Where Is Everyone: Why Assisted Living Residents Participate (or Don’t) in Activities

A recent review looked closely at the literature on assisted living (AL) resident participation in recreational activities to better examine what is known about recreational activity in AL and what factors influence participation.

This review identified 37 organized and self-initiated AL activities, including family visits, book clubs, movies, games, religious activities, social events, exercise, and more.

Overall, the majority of AL residents participated in some sort of recreational activity, but less than half did so regularly. On average, residents participated in less than four activities per week, with low rates of physical activity, particularly strenuous activity. Staff estimated that the amount of activities (15-20 hours per week) was significantly higher than what residents self-reported.

As for factors related to participation, women were more likely to participate than men. However, men were more likely to prefer strenuous forms of activities. The author found that age, socioeconomic status, education, and previous professions influenced participation, as did length of time in AL and the resident’s choice and control in relocating to AL.

In terms of health, both physical and cognitive ability influenced participation, as did sensory ability, mental health, sleep, and pain. One study found that some residents with higher abilities did not want to participate with those who had significant limitations.

Psychologically, self-efficacy and belief that participation would result in positive outcomes were both associated with higher participation. Some participation was also linked to wanting to maintain social status, identity, or appearances.

Socially, strong relationships between residents, strong family-resident, and strong resident-staff relationships promoted participation, while interpersonal conflicts posed a barrier to participation. Appealing spaces in or around the community were also cited as impacting participation.

The studies also revealed considerable dissatisfaction with recreational activity offerings in AL, which were viewed as lacking variety. In addition, “across multiple studies, families and residents described recreational opportunities as stereotypical, demeaning, childish, or lacking physical and cognitive challenge.”

As for the impact of participation, multiple studies have linked it to outcomes such as better functional ability, health, happiness, quality of life, and life satisfaction. Qualitative research suggests that it also aids in better socially integrating into AL.



Plys E. Recreational activity in assisted living communities: a critical review and theoretical model. The Gerontologist. (2017). DOI: 10.1093/geront/gnx138

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