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Journal article review: Active engagement and quality of life for assisted-living older adults

Sarah MallinsonRelationships among active engagement in life activities and quality of life for assisted-living residents – reviewed by Sarah Mallinson, Research Assistant, Faculty of Health and Life Sciences, York St John University

Associate Professor Beverley Horowitz, from York College-CUNY in New York, and Professor Elizabeth Vanner, from Stony Brook University in New York, conducted a cross-sectional study to explore the relationships between quality of life (including mental and physical health) and active engagement in life activities (leisure, social, and instrumental activities of daily living) for assisted-living older adults. The researchers sought to understand:

  • The types of social, instrumental and leisure activities engaged in by residents in assisted living facilities.
  • Relationships between perceived importance of the activity and continuance of participation.
  • Relationships between retained participation in life activities and quality of life and life satisfaction.

Individual interviews were conducted with 131 (77 female; 52 male) residents from 12 assisted living facilities in Long Island and New York City. Eligible residents were at least 65 years old (M age = 83.1; s = 7.2 years), English-speaking, ambulatory, and able to independently schedule and participate in a 45-60 minute interview. Interviews were conducted between 2004 and 2007 and consisted of the 55-item Activity Checklist, a modification of the Activity Card Sort, to assess involvement and participation in instrumental, social and leisure activities in the past and present (Baum, Everard, Fisher, & Lach, 2000), the SF-36v2 to assess quality of life (Ware, Kosinski & Dewey, 2000) and the Life Satisfaction Index-Z Scale to measure psychological health and individual perceptions of psychological well-being (Wood, Wylie & Sheafor, 1969). Demographic questions concluded the interview and included items on gender, age, marital status, living arrangement, religion, ethnicity, and years of schooling.

Results demonstrated significant, low to moderate Spearman correlations between retained engagement in life activities (leisure, social and instrumental activities of daily living) and life satisfaction and several quality of life domains (physical functioning, role-physical and mental health). This validates a positive association between emotional well-being and continuance of participation in daily life activity and suggests that there may be other mediating variables to explore with regards these relationships (e.g., social support). Results also demonstrated that residents had greater continued participation in the life activities that they deemed of greatest importance.

Based on the findings and the numerous challenges associated with both the increase number of ‘well’ independent elders choosing to relocate from home to assisted living environments (p.143) and caring for the oldest old (p. 146), the researchers proposed the following recommendation:

  • Client-centred activity programs can be used to promote participation of residents (in assisted living facilities) in diverse physical, social, and cognitive activities to both maintain resident functional abilities and manage functional decline.

The researchers discussed the limitations of the use of a convenience sample and the confines of the exploratory, non-random, cross-sectional nature of the study.

If you would like to find out more about this study, the full article is published in the peer-reviewed Journal of Housing for the Elderly, April 2010 and Beverley Horowitz is listed as the corresponding author (bhorowitz@york.cuny.edu).

If you wish to read the full article the reference is:

Horowitz, B., & Vanner, E. (2010). Relationships among active engagement in life activities and quality of life, for assisted-living residents. Journal of Housing for the Elderly, 24(2), 130-150.