Occupational justice within residential aged care settings – Time to focus on a collective approach

Toit, Sanetta Henrietta Johanna du; Casteleijn, Daleen; Adams, Fasloen; Morgan‐Brown, Mark

doi:10.1177/0308022619840180

Cited by 15 publications

(13 citation statements)

References 12 publications

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“…Furthermore, we suggest that, to enable meaningful engagement in occupations for people with dementia, requires specialized competencies. This is also stated by Du Toit et al (2019), who argue that activity programming is often run by staff with short-level qualifications instead of specialized staff, such as OTs, with a view to cost saving, despite the fact that OTs are skilled in addressing low levels of engagement in meaningful occupation.…”

Section: Discussionmentioning

confidence: 95%

“…This can be due to implications of the disease. However, social, environmental, economic and cultural factors, such as society’s perceptions of people with dementia, lack of knowledge and support from caregivers, lack of adequate resources and environmental barriers seem to be the main obstacles (Du Toit, Casteleijn, et al, 2019; Smith et al, 2018). The need for formal caregivers to have adequate competencies to facilitate engagement is an issue (Kielsgaard et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Enhancing engagement in meaningful occupation in a dementia town: A qualitative evaluation of MOED – The meaningful occupational engagement intervention for people with dementia

et al. 2022

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Introduction Engagement in meaningful everyday life occupations is linked to well-being. However, people with dementia are often deprived of engagement. As a response, a Danish Dementia Town was established with the intention of transforming care services to improve opportunities for meaningful engagement. The evidence-based The meaningful occupational engagement intervention for people with dementia (MOED) intervention was developed and implemented in dementia town to enhance meaningful occupational engagement. The purpose of this paper is to evaluate the content, impact and implementation process of MOED. Method To evaluate MOED, we applied a program theory-based qualitative approach, building on participant observations and informal conversations with people with dementia ( n = 7) and staff ( n = 9). Data were analysed from a hermeneutic approach to gain an in-depth understanding of how MOED influenced meaningful occupational engagement and to evaluate the implementation process. Findings The main theme ‘Engagement in meaningful occupations – a conditional and fragile process’ emerged along with three subthemes: ‘Creating an everyday space of meaning: Conditions of the intervention’, ‘Occupational engagement as an opportunity to blossom: Impact of the intervention’ and ‘Professional identity, culture and reflections: Contextual barriers to changes to working practice’. Together, the subthemes illustrate how engagement in meaningful occupations arose. However, opportunities to engage in meaningful occupations were fragile, as they depended on various factors within the context. Conclusion Engagement in meaningful occupations emerged when MOED was applied in accordance with the program theory, as it seemed to create spaces where people with dementia could engage in meaningful occupations and they could blossom over time. However, MOED was only partially implemented in accordance with the developed program theory, as several contextual barriers influenced the sustainability of the intervention. MOED showed potential to support improvement in dementia care activity programmes to enhance opportunities to engage in meaningful occupations in everyday life for people living with dementia.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Enhancing engagement in meaningful occupation in a dementia town: A qualitative evaluation of MOED – The meaningful occupational engagement intervention for people with dementia

et al. 2022

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“…Older adults living in RACFs experience detrimental outcomes, including a loss of meaning and purpose, a lack of occupational roles, and increased feelings of isolation and dissatisfaction (du du Toit et al, 2019). Arguably, the ACFI contributes to this by decreasing residents' abilities and limiting opportunities for occupational performance and engagement, which provide meaning and purpose to residents' lives.…”

Section: Discussionmentioning

confidence: 99%

“…Occupational Therapy Australia (2019) has raised concerns regarding the consequences this restricted scope of practice has on residents' health and wellbeing. If occupational therapy within RACFs reflected practice true to the profession's core, it could improve residents' life satisfaction and sense of belonging (du Toit et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Understanding occupational therapy practice in residential aged care facilities under the Aged Care Funding Instrument: A qualitative study

Calderone

Bissett

Molineux

2022

Aus Occup Therapy J

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Introduction Australian occupational therapy practice in residential aged care facilities has been largely funded using the Aged Care Funding Instrument since March 2008. Literature indicates that the funding model constrains occupational therapy practice, impacting on therapists' and residents' experiences. In preparation for the implementation of the new funding model, the Australian National Aged Care Classification, it is timely to understand current practice. Therefore, the aim of this study was to explore occupational therapy practice in residential aged care facilities under the Aged Care Funding Instrument. The objectives were (1) to understand occupational therapists' experiences of working in residential aged care facilities under the Aged Care Funding Instrument; and (2) to explore occupational therapists' perceptions of how the Aged Care Funding Instrument influences residents' occupational performance and engagement. Methods A phenomenological research design was employed to understand therapists' perspectives. Data were collected from seven occupational therapists using a demographic form and a semi‐structured interview. Data were analysed using a modified Colaizzi's descriptive phenomenological data analysis. Ethics approval was obtained. Findings Two themes emerged from the study's findings: a restrictive practice context that disables residents; and a restrictive practice context that inhibits occupational therapists. The first theme describes how the Aged Care Funding Instrument constrains practice and incentivises the disabling of residents. The second theme describes the challenges faced by occupational therapists throughout their journey of employment under the funding model. Conclusion Occupational therapists perceived that the Aged Care Funding Instrument restricts occupational therapy practice and prevents residents from living occupationally rich lives. With the introduction of the Australian National Aged Care Classification in late 2022, it is crucial that national associations and employers advocate to policymakers to ensure future practice reflects the profession's unique knowledge and skills to optimise the health and wellbeing of residents.

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“…Older adults living in residential aged care face structural (e.g., an age‐segregated environment, distanced from established social network) and systemic (e.g., the health‐care system's priority on personal care) challenges to meaningfully engage in daily occupations on a social and/or occupational level (Boamah et al, 2021). Inconsistent social opportunities and limited occupational choices cause occupational deprivation as their rights to meaningfully engage are compromised (Du Toit et al, 2019). The Australian Charter of Aged Care Rights indicates that all residents are entitled to ‘have control over and make choices’ about their personal and social life (Aged Care Quality and Safety Commission, 2019, p. 3).…”

Section: Introductionmentioning

confidence: 99%

Intergenerational live‐in student programmes for meaningful engagement: Creating cohesive and supportive collectives in aged‐care facilities

Lai

Raubenheimer

Toit

2023

Aus Occup Therapy J

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Background and objectives: Older adults in residential aged-care facilities (RACFs) experience segregation from society and face limited opportunities to meaningfully engage on a social and/or occupational level due to various structural and systemic challenges. An occupational therapy-coordinated intergenerational live-in student programme (ILiSP) with allied health students was successfully pioneered across Sydney (Australia) to facilitate ongoing intergenerational contact. We explored how ongoing intergenerational contact influenced meaningful engagement of older adults in RACFs by investigating routinely collected clinical data and exploring stakeholders' perspectives.Research design and methods: We employed a concurrent nested mixedmethods design. Residents' attendance in weekly organisational activities and students' monthly volunteer hour reports were analysed to produce statistics for demonstrating the changes in residents' activity attendance alongside ongoing intergenerational contact. Qualitative data from discussions directed by the nominal group technique (NGT) with staff, management and students, individual interviews with relatives and residents, and narrative clinical documentation were thematically analysed. Results: The Wilcoxon signed-rank test indicated that residents' activity attendance increased during intergenerational contact. Qualitative data yielded three main themes-interdependence, meaningful engagement, and kinshipall associated with intergenerational contact as part of established ongoing relationships. The NGT highlighted consensus on on-site living for maintaining a cohesive and supportive collective. Conclusion:Despite structural and systemic challenges within RACFs that dissuade community integration, ILiSP created opportunities for students to connect/reconnect residents to new/established networks and to support residents to maintain or re-engage with previous lifestyle preferences. Therefore,

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Occupational justice within residential aged care settings – Time to focus on a collective approach

Cited by 15 publications

References 12 publications

Enhancing engagement in meaningful occupation in a dementia town: A qualitative evaluation of MOED – The meaningful occupational engagement intervention for people with dementia

Enhancing engagement in meaningful occupation in a dementia town: A qualitative evaluation of MOED – The meaningful occupational engagement intervention for people with dementia

Understanding occupational therapy practice in residential aged care facilities under the Aged Care Funding Instrument: A qualitative study

Intergenerational live‐in student programmes for meaningful engagement: Creating cohesive and supportive collectives in aged‐care facilities

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