Aim: The aim of this study was to understand volition in people with moderate dementia. The study provided an in-depth description and analysis of volition in eight older people in a memory-support assisted living unit.Method: Guiding questions focused on understanding past life interests, demonstration of volition, volitional continuity, and the relationship among the social environment, volition and daily occupations. Data collection included participant observation, family and staff interviews, and the Volitional Questionnaire. The Mini-Mental State Examination provided a measure of cognitive impairment.Findings: Three interacting themes emerged: variation in volitional expression, redefining meaningful occupation and potency of the social environment. The participants differed in volitional expression, showed changes in continuity between past and present interests, and tended to modify their occupations to match their abilities.Conclusion: The participants' lived experiences consistently reflected dynamism between the social environment and the person in volitional expression.

Although more therapists are responding to the increasing need for visual rehabilitation services for older adults, little is reported in the literature about the emotional experience of vision loss, especially in the words of persons with low vision themselves. This paper reports findings from a qualitative inquiry involving focus groups and in-depth interviews with 15 older adults using or considering using low vision assistive devices (Copolillo & Teitelman, 2005). Although the study's original intent was to focus primarily on decisions about LVAD use, psychological and social implications of vision loss emerged spontaneously as a dominant area of concern for participants. From an analysis of 154 codes derived from transcripted data, three themes related to psychosocial experience were generated: (a) Emotional Challenges, (b) Negative Emotional Outcomes, and (c) Indicators of Emotional Adaptation. In this article, individual components of the themes are described using illustrative quotes, and potential practice implications for therapists are presented.

The purpose of this study was to describe how older adults with low vision make decisions to use low vision assistive devices (LVADs). Analysis of participants' narratives, from both group and individual interviews, revealed three topic areas affecting device use. Two are discussed in this paper: Experiences and Characteristics Leading to Successful LVAD Use Decision Making and Challenges to Successful LVAD Use Decision Making. The third, Adjustment to Low Vision Disability, is briefly discussed. Of particular importance to occupational therapy practitioners in the growing field of low vision rehabilitation was the value placed on low vision rehabilitation services to assist with acquiring devices and integrating them into daily routines. Occupational therapy services were highly regarded. Participants demonstrated the importance of becoming a part of a supportive network of people with low vision to gain access to information about resources. They emphasized the need for systems and policy changes to reduce barriers to making informed decisions about LVAD use. Results indicate that occupational therapists working in low vision can support clients by facilitating development of a support network, acting as liaisons between clients and other health practitioners, especially ophthalmologists, and encouraging policy development that supports barrier-free LVAD acquisition and use. These topics should be incorporated into continuing and entry-level education to prepare practitioners for leadership in the field of low vision rehabilitation.

Background/Aim:  This phenomenological exploration of how caregivers of persons with Alzheimer's disease achieve a mental break defined them as distinct periods of freedom from caregiving concerns and conceptualised them as the essence of respite and as a restorative occupation. Methods:  Four in‐depth interviews each with 15 family caregivers revealed two categories. Results:  Factors associated with achieving a mental break included: social support, traditional respite, relief‐enhancing conditions, techniques for momentary stress reduction, and respite impediments. Achieving a mental break included mental break techniques and experiencing a mental break. Conclusions:  Restorative mental breaks are often within caregiver control, are achievable independent of formal respite services, and involve both rest and engagement in absorbing activities. Restorative breaks are often pleasurable, support productivity, may be entwined with caregiving activities, and importantly, do not compromise care recipient well‐being.

A key element in persons with dementia's occupational engagement is the degree to which the social environment supports participation. This article summarizes the results of a qualitative study of eight assisted living facility residents, that explored volition in persons with moderate dementia. Extensive interviewing and observation were followed by the primary researcher's engagement and documentation of each resident in therapeutic activity sessions. Data were analyzed using van Manen's phenomenological approach, and three themes emerged. One, potency of the social environment, is the focus of this article. From the eight participants, two case studies are presented, one demonstrating the positive impact of therapeutic communication and social support on volitional behavior and occupational engagement and the other demonstrating the inhibiting effect of lack of therapeutic social interaction. Each case is analyzed using Epp's (2003, Person-centred dementia care: A vision to be refined. The Canadian Alzheimer's Disease Review, 14-18) Person-Centered Care model techniques and interaction modes recommended by Taylor's (2008, The intentional relationship: Occupational therapy and use of self. Philadelphia: F.A. Davis.) Intentional Relationship Model. The article concludes with recommendations for promoting positive social interactions at the client, staff/family, and systems levels.