MSc, Occupational Therapy, Faculty of Health Sciences, University of the Witwatersrand / Infants and toddlers living in residential care facilities are at risk of developmental delay. Environmental factors contributing to this risk are the temporal context (how children spend their time) and social context (how and when caregivers interact with children). This study compared time-use patterns of children living in residential care facilities where caregiver training had previously taken place versus those in facilities where caregiver training had not taken place using a non-experimental, cross-sectional static group comparison study design. Spot observations were used to estimate time-use patterns of infants and toddlers living in residential care in Johannesburg. Results show that caregiver training increased the quantity of time infants spent with their caregivers (temporal context) and the quality of time toddlers spent with their caregivers (social context). Thus caregiver training has the potential to improve the environment in residential care facilities and can be used as an intervention strategy by occupational therapists.

With the increase in Canada’s seniors population (age 65 and over), there is a need to understand the residential requirements of this population. Almost 90 percent of seniors in Ontario reside in urban areas (Hodge 2008) and the majority live in the Greater Toronto Area. Of particular concern is the decrease in availability of informal care for aging and weakening individuals due to changes in economy and family relations. These changes are likely to result in a large influx of seniors into residential care facilities (RCFs) because not everyone is able to stay at home or is eligible to live in a long term care (LTC) facility. Seniors’ reasons for relocating as well as an analysis of their experiences after the move are required as the need for RCFs increases. Cultural and/or religious groups have become important providers of RCFs in Canada by offering necessary services for an aging population. The goal of this thesis is to analyse the importance of culture and the built environment within a push-pull framework associated with the decision to move to an RCF through a case study. The guiding question of the research is: Why do seniors choose facilities with cultural affiliations? In 2013, interviews were conducted with 15 residents, who were currently residing in a Ukrainian RCF called Ivan Franko. The results show that seniors move because of certain limitations (e.g., health, difficulty doing housework, family events, etc.). When an older person decides that they want or need to move, they will move to a facility that provides a physical and social environment while reinforcing cultural values (i.e., built environment), assuming a place is available. Acknowledging the limitations of a qualitative case study approach, the findings are important to consider as the multicultural population of the GTA and other large Canadian cities continue to age. The growing demand for places in RCFs reflects social, cultural and religious needs of a diverse older population. A challenge will exist for cultural and religious not-for-profit voluntary organizations, the for-profit sector, and governments at all levels to seek new ways to develop facilities in the future. / Thesis (Master, Geography) -- Queen's University, 2014-06-19 00:28:54.511

Inledning: Under Covid-19 pandemin har ett intresse väckts hos författarna angående hur en upplevd ensamhet påverkar en äldre negativt.Bakgrund: Bland annat kulturen, upplevelsen av ens egen hälsa och förtrogna kontakter påverkar upplevelsen av ensamhet. Äldre som bor på särskilda boenden upplever en större ensamhet än äldre som bor i eget hushåll. Ensamhet är en subjektiv upplevelse och kan delas in i existentiell, emotionell och social ensamhet. Besvär med ensamhet kan leda till en försämrad hälsa och ett ökat vårdbehov. Syfte: Belysa vilka omvårdnadsåtgärder som minskar de äldres besvär av ensamhet på särskilda boenden.Metod: En litteraturstudie baserad på 13 vetenskapliga artiklar med kvalitativa (n=3) och kvantitativ (n=10) metod.Resultat: Resultatet delas in i två huvudteman och åtta underteman. Den äldres syn på hur ensamhet kan minskas med fyra underteman: att få stöd och uppmärksamt, att ha kontroll över sin vardag och vara nöjd med livet, att vara i kontakt med det existentiell och spirituella samt att få distrahera sig. Andra temat handlar om Omvårdnadsåtgärder i form av aktiviteter med fyra underteman: Reminiscens- och kognitivstimulerandeterapi, videosamtal, djur- och robotterapi samt hobbyaktiviteter.Slutsats: Olika omvårdnadsåtgärder lämpar sig till olika former av ensamhet, beroende på om den äldre upplever existentiell, emotionell eller social ensamhet. Vidare är den äldres individuella intresse och förutsättningar av relevans vid val av omvårdnadsåtgärd. / Introduction: A spark of interest has grown during the Covid-19 pandemic about how experienced loneliness can affect elderly in a negative way.Background: For instance, culture, the experience of once own health and close relationships influences experienced loneliness. Elderly in residential care facilities experience loneliness in a higher regard than elderly who lives at home. Loneliness is a subjective experience and can be divided into existential, emotional, and social loneliness. Encumbrance of loneliness can lead to decline in health and increased care needs. Aim: Portray nursing interventions that decrease the elderly’s encumbrance of loneliness at residential care facilities.Method: A literature review based on 13 scientific studies with qualitative (n=3) and quantitative (n=10) methods.Result: The result has been divided into two main themes and eight sub-themes. The elderly’s view of how loneliness can be decreased, with four sub-themes: to get support and attention, to have control over once daily-life and to be satisfied with life, to be in contact with the existential and spiritual dimensions, and to distract one-self. The second main theme is nursing interventions in the form of activities, with four sub-themes: reminiscence- and cognitive stimulation therapy, videocalls, pet- and robot therapy and leisure activities.Conclusion: Different nursing interventions is suitable to different kind of loneliness, depending if the elderly is experiencing existential, emotional, or social loneliness. Furthermore, the elderly’s individual interest and condition is of relevance when applying nursing intervention.

Introduktion: Personer med funktionsnedsättning har nedsatt förmåga att fungera fysiskt, psykiskt eller intellektuellt, vilket kan medföra hinder med att sköta den dagliga munhygienen. I omvårdnaden i bostad med särskild service för vuxna ingår skyldighet att stödja funktionsnedsatta med deras personliga behov. Syfte: Syftet med studien var att undersöka boendeassistenters kunskap om munhälsa. Ytterligare ett syfte var att undersöka boendeassistenters inställning till munvård samt faktorer som påverkar deras inställning till munvård. Material och metod: Studien är en kvantitativ tvärsnittstudie baserad på en enkät med 31 strukturerade frågor samt en öppen fråga.  Enkäten besvarades av 43 boendeassistenter i en kommun i södra Sverige. Resultat: Resultatet visar att majoriteten (n=34) av boendeassistenterna anser att de boende behöver dagligt stöd med munhygienen. Det största hindret är att de boende inte vill ha hjälp med munhygienen. En stor del (n=31) av boendeassistenterna anser att de har tillräcklig kunskap om munvård för att stödja de boende med den dagliga munhygienen. Resultatet visar att 29 av boendeassistenterna har kunskap om fluor och 38 har kunskap om gingivit. Slutsats: Resultatet tyder på att boendeassistenterna i viss mån har kunskap om munhälsa och att de anser att de boende behöver dagligt stöd med munvården. Vidare anser boendeassistenterna att det största hindret till att stödja med munvården är att de boende inte vill ha hjälp vilket påverkar boendeassistenternas inställning till munvård. / Introduction: Persons with disabilities have a reduced capacity to function physically, mentally, or intellectually, which can lead to obstruction in daily oral hygiene. Health care in supervised residential care facilities for adults includes the responsibility to support disabled persons in their personal hygiene. Purpose: The purpose of this study was to examine the knowledge resident assistants have of oral health. A further purpose was to examine the attitude of resident assistants toward oral care and factors that affect their attitude toward oral care. Materials and method: The study is a quantitative cross-sectional study based on a questionnaire with 31 structured questions and one open question. Forty-three resident assistants in one municipality in southern Sweden participated. Results: Results show that the majority (n=34) of resident assistants believe residents need daily assistance with oral hygiene. The greatest obstacle to supporting residents is that residents do not want help with oral hygiene. The majority (n=31) of resident assistants believe they have sufficient knowledge of oral care to support residents in daily oral hygiene. Results show that 29 resident assistants have knowledge of fluoride and 38 have knowledge of gingivitis.  Conclusions: The results indicate that resident assistants have adequate knowledge of oral health to some extent, and that resident assistants believe residents need daily support in oral care. Also, resident assistants report the greatest obstacle in supporting oral care is that residents do not want help, which impacts the attitude of resident assistants towards oral care.

Bakgrund: Att uppleva meningsfullhet i sina aktiviteter är något som arbetsterapeutyrket har kunskap om. Vad arbetsterapeuter har för arbetsuppgifter inom särskilt boende (Säbo) och hur de jobbar med att främja meningsfulla aktiviteter för personer med demenssjukdom saknas det tydliga riktlinjer om Syftet: Syftet med studien var att beskriva arbetsterapeutens roll och hur de arbetar med att främja meningsfulla aktiviteter för personer med demenssjukdom på särskilt boende. Metod: I studien användes en kvalitativ ansats med semistrukturerade intervjuer. Åtta arbetsterapeuter som arbetar inom Säbo intervjuades. Ett strategiskt urval användes för att rekrytera deltagare och data analyserades genom en kvalitativ innehållsanalys. Resultat: Arbetet resulterade i två kategorier och sju subkategorier. De två huvudkategorierna är arbetsterapeutens roll och meningsfulla aktiviteter. Under arbetsterapeutens roll framkom subkategorierna: Kompetens/organisation, personcentrering i aktivitet och att deltagarna saknar tid till aktiviteter. Deltagarna beskrev att arbetsterapeutens roll ser olika ut beroende på uppdrag och att arbetsterapeuterna har vilja och kompetens för att främja meningsfulla aktiviteter på Säbo för personer med demenssjukdom. Den andra huvudkategorin meningsfulla aktiviteter innehåller subkategorierna: Identifiera meningsfulla aktiviteter, främja meningsfulla aktiviteter och att småsaker ger meningsfullhet samt att miljön påverkar meningsfulla aktiviteter. Deltagarna kunde främja meningsfulla aktiviteter genom intervjuer, lyssna på levnadsberättelse, göra aktiviteter i dagliga livet (ADL) bedömning och närvaron med personen för att identifiera vad som är viktigt för den här personen. Slutsats: Arbetsterapeuter kan genom att jobba personcentrerat och jobba i team främja meningsfulla aktiviteter på Säbo för personer med demenssjukdom. För att kunna uppnå detta behöver arbetsterapeuten och teamet jobba mot samma mål. / Background: Experiencing meaningfulness in activities is something that the occupational therapist profession has knowledge of. There are no clear guidelines on what occupational therapists have to do in residential care facilities and how they work to promote meaningful activities for people with dementia. Aim: The aim of the study was to describe the role of occupational therapists and how they work to promote meaningful activities for people with dementia in residential care facilities. Method: The study used a qualitative approach with semistructured interviews. Eight occupational therapists who work within residential care facilities were interviewed. Strategic sampling was used to recruit participants and data were analyzed through qualitative content analysis. Result: The study resulted in two categories and seven subcategories. The two main categories are the occupational therapist's role and meaningful activities. Under the occupational therapist's role, the subcategories emerged: Competence/organization, person-centered in activity and that the participants lack time for activities. The participants described that the occupational therapist's role can look different depending on the assignment and that the occupational therapists have a desire and competence to promote meaningful activities at residential care facilities for people with dementia. The second main category of meaningful activities contains the subcategories: Identify meaningful activities, promote meaningful activities, small things give meaning, and that the environment affects meaningful activities. Participants were able to promote meaningful activities through interviews, listening to life stories, doing activities of daily living (ADL) assessment, being present with the person to identify what is important to this person. Conclusion: By working person-centered and working in teams, occupational therapists can promote meaningful activities at residential care facilities for people with dementia. In order to achieve this, the occupational therapist and the team need to work towards the same goal.

Despite the growing numbers and valuable contributions of older individuals to society, they continue to face negative attitudes towards them. Such attitudes are largely influenced by portrayal of older persons in the media. Understanding how the media portrays older people to the public can provide significant insights into the nature of the images from which older people may make comparisons and which inform the perceptions, opinions, and attitudes of other people. There is little knowledge of perceptions of media portrayal in old age, and this study aimed to obtain insight from the point of view of older people regarding how they are portrayed in the printed media. Qualitative research has been applied to gain insight in the older persons’ perceptions. The case study method was chosen since it allowed the researcher to gain an in–depth understanding of older person’s perceptions regarding how they are portrayed in the media. The participants in this study consisted of nine male and 12 female individuals residing in a residential care facility. Persons between the ages of 60 and 85 were purposively chosen since they can contribute to meaningful insight regarding how they are portrayed in the print media. Data was collected by means of conducting focus group discussions and individual interviews. The use of these methods enabled dynamic interactions resulting in the production of rich, detailed information. Data was analyzed using thematic content analysis and key–word–in–context analysis. Guidelines to ensure the integrity of the findings have been applied. The findings indicated that older persons perceive their portrayal in the media to be minimal in terms of the exposure that they receive. Older persons feel that on the seldom occasion when they are in the media, they are presented as an isolated population separated from younger persons. The portrayal of older persons in the media is also perceived as stereotypical in the sense that older persons are presented as sick, inactive, weak and fragile. The implications of such portrayal according to older persons are that they influence intergenerational relationships and they also confirm stereotypical assumptions about older persons. Older persons feel that they rather want to be portrayed in terms of the valuable contributions that they are making to all spheres of life, despite old age. The media should thus promote positive ageing, which could contribute to the stimulation and motivation of older persons. Findings of this study also indicate that while older persons enjoy reading magazines and newspapers they are often limited to do so due to financial restrictions and physical limitations such as poor eyesight. The findings of this research of older persons perceptions regarding their portrayal in the media has implications for intergenerational relationships as well as to advertisers and marketers who are looking to appeal to the older population. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.

Despite the growing numbers and valuable contributions of older individuals to society, they continue to face negative attitudes towards them. Such attitudes are largely influenced by portrayal of older persons in the media. Understanding how the media portrays older people to the public can provide significant insights into the nature of the images from which older people may make comparisons and which inform the perceptions, opinions, and attitudes of other people. There is little knowledge of perceptions of media portrayal in old age, and this study aimed to obtain insight from the point of view of older people regarding how they are portrayed in the printed media. Qualitative research has been applied to gain insight in the older persons’ perceptions. The case study method was chosen since it allowed the researcher to gain an in–depth understanding of older person’s perceptions regarding how they are portrayed in the media. The participants in this study consisted of nine male and 12 female individuals residing in a residential care facility. Persons between the ages of 60 and 85 were purposively chosen since they can contribute to meaningful insight regarding how they are portrayed in the print media. Data was collected by means of conducting focus group discussions and individual interviews. The use of these methods enabled dynamic interactions resulting in the production of rich, detailed information. Data was analyzed using thematic content analysis and key–word–in–context analysis. Guidelines to ensure the integrity of the findings have been applied. The findings indicated that older persons perceive their portrayal in the media to be minimal in terms of the exposure that they receive. Older persons feel that on the seldom occasion when they are in the media, they are presented as an isolated population separated from younger persons. The portrayal of older persons in the media is also perceived as stereotypical in the sense that older persons are presented as sick, inactive, weak and fragile. The implications of such portrayal according to older persons are that they influence intergenerational relationships and they also confirm stereotypical assumptions about older persons. Older persons feel that they rather want to be portrayed in terms of the valuable contributions that they are making to all spheres of life, despite old age. The media should thus promote positive ageing, which could contribute to the stimulation and motivation of older persons. Findings of this study also indicate that while older persons enjoy reading magazines and newspapers they are often limited to do so due to financial restrictions and physical limitations such as poor eyesight. The findings of this research of older persons perceptions regarding their portrayal in the media has implications for intergenerational relationships as well as to advertisers and marketers who are looking to appeal to the older population. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.

Background and Purpose: To investigate the effect of an individualized exercise program versus a generic group-based exercise program on balance, gait, and functional performance of older adults categorized as having mild balance dysfunction and living in residential care facilities. Methods: Single blind randomized control design. One hundred-twenty residents fulfilled screening criteria for mild balance dysfunction based on the BioSwayTM balance and the Multi-Directional Reach Test (MDRT) primary outcome measures. Secondary assessment was completed using the Modified Physical Performance Test (PPT), hand-held dynamometer (lower-limb muscle strength testing), and gait speed analysis. Sixty subjects received individualized treatment from physical therapists (8 weeks). Another sixty subjects received generic group-based exercises (8 weeks). All outcome measures were collected at baseline and post-intervention (ninth week); and BioSwayTM and PPT measures at follow-up (thirteenth week) for the individualized group. Results: Individualized group (n=60) showed significant improvement compared to the group-based group (n=60) on the two BioSwayTM scores (limits of stability, p < .001; and postural stability, p = .016), the MDRT scores (forward reach, p < .001; backward reach, p = .007; right lateral reach, p < .001; and left lateral reach p < .001), the strength scores (hip flexors, p = .010; knee extensors, p = .002; hip abductors, p = .009; and ankle dorsiflexors, p = .025), the PPT outcomes (p < .001), and the gait scores (p = .012). Effect sizes ranged from small to large, with the largest sizes for limits of stability and MDRT. There were no significant differences between groups for the mCTSIB (p = .538). However, 96.7% of subjects in the individualized group scored within one SD of the reference mean, relative to 75% in the group-based group. At follow-up, the individualized group showed significant differences over time with medium to large effect sizes on the PPT (p < .001), limits of stability (p < .001), postural stability (p < .001), and mCTSIB (p = .005) measures. Post-hoc analysis revealed retention of gains for all measures at follow-up, except the mCTSIB. Conclusion: The individualized group showed significant improvements in the areas of balance, strength, mobility, and functional outcomes.

The social environment has been recognised as one of the key aspects in determining the quality of life throughout the human lifespan. Human behaviour, thoughts, feelings and attitudes are socially constructed and can only be understood when viewed from the perspective of social interaction. Older individuals, who live in residential facilities experience a diminished quality of life due to factors such as loss of independence, reduced social networks, functional dependence, and contextual changes. Depression, loneliness and social isolation are an integral part of these individuals’ lives. People develop specific styles of relating, also referred to as interpersonal styles. The systems theory is used to explain the circular processes of the interaction between people. In particular the Self-Interactional Group Theory (SIGT) is proposed as theoretical framework to explore the relational qualities of older people in a residential care facility. SIGT views the interaction between people on three levels, namely the intra-personal level, the interpersonal level and the group level, which operate interdependently in the interaction between people. The interpersonal level of analysis consists of the definition of the relationship, relational qualities, motivation to engage with people to address needs and needs satisfaction as well as the circular processes of which the interaction consists of. The interactions between people always take place in an interpersonal context, embedded in broader environments. A qualitative and exploratory research design was selected to explore the relational qualities in interactions between older individuals living in a residential care facility. This study is based on data collected during a primary research study at a residential care facility for older individuals in 2013. The purpose of study was to explore the quality of life of older individuals residing in a residential care facility in Gauteng, South Africa. The data-gathering process in the primary research study involved the Mmogo-Method, a visual projective data-gathering method, the World Café method and person-centred interviews to gain insight into the participants’ life experiences at the residential care facility. For the purpose of this research, only the person-centred interviews were used for the secondary analysis of the data. Twelve purposely-selected individuals (aged 80 to 95; 3 men and 9 women) from the residential care facility participated voluntarily in the person-centered interviews, which were audio recorded. The collected data were transcribed verbatim and subjected to two different methods of analyses. First, data were analysed thematically by adopting an inductive approach. The themes identified in this first phase were next subjected to a deductive content analysis. The themes were categorised according to the relational variables in accordance with the Interactional Pattern Analysis (IPA), thereby contributing to the trustworthiness of the findings. The findings revealed that the interactions between older individuals take place in a broader environment that advocate the active participation of people. Active participation takes place both in and outside the facility and older people reported that this contributed to their quality of life. The relational qualities that could be described as enhancing interpersonal connectivity and satisfying older people’s needs for confirmation were identified as empathy, unconditional acceptance of others, confirmation and interpersonal flexibility. This research, however, highlighted relational qualities that restrained quality of life of older people, namely confusing self-presentation, ineffective expression on needs and withdrawal due to physical immobility. Needs were expressed in a very unspecific, blaming or manipulative manner, and consequently needs were not satisfied, but provoked, instead, feelings of frustration, pain and guilt. This research highlighted the predicament that older people find themselves in. Their decreased physical abilities and limited emotional repertoire to move towards others and the environment also limit their needs satisfaction. The presenting problem of social isolation can be explained by the combination of limited physical mobility and relational qualities that restrain quality of life for older people. This research study thus holds important implications for relationship-focused approaches in residential facilities for older individuals in order to empower and enable them to enhance their quality of life. Specific recommendations include interventions to assist older people to express their needs more effectively and to use opportunities in interaction to confirm them as autonomous functioning older people. / MA (Psychology), North-West University, Potchefstroom Campus, 2014

The social environment has been recognised as one of the key aspects in determining the quality of life throughout the human lifespan. Human behaviour, thoughts, feelings and attitudes are socially constructed and can only be understood when viewed from the perspective of social interaction. Older individuals, who live in residential facilities experience a diminished quality of life due to factors such as loss of independence, reduced social networks, functional dependence, and contextual changes. Depression, loneliness and social isolation are an integral part of these individuals’ lives. People develop specific styles of relating, also referred to as interpersonal styles. The systems theory is used to explain the circular processes of the interaction between people. In particular the Self-Interactional Group Theory (SIGT) is proposed as theoretical framework to explore the relational qualities of older people in a residential care facility. SIGT views the interaction between people on three levels, namely the intra-personal level, the interpersonal level and the group level, which operate interdependently in the interaction between people. The interpersonal level of analysis consists of the definition of the relationship, relational qualities, motivation to engage with people to address needs and needs satisfaction as well as the circular processes of which the interaction consists of. The interactions between people always take place in an interpersonal context, embedded in broader environments. A qualitative and exploratory research design was selected to explore the relational qualities in interactions between older individuals living in a residential care facility. This study is based on data collected during a primary research study at a residential care facility for older individuals in 2013. The purpose of study was to explore the quality of life of older individuals residing in a residential care facility in Gauteng, South Africa. The data-gathering process in the primary research study involved the Mmogo-Method, a visual projective data-gathering method, the World Café method and person-centred interviews to gain insight into the participants’ life experiences at the residential care facility. For the purpose of this research, only the person-centred interviews were used for the secondary analysis of the data. Twelve purposely-selected individuals (aged 80 to 95; 3 men and 9 women) from the residential care facility participated voluntarily in the person-centered interviews, which were audio recorded. The collected data were transcribed verbatim and subjected to two different methods of analyses. First, data were analysed thematically by adopting an inductive approach. The themes identified in this first phase were next subjected to a deductive content analysis. The themes were categorised according to the relational variables in accordance with the Interactional Pattern Analysis (IPA), thereby contributing to the trustworthiness of the findings. The findings revealed that the interactions between older individuals take place in a broader environment that advocate the active participation of people. Active participation takes place both in and outside the facility and older people reported that this contributed to their quality of life. The relational qualities that could be described as enhancing interpersonal connectivity and satisfying older people’s needs for confirmation were identified as empathy, unconditional acceptance of others, confirmation and interpersonal flexibility. This research, however, highlighted relational qualities that restrained quality of life of older people, namely confusing self-presentation, ineffective expression on needs and withdrawal due to physical immobility. Needs were expressed in a very unspecific, blaming or manipulative manner, and consequently needs were not satisfied, but provoked, instead, feelings of frustration, pain and guilt. This research highlighted the predicament that older people find themselves in. Their decreased physical abilities and limited emotional repertoire to move towards others and the environment also limit their needs satisfaction. The presenting problem of social isolation can be explained by the combination of limited physical mobility and relational qualities that restrain quality of life for older people. This research study thus holds important implications for relationship-focused approaches in residential facilities for older individuals in order to empower and enable them to enhance their quality of life. Specific recommendations include interventions to assist older people to express their needs more effectively and to use opportunities in interaction to confirm them as autonomous functioning older people. / MA (Psychology), North-West University, Potchefstroom Campus, 2014