Assisted Living Residents With Dementia: Being Out in the World and Negotiating Connections
Assisted Living Residents With Dementia: Being Out in the World and Negotiating Connections
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DOI：
10.1093/geront/gnab113
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发表时间：
2021-09-22
期刊：
影响因子：
5.7
通讯作者：
Bender, Alexis A.
中科院分区：
文献类型：
--
作者：
Ciofi, Joy M.;Kemp, Candace L.;Bender, Alexis A.
背景和目的痴呆症患者，包括长期护理居民，及其护理伙伴强调有意义的参与的重要性，并强调需要活动和户外或异地活动的机会。然而，人们对这一人群中的外出知之甚少。在这里，我们的目标是（a）确定居民的机会，并与经验，走出去;（B）了解走出去的意义;和（c）解释影响因素。研究设计和方法在扎根理论方法的指导下，我们分析了一年内在4个不同的辅助生活社区收集的定性数据。我们跟踪了33名痴呆症患者及其护理伙伴。数据包括详细的现场记录，记录了1，560个观察小时，与居民（在可能的情况下），辅助生活工作人员，家庭成员和其他访客的114次访谈，以及记录审查。结果我们确定了“在外面的世界和谈判连接”的中心地位，其特点是居民的经验与外部世界作为一个过程的“工作”与自然，他人和社区的参与。在外面的世界中生活对幸福和生活质量至关重要。大多数居民至少偶尔会出去，有些人缺乏机会。在逃出去的居民中，大多数人都从随后的联系中受益。然而，并非所有的经验都是积极的。在世界上的变化随着时间的推移和个人，护理车队，辅助生活社区和邻里水平的因素。讨论和影响我们讨论了我们的研究结果对痴呆症患者有意义参与的研究和实践的影响，包括在大流行等危机期间。
Background and Objectives Persons living with dementia, including long-term care residents, and their care partners emphasize the importance of meaningful engagement and stress the need for activity and opportunities to go outdoors or offsite. Yet, little is known about getting out in this population. Here, our objectives are to (a) identify residents' opportunities for, and experiences with, getting out; (b) understand the significance of getting out; and (c) explain influential factors. Research Design and Methods Guided by grounded theory methods, we analyzed qualitative data collected over a 1-year period in 4 diverse assisted living communities. We followed 33 residents with dementia and their care partners. Data include detailed fieldnotes capturing 1,560 observation hours, 114 interviews with residents (where possible), assisted living staff, family members, and other visitors, and record review. Results We identified the centrality of "being out in the world and negotiating connections," which characterizes residents' experiences with the outside world as a process of "working out" engagement with nature, others, and the community. Being out in the world was consequential to well-being and quality of life. Most residents got out at least occasionally; some lacked opportunities. Among residents who got out, most benefitted from ensuing connections. Yet, not all experiences were positive. Being out in the world varied over time and by individual-, care convoy-, assisted living community-, and neighborhood-level factors. Discussion and Implications We discuss the implications of our findings for research and practice surrounding meaningful engagement among persons with dementia, including during crises such as the pandemic.