Challenging the Active Ageing (AA) concept in residential care: the loss of meaningful activities in nursing home residents.

Purpose: Active Ageing is an important concept in gerontology. It reflects the engagement of older persons in meaningful activities of daily living and aims to improve quality of life. Since little is known about how nursing home (NH) residents experience their involvement in meaningful activities, this study describes residents’ activity repertoire (AR) and its influencing factors. Methods: A survey was administered to 143 cognitively healthy residents (mean age 85 years ±SD 5,72; 56-99) with an average stay in the NH of 35 months (±SD 44; mode 6; range 2-235). A comprehensive set of global, cognitive, physical, mood and functional assessments were collected, together with a questionnaire on AR. Descriptive statistics and correlation analysis were performed. Results: All residents reported an average loss of 16 meaningful activities (range 1-37; ±SD 7,5). Residents with higher dependency, weaker mobility, lower educational level and less social support experience greater loss (all correlations range from r=0.204 to r=0.604; p<0.05). Highest loss is seen in advanced activities, including leisure, hobbies and social engagement. Residents experience this loss due to lack of adaptation and support of the environment and limitations in physical functioning. For all activities, residents reported a limited performance (mean 5,7/10; ±SD 1,7), a poor satisfaction (6,1/10; ±SD 1,9) and lack of challenge (mean 5,3/10; ±SD 2,9). Conclusions: Since residents lose meaningful activities due to their admission in NH, adapted assistance and accommodation is needed to enhance AA. Further research is conducted to develop a guideline to organize meaningful activities in NH.