Leisure activities and well-being in residential care: Voices of older Adults in New Zealand.

Abstract

This doctoral thesis contributes to gerontology research by investigating the leisure experiences of older adults living in residential care in New Zealand. There is a need to understand how frail residents experience their leisure in their everyday world. The New Zealand strategies for active and successful ageing focus on community-dwelling seniors rather than on those in residential care. These policy initiatives ignore the leisure practices of the increasing numbers of older adults who require long-term residential care. A few international studies have attempted to highlight the importance of leisure participation among older adults living in residential care, but the information on the New Zealand context is scant. Through a phenomenological approach, this thesis provides clarity to poorly understood leisure experiences. This thesis, which was informed by an integrated theoretical approach (constructs adapted from six major ageing theories), provides insight into leisure experiences and sources of satisfaction for older adults living in residential care. In a supplementary finding, it also sheds light on their adaptation to the conditions they encounter in residential care. Data were collected through triangulating participation observation, in-depth interviews, and key informant interviews. This involved six residential care facilities (two large, two medium, and two small). I spent one day of observation in each residential care facility, then conducted semi-structured interviews with a total of twenty-four residents and ten key informants. The data were analysed using thematic analysis. Together the residents and staff provide insights on the importance of leisure activities during adjustment, and the benefits of and barriers to participation, satisfaction, and well-being. The study also revealed the diverse and complex needs of older adults after their transition to residential care. Given their unique life histories and circumstances, the interests and abilities of residents vary, a fact that seems to be largely ignored in the development of leisure activities in these facilities. Loss of identity and challenges of adaptation were the results of frailty, losses and feeling of institutionalisation. The adjustment processes were influenced by residents’ leisure participation. The finding elucidates the significant impact of leisure activities in residents’ lives. Lack of leisure opportunities resulted in enforced idleness. From residents’ point of view, barriers to implementing leisure activities include the mismatch between their interests and abilities and the activities on offer, facilities’ lack of resources, and deteriorating health/functional status, which resulted in passivity among the residents. Activities tailored to residents’ abilities and interests are an important part of person-centred care because of the many benefits associated with participation. Older adults with active participation in both self-led and offered activities experienced numerous benefits such as feelings of contribution and achievement, sense of belonging and connection, socialisation, companionship, pleasure, enjoyment, and relaxation. The main barriers to participation reported by both residents and staff were residents’ health condition, lack of budget for activities, shortage of staff, and lack of social network. The key to satisfaction was developing identity through meaningful engagement in the activities of their interest. This study acknowledges the importance of leisure activities and highlights the importance of person-centred care in meeting the diverse needs and enhancing the well-being of older adults in residential care.