The Power of the Social Environment in Motivating Persons with Dementia to Engage in Occupation: Qualitative Findings

ABSTRACT

A key element in persons with dementia's occupational engagement is the degree to which the social environment supports participation. This article summarizes the results of a qualitative study of eight assisted living facility residents, that explored volition in persons with moderate dementia. Extensive interviewing and observation were followed by the primary researcher's engagement and documentation of each resident in therapeutic activity sessions. Data were analyzed using van Manen's phenomenological approach, and three themes emerged. One, potency of the social environment, is the focus of this article. From the eight participants, two case studies are presented, one demonstrating the positive impact of therapeutic communication and social support on volitional behavior and occupational engagement and the other demonstrating the inhibiting effect of lack of therapeutic social interaction. Each case is analyzed using Epp's (2003, Person-centred dementia care: A vision to be refined. The Canadian Alzheimer's Disease Review, 14–18) Person-Centered Care model techniques and interaction modes recommended by Taylor's (2008, The intentional relationship: Occupational therapy and use of self. Philadelphia: F.A. Davis.) Intentional Relationship Model. The article concludes with recommendations for promoting positive social interactions at the client, staff/family, and systems levels.

KEYWORDS. :

• persons with dementia
• social environment
• occupation
• motivation
• volition