues for occupational science. This study takes an occupational science perspective for focusing on the occupational engagement of nursing home residents with middle- and late-stage dementia. Its main objectives are to generate new understandings of the complexity of residents` occupational engagement in their everyday life in the nursing home environment and to find a new way to characterize and conceptualize occupations.

Using a qualitative research design based on ‘grounded theory’ (Charmaz, 2006), data was collected in two ways: In ethnographic-participant observations in two German nursing homes, a wide range of occupational situations for residents with middle- and late-stage dementia were studied. In episodic interviews (Flick, 2009), occupational therapists, nurses and care assistants were asked about their perspectives on the residents’ occupational engagement. The data were coded openly and in a focused way and continually compared (Charmaz, 2006). Several methods, data and perspectives were triangulated (Flick, 2009).

Our results show four specific dimensions of occupational engagement: ‘being together and connected with each other’, ‘spending time, waiting, dozing and dreaming’, ‘covering excessive demands, creative recreations ’ and ‘searching for anchor points, connecting between past and present’. Nursing home residents’ occupational engagement can be characterized by elusiveness, coincidence and fragility. They no longer get involved in occupations in the habitual and culturally shared ways. The results advance the understanding of the occupational engagement patterns of residents with dementia under the specific conditions in nursing homes.

Keywords: Occupational Engagement, Nursing Home Residents, Dementia

References

Charmaz, K. C. (2006). Constructing Grounded Theory. A Practical Guide Through Qualitative Analysis.London,Thousand Oaks,New Delhi,Singapore: Sage Publications.

Christiansen, C. H., & Townsend, E. A. (2011). An Introduction to Occupation. In C. H. Christiansen & E. A. Townsend (Eds.), Introduction to Occupation. The Art and Science of Living (pp. 1-34).London: Pearson.

Hammel, K. W. (2009). Self-care, productivity, and leisure, or dimensions of occupational experience? Rethinking occupational “categories”. Canadian Journal of Occupational Therapy, 76(2), 107–114.

Meyer, A. (1922). The Philosophy of Occupational Therapy. Archives of Occupational Therapy, 1(1), 1–10.

Flick, U. (2009). An Introduction to Qualitative Research. Edition 4.London,Thousand Oaks,New Delhi,Singapore: SAGE.

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Oct 17th, 10:30 AM Oct 17th, 11:00 AM

Dozing, dreaming, searching, being together and doing in another way – occupational engagement patterns of nursing home residents with dementia

Hiawatha 3

Occupational engagement refers to doing occupations and a sense of being involved in occupations (Christiansen & Townsend, 2011). Patterns of occupations are mostly conceptualized in the way of what Meyer (1922) called the big four: Work, Play, Rest and Sleep. These gradations of occupation neglect individual experiences and the social dimensions of occupations. Hammel (2009) suggests conceptualizing occupations in experienced-based categories as an alternative. In case of nursing home residents with dementia, their occupational engagement is affected by disease-specific losses of capacities and abilities as well as the conditions, procedures and care routines in nursing homes. Previous research on nursing home residents’ occupations often included interviews with persons with mild dementia; there is a lack of knowledge concerning the occupational engagement of residents with middle- and late-stage dementia.

Analyzing and conceptualizing unknown aspects of the occupational engagement of specific groups are important issues for occupational science. This study takes an occupational science perspective for focusing on the occupational engagement of nursing home residents with middle- and late-stage dementia. Its main objectives are to generate new understandings of the complexity of residents` occupational engagement in their everyday life in the nursing home environment and to find a new way to characterize and conceptualize occupations.

Using a qualitative research design based on ‘grounded theory’ (Charmaz, 2006), data was collected in two ways: In ethnographic-participant observations in two German nursing homes, a wide range of occupational situations for residents with middle- and late-stage dementia were studied. In episodic interviews (Flick, 2009), occupational therapists, nurses and care assistants were asked about their perspectives on the residents’ occupational engagement. The data were coded openly and in a focused way and continually compared (Charmaz, 2006). Several methods, data and perspectives were triangulated (Flick, 2009).

Our results show four specific dimensions of occupational engagement: ‘being together and connected with each other’, ‘spending time, waiting, dozing and dreaming’, ‘covering excessive demands, creative recreations ’ and ‘searching for anchor points, connecting between past and present’. Nursing home residents’ occupational engagement can be characterized by elusiveness, coincidence and fragility. They no longer get involved in occupations in the habitual and culturally shared ways. The results advance the understanding of the occupational engagement patterns of residents with dementia under the specific conditions in nursing homes.

Keywords: Occupational Engagement, Nursing Home Residents, Dementia