Activity Participation and Well-Being of People with Dementia in Long-Term—Care Settings

Abstract

This study examines the activities engaged in by nursing home residents with dementia and their states of well-being. Dementia Care Mapping was used to record the activities engaged in by, and the well-being of, 43 participants during a 6-hour period. The average age of the group was 81 years and length of stay at the nursing home was 27 months. Fourteen percent of participants had received a Clinical Dementia Rating (CDR) score of 1 (mild level of cognitive impairment), 35% had a CDR score of 2 (moderate impairment), and 51% had a CDR score of 3 (severe impairment). Results indicated that the three CDR groups engaged differently in activities. The CDR1 group participated significantly more in therapeutic/leisure activities and activities of daily living than did the CDR2 group ( p < .001 and p < .05) and CDR3 group ( p < .001). Conversely, the CDR3 group engaged in significantly more passive activities than did the CDR1 group ( p < .001), and had fewer social interactions and displayed more negative behavior than the other two groups ( p < .05). Moreover, their well-being was significantly worse than that of the other two groups (p < .001). A majority of participants (82%) demonstrated poor to very poor well-being. Because better well-being was associated with positive and enjoyable engagement in activities (τ = +0.67, p < .001), the low level of activity participation demonstrated by low-functioning individuals with dementia needs to be addressed. Moreover, further studies are indicated to explore the possible factors influencing their limited activity participation.