Pathways of Participation by Older Adults Living in Continuing Care Homes: A Constructivist Grounded Theory Study

Introduction and objectives: Participation in meaningful activities has psychological, physical, social and cognitive benefits for older adults living in continuing care homes. The subjective experiences of the process of participation for cognitively competent older adults living in a continuing care home and how personal and environmental features influenced the process were explored. Methods: Using a constructivist grounded theory approach to collection and analysis in the tradition of Charmaz, data were gathered with observation and a series of in-depth, semi-structured interviews with nine older adults (aged ≥ 70 years). Results: Participants actively engaged in an individualized, activity-specific process of positioning themselves to make choices and enact core values through meaningful activities. Personal and environmental barriers to participation could sometimes be managed through this process, although at other times barriers resulted in activity loss. Discussion: These findings reinforce the importance of participation in the lives of older adults living in a continuing care home, and present a model of how participants were actively occupied in a continuous process of negotiating opportunities for meaningful activity engagement. Implications address possible ways to facilitate this process of participation by care partners.