Article

Doing as much as I can do The meaning of activity for people with dementia

School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada.
Aging and Mental Health (Impact Factor: 1.75). 08/2007; 11(4):384-93. DOI: 10.1080/13607860601086470
Source: PubMed

ABSTRACT

While it is assumed that persons with dementia benefit from being involved in meaningful activity, research examining this claim is limited. In particular, how individuals with dementia perceive this involvement is poorly understood. Therefore, the purpose of this research is to determine what constitutes meaningful activity from the perspective of persons with dementia, and to explore how they perceive its significance in their lives. We conducted an interpretive phenomenological analysis of multiple interviews and participant observation conducted with eight community-dwelling elders with mild to moderate dementia. For several participants, the single most important driving force in their lives was being active, doing as much as they possibly could. They were involved in a wide range of activities including leisure pastimes, household chores, work-related endeavors, and social involvements. These activities were meaningful in three ways: Through their involvement, participants experienced feelings of pleasure and enjoyment; felt a sense of connection and belonging; and retained a sense of autonomy and personal identity. Findings suggest that familiarity of the social and physical environment promotes involvement in activities. This provides a sense of continuity for people with dementia, with implications for their quality of life and personhood. Further implications of these findings for dementia care and future research are discussed.

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Available from: Habib Chaudhury, Dec 26, 2014
    • "Likewise, Phinney, Chaudhury, and O'Connor (2007) found that individuals with dementia continued to value and engage in their favorite leisure activities (e.g., handicrafts , playing piano, crossword puzzles, going on long walks), as well as household chores and social activities. Individuals reported that involvement in activities brought enjoyment and pleasure, a sense of autonomy and identity, and helped them feel connected to the larger community (Genoe & Dupuis, 2014; Phinney et al., 2007). Although individuals with and without cognitive impairments find enjoyment, satisfaction, and purpose in life through continued participation in meaningful activities , intrinsic factors (e.g., health, motivation) and extrinsic barriers (e.g., transportation, lack of opportunities, lack of time) may impact participation (Dahan-Oliel, Mazer, Gélinas, Dobbs & Lefebvre, 2010; Innes, Page, & Cutler, 2015; Levasseur et al., 2015; Nimrod & Shrira, 2014). "
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    ABSTRACT: Purpose of the study: Using the National Health and Aging Trends Study (NHATS), we examined activity preferences and participation among individuals with and without cognitive impairments. Design and methods: Respondents were classified as having No Dementia (n = 5,264), Possible Dementia (n = 893), or Probable Dementia (n = 518). Respondents rated importance of and actual participation (yes/no) in four activities (visiting friends/family, religious services, clubs/classes, going out for enjoyment). We also examined whether transportation or health limited participation. Results: Overall, visiting friends/family was most important (64.03%); although relative importance of activities varied with cognitive status. Compared to cognitively healthy individuals, those with possible and probable dementia were less likely to indicate activities were important and engage in valued activities (ps < .0001). Additionally, poor health limited participation in activities for those cognitively intact or with possible dementia; this was not true for those with probable dementia. Transportation difficulty limited going out for enjoyment for a greater percentage of those with cognitive impairment than those without impairment. Implications: Regardless of cognitive level, older adults highly value activities; however, actual participation may decrease with greater impairment in cognitive and physical health and with transportation challenges. Developing tailored interventions for specific populations to achieve desired activity goals is needed.
    No preview · Article · Nov 2015 · The Gerontologist
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    • "Regardless, walking (sometimes alone, but more often with others) was becoming an increasingly important way for them to be active and engaged in the world. This aligns with previous research showing how people with dementia respond through changes in general activity (Menne et al., 2002; Phinney et al., 2007; Phinney et al., 2013 ). It resonates also with findings from a recent metasynthesis of older adults' perceptions of mobility and its importance in their lives. "
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    ABSTRACT: Physical activity is beneficial for people with dementia, but little research explores subjective experiences of physical activity in this population. Interpretive description guided the analysis of 26 interviews conducted with 12 people with dementia. Three themes described the subjective meaning of everyday physical activity: Participants were attracted to activity because it improved physical well-being, provided social connections, gave opportunity to be in nature, and provided structure and focus; participants experienced impediments to activity because of physical discomfort, environmental factors, lack of enthusiasm, and memory loss; and participants made adjustments by choosing walking over other activities and by being active with others. Results show that physical activity remains important for people with dementia, although they encounter barriers. They may prefer walking with others as a form of activity. Findings could influence how nurses conceptualize wandering and suggest that walking programs could be well received by people with dementia.
    Full-text · Article · Sep 2015
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    • "To maximise functional ability in people with dementia, all participation should be focused on the sort of activities that the residents used to manage and enjoy prior to the onset of dementia, as mentioned in the example in our findings. We believe that the residents may find meaning in the pleasure and enjoyment they experience, thus feeling that they still belong to the world (Phinney et al. 2007). We suppose that joy is greatest when the resident has the ability to be engaged and participate in his/her own life. "
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    ABSTRACT: To explore nurses' strategies that may support the sense of coherence in people with dementia. People with dementia are often described as people with no resources, people who need support from family or from healthcare personnel to function in everyday life. Despite the disease, some people still have the resources needed to cope well with parts of their lives and experience coherence. To date, no research has explored any nurses' strategies that may support the sense of coherence in people with dementia. The design of the study is qualitative and exploratory. Data were collected by participant observation and focus group interviews. Sixteen registered nurses from two different Norwegian nursing homes were recruited and participated in the study. Qualitative content analysis was used to analyse the data. The empirical material consisted of field notes from participant observation and transcripts from focus group interviews. Three generic categories were identified as strategies that may support sense of coherence in people with dementia: 'Finding and nurturing the individual's resources', 'Customising meaningful activities' and 'Finding creative solutions'. These categories were identified as strategies that may support and possibly enhance the sense of coherence in people with dementia. The findings provide an empirical base for assuming that with support and help from nurses, people with dementia may experience and strengthen their sense of coherence, therefore, the nurses need to be aware of the activities that may support and possibly enhance the sense of coherence in people with dementia. Despite the contextual limitations, this study highlights the need to identify and nurture resources in people with dementia, thus supporting their sense of coherence. The findings may contribute in enhancing the quality of care for people with dementia. © 2015 John Wiley & Sons Ltd.
    Full-text · Article · Aug 2015 · Journal of Clinical Nursing
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