A psychological needs-based intervention to facilitate adjustment and improve wellbeing in newly admitted aged care residents: three illustrative case studies

ABSTRACT

Objective

Moving into residential aged care (RAC) is recognised as a major life transition and is associated with adjustment difficulties and depression for many older adults. We developed the Programme to Enhance Adjustment to Residential Living (PEARL) to assist newly admitted residents to adjust to their new environment through the introduction of tailored strategies that meet their psychological needs for autonomy, relatedness, and competence.

Method

The structure and content of PEARL is described. Clinical information via three cases are presented to illustrate how the programme facilitates the adjustment and psychological wellbeing of residents following their transition to RAC.

Results

The cases highlight the potential benefit of individualised approaches to address the psychological needs of new residents and demonstrate how staff can be assisted to facilitate these needs through a simple, brief intervention.

Conclusions

PEARL is a structured step by step programme that can be used by clinicians working in this field. While additional empirical data evaluating the efficacy and cost-effectiveness of this intervention is required, PEARL offers promise as a non-pharmacological approach to address the current high rates of distress and mental health disorders in RAC.

KEY POINTS

What is already known about this topic:

(1) Mental health concerns among older adults in permanent residential aged care are common, and many newly admitted residents find it difficult to adjust to an institutional environment.

(2) Newly admitted residents should have the opportunity to receive adequate support to meet their psychological needs; however, currently, these needs are poorly met.

(3) Previous research has identified factors that can contribute to better adjustment to residential aged care however, there are limited evidenced based programmes that support and assist residents during this transition.

What this topic adds:

(1) PEARL is a five session, structured, tailored intervention that enables clinicians to collaborate with admitted residents and facility staff in an attempt to meet residents’ psychological needs and assist in facilitating their adjustment to residential aged care.

(2) Clinical information including the structure and content of PEARL is provided including case studies to illustrate the implementation of the programme.

(3) While the clinical approach underpinning PEARL is simple, it represents a major departure from standard care that is potentially feasible for wide-spread use.

KEYWORDS:

• Adjustment
• depression
• long-term care
• nursing homes
• psychological wellbeing
• residential aged care

Acknowledgments

The authors would like to acknowledge all clinicians on this project: Anastasia Konis, Fiona Lynch, Mayio Konidaris-Kozirakis, Vera Camões-Costa, and Alexandra Creighton. Thanks are also expressed to Jessica Byers, who developed the clinician manual for the programme. The authors have no conflicts of interest to declare.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Health and Medical Research Council [APP1102997].