The older person’s component of the population has increased rapidly in recent years due to developments in medicine, technology and other areas of life. Growing older implies a gradual decline in the physical, mental and social functioning of an individual. Older people consequently have to rely on others for assistance, and, in some instances, they are looked after in residential care facilities. These facilities should be sensitive to older person’s culture, religion, ethnicity, privacy, dignity and independence. The aim of this study was to explore older person’s experiences in an economically deprived residential care facility in order to understand what their needs are and how these needs can be met so as to enhance older person’s subjective well–being. Socio–ecological theory and the BBB (Being, Belonging and Becoming) model were used to assess the extent to which the facility promoted the well–being of the residents of the facility. A qualitative research study was undertaken to determine the older person’s experiences of the residential care facility. A purposive sample of eight participants - three black and five white with ages ranging from 65 to 75 - was used in the focus group discussions. Another method, the Mmogo–methodTM, made use of a sample of 23 participants - eight black and 15 white with ages ranging from 65 to 75. The focus group discussions yielded insight into the older person’s experiences of the facility while in the Mmogo–methodTM, a visually projective method, the participants made visual representations of their experiences thereby revealing the deeper meanings of the experiences. The data, both textual and visual, obtained from the focus group discussions and the Mmogo–methodTM, were analysed using thematic content analysis. The trustworthiness of the study was ensured through crystallisation. The study revealed that the older persons in the facility experienced a lack of autonomy, isolation and discrimination. It also appeared that they wanted more contact with people outside the facility. Some of the older persons engaged actively with their environment while others adopted a more passive stance. The study suggests that older persons should be given the opportunity to take decisions regarding certain aspects of their lives. Also, interventions aimed at dealing with personal loss and relational deficiencies and at promoting respect for diversity should be planned and implemented in order to improve the subjective well–being of older persons in residential care facilities. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2012.

The older person’s component of the population has increased rapidly in recent years due to developments in medicine, technology and other areas of life. Growing older implies a gradual decline in the physical, mental and social functioning of an individual. Older people consequently have to rely on others for assistance, and, in some instances, they are looked after in residential care facilities. These facilities should be sensitive to older person’s culture, religion, ethnicity, privacy, dignity and independence. The aim of this study was to explore older person’s experiences in an economically deprived residential care facility in order to understand what their needs are and how these needs can be met so as to enhance older person’s subjective well–being. Socio–ecological theory and the BBB (Being, Belonging and Becoming) model were used to assess the extent to which the facility promoted the well–being of the residents of the facility. A qualitative research study was undertaken to determine the older person’s experiences of the residential care facility. A purposive sample of eight participants - three black and five white with ages ranging from 65 to 75 - was used in the focus group discussions. Another method, the Mmogo–methodTM, made use of a sample of 23 participants - eight black and 15 white with ages ranging from 65 to 75. The focus group discussions yielded insight into the older person’s experiences of the facility while in the Mmogo–methodTM, a visually projective method, the participants made visual representations of their experiences thereby revealing the deeper meanings of the experiences. The data, both textual and visual, obtained from the focus group discussions and the Mmogo–methodTM, were analysed using thematic content analysis. The trustworthiness of the study was ensured through crystallisation. The study revealed that the older persons in the facility experienced a lack of autonomy, isolation and discrimination. It also appeared that they wanted more contact with people outside the facility. Some of the older persons engaged actively with their environment while others adopted a more passive stance. The study suggests that older persons should be given the opportunity to take decisions regarding certain aspects of their lives. Also, interventions aimed at dealing with personal loss and relational deficiencies and at promoting respect for diversity should be planned and implemented in order to improve the subjective well–being of older persons in residential care facilities. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2012.

An exploration of the interpersonal experiences of loneliness by older people in a residential care facility It is estimated that there were about 3, 8 million older people in South Africa in 2010 (Statistics South Africa, 2010). Many older people have to be cared for in residential care facilities due to their weakening health, the migration of children and grandchildren, or due to limited financial resources. This has led to the attempt in this research study to explore the interpersonal experiences of loneliness by older people living in a residential care facility. Loneliness is an unpleasant experience associated with inadequate interpersonal contact. It is widely accepted that loneliness is closely associated with ageing as a consequence of multiple losses – loss of abilities, loss of and changes in personal relationships, loss of relationships with familiar environments and changed contact with friends and relatives resulting in reduced relationships. Changes in the relationship with the environment are regarded as a particular loss by older people, especially if they have to rely on institutionalized care and loose contact with familiar social networks and the free association with other people. Lonely people are isolated people. For the purpose of this study, loneliness is regarded as a relational phenomenon, and the theory of complex responsive processes of relating will be used as the theoretical framework for this study. In an attempt to understand the interpersonal experiences associated with loneliness, a qualitative and exploratory research method was used. The research was conducted in a residential care facility in Johannesburg, South Africa. The group of older people, who was purposively selected for the study, consisted of 10 older persons: 7 female and 3 male and with ages ranging between 62 and 82 years of age. The data was collected by means of various qualitative techniques, including the Mmogo-methodTM and visual drawings. The collected data was analysed by using thematic analysis, visual analysis and key-words-in-context, and crystallization was used to increase the trustworthiness of the findings. Ethical approval for the research project was obtained from the North-West University. Two themes emerged from the findings, being: 1) Relationships are experienced in terms of the interactions in relationships as well as in terms of preferred interpersonal styles; and 2) The relationships experienced in the context of the residential care facility are described as being unsafe and lacking in care, while the environment is described as non-stimulating. Some of the findings are confirmed by existing literature. However, the unique contribution of the study is the finding that the environment in which the relationships are embedded is perceived to be dangerous, and that it is perceived to be a risk to become visible to each other in order to establish meaningful interpersonal relationships. Several suggestions regarding future interventions are made and some limitations of the study are mentioned. The contribution of the study is that loneliness are expressed and described in terms of interpersonal relationships embedded in the broader environment. Thus, the potential of older people to form meaningful interpersonal relationships are limited in the broader environment if the environment is experienced as unsafe and lacking in care. / Thesis (MSc (Research Psychology))--North-West University, Potchefstroom Campus, 2012

An exploration of the interpersonal experiences of loneliness by older people in a residential care facility It is estimated that there were about 3, 8 million older people in South Africa in 2010 (Statistics South Africa, 2010). Many older people have to be cared for in residential care facilities due to their weakening health, the migration of children and grandchildren, or due to limited financial resources. This has led to the attempt in this research study to explore the interpersonal experiences of loneliness by older people living in a residential care facility. Loneliness is an unpleasant experience associated with inadequate interpersonal contact. It is widely accepted that loneliness is closely associated with ageing as a consequence of multiple losses – loss of abilities, loss of and changes in personal relationships, loss of relationships with familiar environments and changed contact with friends and relatives resulting in reduced relationships. Changes in the relationship with the environment are regarded as a particular loss by older people, especially if they have to rely on institutionalized care and loose contact with familiar social networks and the free association with other people. Lonely people are isolated people. For the purpose of this study, loneliness is regarded as a relational phenomenon, and the theory of complex responsive processes of relating will be used as the theoretical framework for this study. In an attempt to understand the interpersonal experiences associated with loneliness, a qualitative and exploratory research method was used. The research was conducted in a residential care facility in Johannesburg, South Africa. The group of older people, who was purposively selected for the study, consisted of 10 older persons: 7 female and 3 male and with ages ranging between 62 and 82 years of age. The data was collected by means of various qualitative techniques, including the Mmogo-methodTM and visual drawings. The collected data was analysed by using thematic analysis, visual analysis and key-words-in-context, and crystallization was used to increase the trustworthiness of the findings. Ethical approval for the research project was obtained from the North-West University. Two themes emerged from the findings, being: 1) Relationships are experienced in terms of the interactions in relationships as well as in terms of preferred interpersonal styles; and 2) The relationships experienced in the context of the residential care facility are described as being unsafe and lacking in care, while the environment is described as non-stimulating. Some of the findings are confirmed by existing literature. However, the unique contribution of the study is the finding that the environment in which the relationships are embedded is perceived to be dangerous, and that it is perceived to be a risk to become visible to each other in order to establish meaningful interpersonal relationships. Several suggestions regarding future interventions are made and some limitations of the study are mentioned. The contribution of the study is that loneliness are expressed and described in terms of interpersonal relationships embedded in the broader environment. Thus, the potential of older people to form meaningful interpersonal relationships are limited in the broader environment if the environment is experienced as unsafe and lacking in care. / Thesis (MSc (Research Psychology))--North-West University, Potchefstroom Campus, 2012

Bakgrund Det finns en ökad risk hos äldre personer att drabbas av åldersförändringar som kan medföra behov av utökad omvårdnad. En flytt till ett vård- och omsorgsboende kan vara ett alternativ för många äldre, med möjlighet till vård och omsorg dygnet runt. Flytten kan innebära en stor förändring inom individen. Sjuksköterskans ansvar är att identifiera risker och behov för att främja välbefinnande varpå det är av vikt att sjuksköterskan medvetandegör de äldres upplevelser i samband med flytt för att vidta åtgärder vid behov. Syfte Syftet med föreliggande litteraturöversikt är att beskriva äldre personers upplevelser i samband med flytt från det egna hemmet till ett vård- och omsorgsboende. Metod Arbetet utfördes som en strukturerad litteraturöversikt med artiklar hämtade från databaserna CINAHL, PubMed samt PsycINFO. Resultatet analyserades med hjälp av innehållsanalys. Resultat Resultatet frambringade två huvudkategorier; Beslutet att flytta och Anpassningen. I samband med beslutet upplevdes delaktighet som bidragande till känsla av lättnad och trygghet medan motsatsen ledde till stress och maktlöshet. Vid anpassningen upplevdes regler och rutiner som frustrerande och kontrollerande. Möjligheten att bibehålla relationer, upprätthålla sin självbild och fortsätta med tidigare aktiviteter var viktigt för välbefinnandet. Slutsats Upplevelsen hos en äldre person i samband med flytt till ett vård- och omsorgsboende har visat sig bero på en rad påverkbara faktorer. Faktorer som sjuksköterskan kan medvetandegöra och med hjälp av omvårdnadsprocessen bidra till en positiv transition för den äldre i samband med flytten. / Background There is an increased risk in older persons of being affected by age-related changes that may entail the need for extended care. A move to a residential care facility can be an option for many elderly persons, with the possibility of round-the-clock care. There location can lead to a major change within the individual. The nurse's responsibility is to identify risks and needs to promote well-being, where upon it is important that the nurse raises awareness of the elderly's experiences when moving in order to implement measures if necessary. Aim The purpose of the present literature review is to describe older persons ́ experiences when moving from their own home to a residential care facility. Method This study was carried out as a structured literature review with articles from the databases CINAHL, PubMed and PsycINFO. The results were analyzed using a content analysis. Results The result produced two main categories; The decision to move and Adaptation. In relation with the decision, the older person experienced participation as contributing to feeling of relief and security, while the opposite led to stress and powerlessness. During adaptation, rules and routines were perceived as frustrating and controlling. The ability to maintain relationships, one's self-image and continue with previous activities was important for well-being. Conclusions The experience of an elderly person when moving to a residential care facility has been shown to depend on several influenceable factors. The nurse should raise awareness of the factors and with the help of the nursing process contribute to a positive transition for the elderly when moving.

Esta tesis propone una solución a la problemática actual del crecimiento poblacional de los adultos mayores a nivel mundial a través de un centro de atención residencial en el distrito de San Martín de Porres. Se analizan los antecedentes de la tipología, así como referentes a tomar en cuenta para tener una investigación teórica y arquitectónica completa que nos den una visión global del proyecto. A su vez, se analizan los usuarios para la elaboración de un programa arquitectónico que cumpla con satisfacer las distintas necesidades. Se consideran los aspectos físicos y psicológicos del adulto mayor para el planteamiento de la arquitectura, eligiendo como énfasis la neuro-arquitectura, la cual evitará el deterioro cognitivo y el aislamiento de los usuarios residentes. Por consiguiente, se analizarán referentes para el énfasis, el cual nos ayudará a obtener las características que debe tener la arquitectura dentro de los distintos espacios. Finalmente, mediante la sinergia del análisis del entorno urbano, como la teoría, el programa elaborado, y el énfasis se busca brindar un espacio residencial que cuente con un área de atención médica básica el cual fomente la participación activa del adulto dentro de un entorno urbano a nivel barrial, mejorando su calidad de vida. / This thesis proposes a solution to the worldwide current problem of the elderly growing population through a residential care center in San Martín de Porres. The antecedents of the typology are analyzed, as well as references to take into to have a complete theoretical and architectural investigation that gives us a global vision of the project. At the same time, the users are analyzed to create an architectural program that meets the different needs. The physical and psychological aspects of the elderly are considered for the approach to architecture, choosing neuro-architecture as emphasis in this project, which will avoid cognitive deterioration and isolation of resident users. Consequently, references will be analyzed for this emphasis, which will help us to obtain the characteristics that architecture should have within the different spaces. Finally, through the synergy of the analysis of the urban environment, the previous theory, the elaborated program, and the emphasis we provide a residential space that has a medical care area which encourages the active participation of the adult in an urban environment. at a neighborhood level, improving their quality of life. / Trabajo de investigación

Older people often experience loneliness and depression, especially those dependent on institutional care. The loneliness can be attributed to multiple losses such as the loss of physical and cognitive abilities, the loss of relationships with familiar environments, the loss of significant others, as well as changing contact with family members and friends. The strategy commonly used by older people to deal with such feelings of loss, is to reminisce on such losses as well as on the lost or altered relationships. This strategy might result in a situation where the focus older people have on the past prevents them from recognizing the potential of relationships in their immediate environment. In order to make older people more aware of meaningful relationships in their immediate environment, the method of appreciative inquiry was used. Appreciative inquiry uses questioning as an intervention. Questions were formulated in such a way that the positive aspects of possible relationships in interpersonal environments were emphasised. The aim of the appreciative inquiry was to determine what relationship qualities older people experience as meaningful or effective. A qualitative and investigative research method was used in an attempt to investigate older people's subjective experiences of the relationships they have in the residential care facility. Participants to the study were volunteers who permanently reside in a residential care facility for older people in Gauteng, South Africa. Textual- and visual data was collected through the use of the World Café method, where the participants were divided into three separate groups of approximately six members each. Group discussions were facilitated as group leaders alternated with various activities between the groups. Sheets of A2 paper served as tablecloths allowing participants to conveniently jot down notes from the group discussion, and also to draw symbolic representations of their subjective experiences of the relationships they enjoy in their immediate environment. Data gathered in the various groups was then visually displayed so that a focus group discussion could occur. Crystallization confirmed the trustworthiness of the findings. Crystallization is an approach where data is combined using two or more genres of representation of socially constructed meanings as well as different methods of data analysis. In this study, several different data collection methods were used, including the use of symbols, group discussions and a focus group. The data analysis comprised of a combination of several methods of analysis, being thematic analysis, interactive pattern analysis and the visual analysis of posters. Approval pertaining to the ethical aspects of the research project was obtained from the North-West University. From the findings it became apparent that essential relationship qualities such as confirmation, empathy, unconditional acceptance and clarity of self-presentation between the residents spontaneously developed out of the safe and enabling interpersonal environment created by the management. This safe and enabling interpersonal environment is characterized by predictability, interpersonal flexibility, confirmation, congruence and empathy. According to this research, it can be argued that residents in this specific care facility were still able to identify and describe relationships that could effectively satisfy their needs – despite having experienced multiple losses associated with the aging process and/or losses in their particular lives. This study hence holds important implications for the creation of an interpersonal context by management in order to promote wellbeing among older people that reside in residential care facilities. / Thesis (MA (Clinical Psychology))--North-West University, Potchefstroom Campus, 2013.

Ageing populations and the unique challenges they pose are characteristic of the accelerating demographic transition evident in both developed and developing countries. In South Africa the elderly population is also increasing dramatically. There is a disproportionate distribution of older persons per ethnic group, with white older people representing the largest group of older South Africans (21%, proportional to ethnic group). The influx of the baby boomer generation will inevitably lead to an exponential increase in the numbers of white older people within the next two decades. Regardless of integration policies in post-apartheid South Africa, 90% of all residential care facilities are still occupied solely by white older people. Such facilities are described as buildings or other structures used primarily for the purposes of providing accommodation and of providing a 24-hour service to older persons. The increasingly larger segment of white older people holds considerable implications for the future of these facilities since more individuals will turn to this living arrangement. The Older Persons Act of South Africa was inaugurated by the government in 2006 and its key objectives are aligned with the recommendations of the Madrid International Plan of Action on Ageing (2002). Amongst many other objectives, the Older Persons Act emphasises practices that enhance the wellbeing and quality of life (QoL) of all older persons. However, the reigning circumstances in most residential care facilities have been described as challenging. A national audit of residential care facilities in 2010 indicated a need for psychosocial interventions since the QoL of residents was found to be undefined and unspecific. The purpose of the study was to explore the construction of QoL, from the perspective of the older people living in residential care facilities. A purposive sample of 54 participants (male, n=10; female, n=44) with ages ranging between 62 and 95 years was drawn. The participants were able to communicate congruently and understood the research purpose. Participants resided in four similar facilities situated in urban areas in two South African provinces. A multiple-context inquiry was conducted to gather rich data and collateral information. The study made use of interviews, focus groups, journals, and the Mmogo-method® to collect qualitative data. Interpretative Phenomenological Analysis (IPA) and visual analysis methods were used to analyse the data. Interactive Qualitative Analysis (IQA) was conducted with 19 participants, resulting in a conceptual model of QoL. Member-checking was performed by the participants. Ethical approval was granted by the Ethics Committee of the North-West University (Potchefstroom Campus), as part of a larger project, namely “An exploration of enabling contexts (05K14)”. The findings revealed that the nature of QoL is informed by spiritual worldviews, interpersonal contexts and the maintained ability of older people to regulate aspects of their own lives. The nature of QoL was also revealed as transitional throughout the ageing process and that the dimensions of QoL may be found on a continuum. Six domains were elicited in the construction of QoL, namely spirituality, health, relationships, meaningfulness, autonomy and sense of place. Each domain presented with certain contributors and inhibitors influencing the older person’s ability to experience QoL. Findings revealed the strengths of older people to deal with adversities associated with later life. The inhibitors of QoL are emphasised for the attention of policy makers, the managers of residential care facilities, care givers and family members. The study provided insight into the causal influences between the domains of QoL. A conceptual model with systemic properties is proposed. The theoretical implications of this systems model are that QoL domains are mutually informing and exercise a particular influence on the relational states of older people. It is hoped that new knowledge in the area of QoL might direct future research efforts and put resources channeled to residential care facilities to better use. / Thesis (PhD (Psychology))--North-West University, Potchefstroom Campus, 2013.

Older people often experience loneliness and depression, especially those dependent on institutional care. The loneliness can be attributed to multiple losses such as the loss of physical and cognitive abilities, the loss of relationships with familiar environments, the loss of significant others, as well as changing contact with family members and friends. The strategy commonly used by older people to deal with such feelings of loss, is to reminisce on such losses as well as on the lost or altered relationships. This strategy might result in a situation where the focus older people have on the past prevents them from recognizing the potential of relationships in their immediate environment. In order to make older people more aware of meaningful relationships in their immediate environment, the method of appreciative inquiry was used. Appreciative inquiry uses questioning as an intervention. Questions were formulated in such a way that the positive aspects of possible relationships in interpersonal environments were emphasised. The aim of the appreciative inquiry was to determine what relationship qualities older people experience as meaningful or effective. A qualitative and investigative research method was used in an attempt to investigate older people's subjective experiences of the relationships they have in the residential care facility. Participants to the study were volunteers who permanently reside in a residential care facility for older people in Gauteng, South Africa. Textual- and visual data was collected through the use of the World Café method, where the participants were divided into three separate groups of approximately six members each. Group discussions were facilitated as group leaders alternated with various activities between the groups. Sheets of A2 paper served as tablecloths allowing participants to conveniently jot down notes from the group discussion, and also to draw symbolic representations of their subjective experiences of the relationships they enjoy in their immediate environment. Data gathered in the various groups was then visually displayed so that a focus group discussion could occur. Crystallization confirmed the trustworthiness of the findings. Crystallization is an approach where data is combined using two or more genres of representation of socially constructed meanings as well as different methods of data analysis. In this study, several different data collection methods were used, including the use of symbols, group discussions and a focus group. The data analysis comprised of a combination of several methods of analysis, being thematic analysis, interactive pattern analysis and the visual analysis of posters. Approval pertaining to the ethical aspects of the research project was obtained from the North-West University. From the findings it became apparent that essential relationship qualities such as confirmation, empathy, unconditional acceptance and clarity of self-presentation between the residents spontaneously developed out of the safe and enabling interpersonal environment created by the management. This safe and enabling interpersonal environment is characterized by predictability, interpersonal flexibility, confirmation, congruence and empathy. According to this research, it can be argued that residents in this specific care facility were still able to identify and describe relationships that could effectively satisfy their needs – despite having experienced multiple losses associated with the aging process and/or losses in their particular lives. This study hence holds important implications for the creation of an interpersonal context by management in order to promote wellbeing among older people that reside in residential care facilities. / Thesis (MA (Clinical Psychology))--North-West University, Potchefstroom Campus, 2013.

Ageing populations and the unique challenges they pose are characteristic of the accelerating demographic transition evident in both developed and developing countries. In South Africa the elderly population is also increasing dramatically. There is a disproportionate distribution of older persons per ethnic group, with white older people representing the largest group of older South Africans (21%, proportional to ethnic group). The influx of the baby boomer generation will inevitably lead to an exponential increase in the numbers of white older people within the next two decades. Regardless of integration policies in post-apartheid South Africa, 90% of all residential care facilities are still occupied solely by white older people. Such facilities are described as buildings or other structures used primarily for the purposes of providing accommodation and of providing a 24-hour service to older persons. The increasingly larger segment of white older people holds considerable implications for the future of these facilities since more individuals will turn to this living arrangement. The Older Persons Act of South Africa was inaugurated by the government in 2006 and its key objectives are aligned with the recommendations of the Madrid International Plan of Action on Ageing (2002). Amongst many other objectives, the Older Persons Act emphasises practices that enhance the wellbeing and quality of life (QoL) of all older persons. However, the reigning circumstances in most residential care facilities have been described as challenging. A national audit of residential care facilities in 2010 indicated a need for psychosocial interventions since the QoL of residents was found to be undefined and unspecific. The purpose of the study was to explore the construction of QoL, from the perspective of the older people living in residential care facilities. A purposive sample of 54 participants (male, n=10; female, n=44) with ages ranging between 62 and 95 years was drawn. The participants were able to communicate congruently and understood the research purpose. Participants resided in four similar facilities situated in urban areas in two South African provinces. A multiple-context inquiry was conducted to gather rich data and collateral information. The study made use of interviews, focus groups, journals, and the Mmogo-method® to collect qualitative data. Interpretative Phenomenological Analysis (IPA) and visual analysis methods were used to analyse the data. Interactive Qualitative Analysis (IQA) was conducted with 19 participants, resulting in a conceptual model of QoL. Member-checking was performed by the participants. Ethical approval was granted by the Ethics Committee of the North-West University (Potchefstroom Campus), as part of a larger project, namely “An exploration of enabling contexts (05K14)”. The findings revealed that the nature of QoL is informed by spiritual worldviews, interpersonal contexts and the maintained ability of older people to regulate aspects of their own lives. The nature of QoL was also revealed as transitional throughout the ageing process and that the dimensions of QoL may be found on a continuum. Six domains were elicited in the construction of QoL, namely spirituality, health, relationships, meaningfulness, autonomy and sense of place. Each domain presented with certain contributors and inhibitors influencing the older person’s ability to experience QoL. Findings revealed the strengths of older people to deal with adversities associated with later life. The inhibitors of QoL are emphasised for the attention of policy makers, the managers of residential care facilities, care givers and family members. The study provided insight into the causal influences between the domains of QoL. A conceptual model with systemic properties is proposed. The theoretical implications of this systems model are that QoL domains are mutually informing and exercise a particular influence on the relational states of older people. It is hoped that new knowledge in the area of QoL might direct future research efforts and put resources channeled to residential care facilities to better use. / Thesis (PhD (Psychology))--North-West University, Potchefstroom Campus, 2013.