Social participation of seniors: Applying the Framework of Occupational Justice for healthy ageing and a new approach to policymaking

Figures & data

Figure 1. A Framework of Occupational Justice. Adapted from Stadnyk, R. L. (2007). A framework of occupational justice: Occupational determinants, instruments, contexts, and outcomes. In E. A. Townsend and H. J. Polatajko. (2013), Enabling occupation II: Advancing an occupational therapy vision for health, well-being, and justice through occupation (p. 81). CAOT Publications ACE. Adapted from Townsend, E. A. & Wilcock A. A. (2004). In C. H. Christiansen & E. A. Townsend. Introduction to occupation: The art and science of living (p. 251). Prentice Hall. Adapted with permission from the CAOT Publications ACE.

Table 1. Group Characteristics.

Number of Participants	Age Range	Number of Immigrants	Number of Men	Location of Group
10	72-87	0	5	Private seniors’ residence
9	61-97	0	4	Private seniors’ residence
11	75-98	3	1	Private seniors’ residence
10	75-90	4	0	Private seniors’ residence
10	57-85	4	4	Low-income housing
6	67-76	3	0	Low-income housing
8	56-83	0	0	Low-income housing
9	62-83	0	9	Community centre
10	61-78	0	2	Local community health centre
7	80-94	4	1	Local community health centre
13	62-85	7	4	Community centre
8	66-74	2	4	Community centre

Figure 2. Coding Tree.

Figure 3. Policy Flow Chart of Social Participation and Occupational Justice.

Table 2. Thematic Content Analysis in Accordance with the Four Definitions of Occupational Rights and Injustices.

	Selected Codes	Themes	Central theme
Occupational deprivation and participation
Occupational injustice	Issues related to personal and physical security in their home environment or neighbourhood Wait lists or regulations for occupations Loss of space/occupation/person/committee Gossip Transportation (i.e. cost, length of the journey) Poor accessibility Poor understanding of technology Lack of access to information Cost of occupations Pressure from family or friends to abandon an occupation (e.g., driving) or move Fear (i.e., of falling)	Issues exist with availability and affordability of occupations Issues exist related to low socioeconomic status Lack of skills to participate	Importance of analyzing the context before introducing occupation
Occupational right	Resilient, open, and positive mentality of individual/group/management of residence Presence of a person or pet that links an individual with other people or an occupation Low cost of an occupation Ability to use technology to maintain contact with family and friends Delegation of household tasks Environments that facilitate connection Modification of how the person participates in a given occupation	Psychological response can positively influence participation Environmental enablers promote participation Equal opportunity for participants to participate
Occupational alienation and meaning
Occupational injustice	Feeling pressure from society to age in accordance with positive ageing Judgment from others Gentrification Difficulty identifying with the need to learn how to use technology Little interest in the types of occupations offered	Underlying cultural values negatively influence participation Range of occupations offered does not reflect the needs and interests of seniors	Need to acknowledge the diversity amongst older adults and understand how this diversity influences participation
Occupational right	Recognition for efforts in a given occupation The maintenance of strong bonds between family and friends Feeling an attachment to their community/dwelling Participant expresses the significance of a given occupation to them	Positive social participation is experienced Expressing feelings of competence and accomplishment Sense a feeling of belonging
Occupational marginalization and choice
Occupational injustice	Being excluded from occupations as a result of physical disability or use of technical aid Made to feel unwelcome during volunteer occupations by paid employees or management Ageism in the workplace Unable to do occupations as before if not adept at using technology Isolation when moving to a seniors’ residence Not invited to participate due to sexual preference	Inaccessible environments limit access to community occupations for participants with physical disabilities Ageism and other stigmatizing attitudes undermine a participant’s social participation	Revisit the concepts of what it means to age successfully, to reduce ageist perceptions of older adults
Occupational right	Making a conscious decision to put their needs and desires first Activity schedules that are coherent with seniors’ schedule	Perceptions and attitudes of participants favour occupations of preference Timing of schedules interfere with seniors’ participation
Occupational imbalance and balance
Occupational injustice	Difficulty participating in occupations due to caregiving for partner or grandchildren Lack of opportunity in occupations in place of residence	Social participation not seen as a priority	Social participation needs to be viewed as a determinant of health and as a right to which all persons should have access to
Occupational right	Ability to continue paid employment with a flexible schedule	Favorable condition to promote continued employment

Data Availability Statement

The data that support the findings of this study are available from the second author, upon reasonable request.

Acknowledgements

We honour and thank the Kanien’kehà:ka (Mohawk) and the Anishinabeg (Algonquin) peoples as the traditional inhabitants of the lands of Tiohtiá:ke, Montreal, where this research was conducted.

The authors thank the participants for their time and insights provided on their experiences with social participation. The principal author expresses her sincere gratitude to Dr. Nigel Livingston and Dr. Nathan Lachowsky in the School of Public Health and Social Policy of the University of Victoria, and Dr. Marika Demers in the Department of Occupational Therapy at McGill University for providing valuable input with the writing of this manuscript.