Older adults’ experiences of maintaining social participation: Creating opportunities and striving to adapt to changing situations

Abstract

Background

Social participation concerns the possibility of engaging in activities in interaction with others or society at large and contributes to the health and well-being of older adults. In contrast, a lack of social participation is associated with loneliness. It is, therefore, important to understand what strategies older adults use to maintain social participation.

Aim

To explore and describe older adults’ experiences of maintaining social participation.

Materials and methods

Nine older adults, aged 69–92 years, participated in interviews that were analysed through qualitative content analysis.

Results

The overall findings reflect how older adults create opportunities for social participation by developing strategies and striving to adapt to changing situations, emphasizing how maintaining social participation is an active process. Preserving social participation requires motivation and an effort to take initiative to cultivate social relations, maintain community bonds, engage in social events and activities and stay connected with society.

Conclusions and significance

These results may extend our understanding of strategies that older adults use, as well as the challenges they face when striving to adapt to new circumstances. This study may have implications for the practice of how to support older adults’ social participation.

Keywords:

• Active ageing
• COVID-19
• healthy ageing
• social engagement
• qualitative

Introduction

It is well-known that social participation is important for healthy ageing [1,2] and can be described as a person’s engagement in activities in interaction with others or society at large. Thus, social participation concerns the possibility of participating and engaging in social life [3]. Social participation comprises different levels of engagement: being with others, interacting with others, preparing for activities around others without interacting, doing activities with others and contributing to others and society [3,4]. Earlier research in occupational therapy has found that doing everyday activities with others, contributing to others and experiencing togetherness create meaning in everyday life [5,6]. Engaging in activities that support social contact and the preservation of community also reduces social isolation among older adults [7]. On the other hand, low levels of participation in social activities and a limited social network can pose a threat to older adults’ physical and mental health [8,9].

For older adults, possibilities for social participation often change for various reasons, such as deteriorating health, the loss of a partner, the loss of friends or reduced opportunities for social interactions associated with, for example, retirement [10]. Experiences of loneliness can be the outcome of such changes [11], and loneliness is a prevalent, complex phenomenon among older adults [12]. Loneliness can be described as a negative feeling connected to a person’s lack of social relationships [13] and can be a risk factor for both deteriorating physical and mental health [14,15], which in turn may influence possibilities for social participation.

The awareness of the relationship between social participation and healthy ageing [16], as well as the fact that a lack of social participation is associated with perceived loneliness among older adults [11,17], brings about a need to further explore and develop knowledge around these issues. This need has become especially important in light of the COVID-19 pandemic, which has aggravated the situation for older adults in terms of engaging in social activities and socializing with others. Previous research of relevance for occupational therapy has focussed on different aspects of social participation; for example, the importance of supporting neighbourhood environments and local communities [18], the meaning of togetherness and connectedness [5,6], having personal needs and interests recognized, and being appreciated as a valuable person [19]. Further, research has explored older adults’ experiences of how digital technology can support social participation [20,21] and, in particular, reduce experiences of loneliness [22]. However, little is known about what strategies older adults employ to maintain social participation over time. Developing knowledge and understanding of how older adults preserve social participation, as well as the strategies they use, can provide insight into how an active social life, and thus, healthy ageing can be supported. This knowledge is of importance as research highlight that existing occupational therapy practice often fails to address social participation [23]. Therefore, the aim of this study is to explore and describe older adults’ experiences of maintaining social participation.

Materials and methods

Study design

An explorative qualitative research design [24] was applied with the intention of achieving descriptions of older adults’ experiences of maintaining social participation in accordance with the study’s aim. The study was approved by the Swedish Ethical Review Authority (Dnr: 2020-00103).

Participants and sampling

The participants were recruited from a municipality in northern Sweden through health-promoting, municipality-based services supporting older adults. Prior to data collection, written approval was given by the management responsible for the municipal services. The services aim to support health-promoting activities for older adults and their relatives, with an emphasis on increasing social activities and reducing experiences of loneliness. Participants were recruited by a purposeful sampling strategy [24], potential participants were sought based on the following criteria: (a) aged 65 years or older, (b) being in contact with the services mentioned above and (c) experiencing a change in social participation or loneliness. As the recruitment process started during the ongoing COVID-19 pandemic and restrictions of social distancing, additional criteria were applied to the first four participants as physical meetings were not possible: (1) access to a computer or tablet, (2) an e-mail account and (3) some experience using the Internet. The intention of this purposeful sampling was to achieve a variation of participants to cover different experiences and attain rich data.

An employee at the services was informed about the study and thereafter informed potential participants who met the criteria. Those interested received an information letter with further information. The information letter contained details about the study, its implementation, how the interview would take place and topics that would be addressed. Further, the letter stated that participation was voluntary and that they could withdraw from the study at any time. Potential participants were asked to contact the first author through telephone, mail or e-mail. They were then contacted by the first author and provided oral information about the study. In this conversation, the first author verified that the participants met the inclusion criteria. Written consent was signed prior to the interviews.

In total, 22 letters were sent from the end of April to mid-October 2020. Thirteen persons answered, of whom nine agreed to participate. All participants were living in an urban environment in northern Sweden; for further details of the participants’ demographic characteristics (see Table 1).

Table 1. Participants’ characteristics.

Participants
Total number	9
Sex
Women	6
Men	3
Age
Range	69–92
Mean	82.5
Social status
Co-habiting	2
Living alone	7
Accommodations
House	2
Apartment	7
Education
Elementary school, 7 years	4
University/university college education	5
Retirement time
8–20 years	4
>25 years	5
Transportation
Drive a car	3
Use public transportation	2
Hesitate to use public transportation or use it accompanied by others	4

Data collection

Data collection consisted of qualitative research interviews [25] performed by the first author, using an interview guide based on questions with an open-ended format. To enhance the credibility and dependability of the interview guide, a pilot interview was performed by the first author with an older adult experiencing change in social participation (not included in the study). After the pilot interview, the interview guide was revised to better suit and capture the study’s aim. In the interview sessions, participants were asked to narrate, for example, social activities they perform, social activities of meaning to them, how social contacts are maintained and what kinds of challenges and possibilities they encounter in terms of engaging in social life. Considering the ongoing COVID-19 pandemic the participants were also asked to narrate how social activities and social contacts were influenced. Depending on the participants’ experiences and descriptions, probing questions were asked to explore issues in greater detail and to ensure richness in the material.

According to the participants’ wishes, the time and place for the interviews were agreed upon. The first four interviews were performed digitally online as video conversations due to the COVID-19 pandemic. The last five interviews, which took place during the summer season, were carried out as personal meetings situated outside of participants’ homes, or at another place outdoors suggested by the participants. Most of the interviews took place on a single occasion, but one participant wanted a break, and the interview continued at a later date. The interviews lasted between approximately 45 and 90 min and were digitally audio recorded.

Data analysis

The data were analysed using qualitative content analysis with an inductive approach [26], as the focus was to identify, describe and categorize patterns within the data by searching for similarities and differences. The first author transcribed the interviews verbatim, including notes of laughter, hesitations and sighs. The interviews were then broken down into meaning units appropriately corresponding to the study’s aim. The meaning units were condensed for their core meaning, and as a next step, the condensed meaning units were given a code that briefly described the content. The names of the codes were kept close to the data, such as neighbourhood contacts and not being invited. All codes were given a number making them traceable to each interview. In an overview, some codes were revised to be kept close to content. Codes with similar content were then sorted into groups that could be characterized as a first version of labelled preliminary subcategories, such as responsibility for one’s own efforts and communication opportunities. The preliminary subcategories were then further analysed and discussed among all authors on several occasions. Some subcategories were merged or regrouped according to similarities and differences within the content. The subcategories were then discussed and revised in relation to their core features and meaning. On several occasions during the analysis, the interviews were read through to ensure that the findings were grounded in the data and to establish trustworthiness [27]. Finally, the analysis resulted in three categories and a latent theme (Table 2).

Table 2. Results revealed an overall theme and three categories.

Theme	Creating opportunities for social participation: Developing strategies and striving to adapt to changing situations.
Categories	Cultivating my social relations	Belonging to a community	Connecting with society and having access to different places

Results

The theme Creating opportunities for social participation: Developing strategies and striving to adapt to changing situations comprehend the central features of all categories and addresses an active process of creating and maintaining social participation over time. The three categories (1) Cultivating my social relations, (2) Belonging to a community and (3) Connecting with society and having access to different places describe different aspects of how social participation is created and maintained by adapting to shifting circumstances and developing strategies to experience social participation. Together, these results contribute to an understanding of what social participation means for older adults, how it is maintained over time, and how different social dimensions contribute to the overall experience of social participation.

Creating opportunities for social participation: developing strategies and striving to adapt to changing situations

The overall theme reflects how social participation cannot be taken for granted. Rather, active engagement is required to make commitments, to take initiative and to make plans, but also to invest time in others. This active engagement, reflected in the findings, is partly expressed as a strain relying on older adults’ own efforts. The results show how opportunities for social participation are about making conscious choices concerning what activities, contexts and social relations to pursue, develop or terminate, focussing on possible options in given circumstances. However, maintaining social participation overtime was challenging, and there was a need to develop strategies and adapt to new circumstances, especially when the person’s life was challenged in some way. This became particularly prominent regarding the COVID-19 pandemic, which further influenced older adults’ course of action for maintaining social participation in various ways.

Cultivating my social relations

This category describes older adults’ experiences and efforts to preserve and develop their relations with others to maintain social participation. The older adults were consciously engaged in and nurtured contacts with others, which in diverse ways contributed to their overall experience of social participation. Their experiences revealed how cultivating social relations entails negotiations of making efforts to uphold relations, but also the need to accept that some relationships are not built on reciprocity.

The findings point to numerous approaches taken by older adults to maintain social relations with others involving phone calls, the use of social media and personal meetings. Phone calls were described as one way to maintain contact and stay in touch with others; they often followed patterns such as daily, weekly or monthly calls to different persons. The older adults described a need for experiencing reciprocity regarding contact with others. Limiting one’s telephone contact and waiting for others to call back were conscious choices to avoid feeling intrusive and not becoming a burden to others. At the same time, their experiences reflected that to maintain social relations, they had to be intrusive; otherwise, they risked diminished contact. However, reciprocity regarding contact with others could not be taken for granted. The older adults’ experiences also reflected that the frequency and patterns of telephone contact to maintain social relations changed over time due to different circumstances.

My son, he asks, “Have you called your friends lately?” Sometimes I almost feel like lying, but I think it is unpleasant to lie, so I say, “No, I have not.” I think they can call me at some point. I have called them several times when they have only called me once. (no 8)

Social relations were also maintained through social media, such as Facebook or Instagram. Social media were described as a way to cultivate relations by taking part in what others are doing, sharing pictures of events, communicating and interacting with others. However, not all of the older adults used social media, and those who did said it was a compliment to phone calls and personal meetings. Social media provided an alternative way to stay in touch with family and friends.

Personal meetings were described as meaningful and as an important way to maintain and cultivate social relations. The analysis revealed how conscious choices and actions were taken to visit others or invite others for coffee or to share a meal. They all described important persons with whom they shared a history and still had ongoing contact with, such as old friends, neighbours or relatives. In these social relations, they felt fellowship, safety and the relations were described as an unpretentious company. Their experiences also reflected how contact with old acquaintances or childhood friends had been re-established in later days, and that their shared history was significant and meaningful. Nonetheless, cultivating relations, inviting or visiting others came with strains in terms of planning and preparations that were expressed as tiring. They described a need of being able to rely on support from others, for example to plan arrangements.

You know what, you get accustomed to convenience over the years. No preparations at all, you come to a ready-served table. Unfortunately, that is the case. I’d rather pay than make an effort. I think, uh, I have been doing so much over the years. No, I don’t have the energy. (no 5)

The older adults’ experiences also indicated that their social relations had diminished. They described how previously important relations had faded, resulting in reduced social contact, and they described a weakened motivation to take initiative to cultivate different relations. Instead, close relation ties with immediate family became more important, and for some older adults, their main contact with others was through home care services. They also expressed that the COVID-19 pandemic and public advice on social distancing made it even more challenging to maintain relations, especially since opportunities for personal meetings to cultivate social relations had been restricted.

Belonging to a community

This category reveals how experiences of belonging to a community contribute to maintaining social participation. The analysis shows how connections to communities can function as a facilitator and source for potential interactions and activities with others. It indicates older adults’ endeavours to preserve and develop their sense of belonging in different communities, and how this involves experiences of mixed feelings: To be accepted on their own terms and to be able to contribute to others. Overall, the older adults’ experiences show that they continuously adapted or changed their level of social engagement. Belonging to a community is an ongoing process that requires adjustment with respect to shifting situations, partly because of one’s own preferences, but also depending on others’ circumstances.

The older adults’ experiences reflect how they strived to belong in communities by trying to find opportunities to be among somewhat like-minded people, to find recognition and a sense of togetherness or to enjoy the unpretentious company of others. They described a need to feel accepted by others, to be able to talk about things of interest and importance, in a place where they could feel safe and be themselves. It was also important to be invited and encouraged by others. They described how persons close to them encouraged them to share social activities, join different events, and offered transportation. Belonging to a community was also about contributing to others in different ways. They described different activities they took on for others, such as walking a neighbour’s dog or mowing their lawn, getting involved in congregations, baking or cooking for others, or driving someone to an appointment or event. Doing activities for others gave them a sense of purpose, resulting in feelings of being valuable and important. Additionally, the analysis implies that belonging to a community can enhance motivation for maintaining social participation.

Overall, the older adults expressed that they used different strategies for belonging in communities, such as retaining established routines for recurring social activities (e.g. involvement in associations, churches or regular gatherings and meals shared with others). Planned activities of this kind were preserved since they could function as a resource for maintaining togetherness in existing communities. The older adults described looking forward to these occasions since they played an important role in their daily or weekly routine. Having these occasions to look forward to contributes to a general experience of social participation and reduced experiences of loneliness.

We have great companionship in church. We meet every week for a coffee outside, and for a meal of soup on one evening. It is truly nice. We sit together and talk about life in general, and I must say, I am content with that…You can talk about just whatever you want. The whole bunch there in church, they do a lot for me just by being there. (no 4)

Searching for and maintaining neighbourhood contact was another strategy described: the place where they live, and the nearby neighbourhood created opportunities for doing things together with someone or for someone. This context led to possibilities for daily encounters and for helping and looking after each other. However, the older adults’ experiences also reflected concerns over doubts and difficulties in terms of trying to belong in neighbourhood communities, such as when relocating. Those who, for different reasons, had been forced to relocate described feelings of not belonging to the neighbourhood and difficulties reaching out to others.

We used to have a house, and there you knew all the neighbours. Since we moved here, I don’t know who they are. You have no social contact with them; it is pretty strange, and I actually miss it. I have tried, also. You say hello and so on, but I do not know their names. So, I don’t know. Maybe people who move here want to protect their privacy, if that is what it is. (no 9)

Striving to belong to a community required adaptation due to changing circumstances. The older adults’ experiences indicate how a sense of togetherness had become altered or ceased to exist, depending on others or on their own personal needs and desires. They described an ongoing effort to adjust to new situations and to find a community with others that corresponded to their needs, wishes and conditions. This was revealed as a balancing act of reaching out, struggling with the responsibility for taking initiative or contributing to others, and feeling invited and included by others.

The COVID-19 pandemic has further created a need for adjustment due to changed circumstances. Overall, their experiences reflect how they had been deprived of opportunities to share social activities or join events and gatherings together with others. However, the results also show that the pandemic inspired older adults to find new ways to keep community bonds in shifting situations, such as engaging in social media or taking part in association meetings online.

Connecting with society and having access to different places

This category shows how maintaining social participation is about staying connected to a wider context and being part of society at large. The experiences of older adults suggest that it is important to be updated and informed about what is happening in society. Additionally, that they are able to visit different places for social connections and engage in activities with others. In this way, they have something to look forward to, they feel included, and meaning is added to their overall life situation.

Older adults’ experiences reflected a wish to access a larger world apart from their community and social relations with family and close friends. Their experiences revealed how they consciously strived to employ strategies to stay updated by reading newspapers on a regular basis, watching TV or going online on the Internet to follow what is going on in the world. Further, that it was vital to keep up with developments related to the digitalization of society. To connect with the wider world, the older adults described how they, through the use of different media such as the Internet, searched for activities offered by the municipality or other actors in their local community to support their personal growth and interests, such as cultural events and courses. Some of those who did not use technology and the Internet to stay updated expressed an interest in learning how in order not to become marginalized, as one older adult said:

Before the coronavirus, I had signed up for two computer courses, but they were fully subscribed so they said they would get back to me. I would need to learn more, and a person helped me get started, but it was put on hold…Yes, but then the world opens up to you! Then, you can keep up in a totally different way. I feel completely excluded. Everything goes via the computer currently. That is where you get all the information. (no 9)

Having the freedom to access outdoor surroundings in the local community as part of a daily or weekly routine, such as walking in the neighbourhood, grocery shopping or visiting the library, was described as an important part of feeling included in society. For example, taking a walk in the local community opened the possibility for spontaneous meetings that are encompassed with meaning.

And then when I’m out exercising, I sometimes meet other people who I walk with for a while, as company and to talk to them. (no 6)

Additionally, having access and the possibility to go to different places in society provided opportunities to meet and connect with people and exchange shorter conversations.

Well, when I go into town sometimes. I just go sit on a bench there, and then I start talking to the person sitting next to me and it goes very easily, even if we don’t know each other. (no 4)

Even if accessing different places was an important part of older adults’ routines, it required motivation and determination. The results reflect how older adults applied diverse strategies to be part of society, such as planning and saving energy for social activities at preferable times during the day to be able to continue with social activities of importance. Moreover, they applied strategies to limit the time spent on passive activities, for example, remaining seated in front of the computer or television. Their experiences showed that all kinds of social activities involving visiting places in society required some level of planning and preparation. At the same time, planning and preparation might become too overwhelming, resulting in these activities not taking place.

The older adults’ experiences illustrated the need for continuous adaptations since neither the older adults themselves nor surrounding environments are constant and the same; personal conditions vary, social relations shift, venues in society close and the range of activities in society change. They described how different circumstances must be considered in regard to accessing different places, such as the ability to drive or use public transportations, financial status, physical conditions or the need for support from others. The older adults also reflected upon how their possibilities to access different places for social activities and events in society have changed over time due to altered personal circumstances. They described how more of their social activities were performed at home or in a nearby neighbourhood. Due to the COVID-19 pandemic, they stated that various social activities they previously attended had been put on hold. Travel was not possible; spontaneous meetings in, for example, the grocery store was limited, and social events at venues were closed. As such, opportunities for social participation were restrained. Restrictions on social distancing had an impact on the freedom to visit places and being part of society, resulting in experiences of loneliness, boredom and fear. However, the restrictions and spending more time at home also encouraged them to find new ways to feel connected with society, such as through the Internet and social media.

Discussion

This study sheds light on older adults’ experiences of maintaining social participation as an active process, with older adults as creators of their own possibilities. However, options for making choices to uphold social relations, engage in communities of importance, access places and connect with society are also influenced by situational and contextual factors. The findings reflect the challenges older adults face when striving to develop strategies and adapt to new circumstances. It also became evident that the COVID-19 pandemic had influenced the older adults’ possibilities for social participation.

In line with the concept of social participation mentioned by Levasseur et al. [3], different dimensions of social participation are revealed in the findings that show how social participation is experienced and conducted at different levels, in different contexts, with different depths and scopes. Overall, the results indicate that engagement at different levels appears important for an overall satisfactory experience of social participation. Adapting to changing situations and maintaining social participation over time by cultivating social relations, striving to belong in various communities and connecting with the wider world seem to give meaning to older adults’ lives. Additionally, engaging in social activities on a regular basis gives older adults something to look forward to and was expressed in contrast to feelings of loneliness. In line with this, research highlights that social participation has the potential to reduce loneliness [28] and is connected to experiences of health [2].

The findings demonstrate how older adults maintain social participation through conscious efforts to cultivate social relations. Further, cultivating social relations could subsidize several levels of social participation [3,4]. As seen in the results, social relations change over time and are not always based on reciprocity. This is in line with earlier research in occupational therapy indicating that social relations take on new patterns over time [29], and that there is a risk that relations may fade if they are not based on reciprocity [6], which was also found in this study. Cultivating social relations by engaging with others in social activities was associated with different actions, such as making plans and preparations that sometimes took up too much energy and were therefore refrained from. Reduced engagement in social activities can hereby have a negative influence on the overall experience of social participation, as the findings imply how social activities with friends and family are connected to experiences of meaning in everyday life. Supporting engagement in social activities and thus social participation is, therefore, significant in occupational therapy practice and in line with occupational therapy theory [30–32] suggesting that engagement in meaningful occupation that supports participation is the key outcome and focus for the service.

As outlined in the results, telephone calls and the use of social media were also expressed as ways to keep in touch with others and cultivate social relations. Earlier research has revealed that use of the Internet and social media is experienced as a complement of togetherness but cannot replace the meaning of togetherness created through physical encounters [20]. However, this was not contrasted in the present findings, but alternative ways to cultivate social relations had become more prominent due to the COVID-19 pandemic. As found in other studies [33], an increase in contact with others even occurred during the pandemic as older adults turned to extend their telephone contacts, or contacts through social media. Considering the arguments above, it becomes important to support older adults in maintaining different ways of building social relations, as they can hold different kinds of meaning.

The findings reflect how belonging in various communities is a balancing act. Being invited and encouraged by others to join different events and social activities creates a sense of togetherness. The findings also highlight the importance of taking initiative and contributing to others to uphold vital communities. As such, belonging in communities is about feeling included and being valuable to others, which also points to earlier research [6,19]. Furthermore, belonging in communities was reflected as an ongoing process where older adults used different strategies to adapt to changing circumstances; for example, establishing routines for participating in social events, engaging in social activities on a regular basis and searching for and preserving neighbourhood contacts. Having something meaningful to look forward to on a regular basis provides motivation to maintain important communities. Therefore, supporting older adults’ opportunities for belonging in various communities is of importance. This is in line with earlier research showing that efforts to increase social activities and networks seem associated with more engagement in social activities [34].

Connecting with society was experienced as important for older adults’ sense of feeling included and part of the wider world. Therefore, possibilities to take part in society under the same conditions as others can be considered a matter of occupational justice [35,36]. For example, our findings show how staying updated and informed using different media such as the Internet implied a constant struggle not to feel excluded. Earlier research confirms how different media facilitate older adults’ participation in society [37]. However, not having the opportunity to access or utilize technology can also become a source of deprivation [36]. Having access to different places in society seemed important for the feeling of being connected to the local community. Nevertheless, accessing different places was also associated with challenges due to conditions relating to the older adult and/or the environment. These results are coherent with earlier findings where closeness to community services and resources, and being able to choose activities of interest, influenced possibilities for interaction with others and the community [10,38]. Further, the results demonstrate how older adults continuously need to adapt to changing circumstances, such as meeting places that close and the range of activities in society change. Not having places to meet carries the risk of becoming an additional burden for older adults, as it could diminish their opportunities to maintain social participation. The importance of older adults having places to meet has been found in earlier research [6].

From the findings, it became clear that older adults’ possibilities of maintaining social participation became further restricted due to the COVID-19 pandemic. Globally, recommendations for social distancing and self-isolation have been a public health strategy [39,40]. Accordingly, older adults have been advised against attending public places and activities in interaction with others, thereby becoming hampered from diverse forms of social interaction, with an increased risk of experiencing involuntary loneliness and becoming socially isolated [41]. However, the constraints on social distancing have also inspired older adults and opened alternative ways of upholding social relations, keeping community bonds and staying connected with society using the Internet and social media. This is in line with recent research [42] showing that the use of digital solutions could support meaningful relationships for older adults during the pandemic. Nevertheless, the findings indicate variations in older adults’ ability to use computers or the Internet. The pandemic has in that sense made the situation for older adults even more tangible. From a societal angle, regardless of the situation of the pandemic, it is essential to reflect on how older adults’ digital competence can be promoted and supported by societal actors [43]. Here, occupational therapists have a vital role to fill, as digital technology has become an integral part of everyday activities [44] and thus older adults’ possibilities to maintain social participation.

Older adults’ personal responsibility to maintain social participation is prevalent throughout the results. Their experiences reflect a drive to take initiative to cultivate social relations, keep community bonds and engage in social events and activities. The importance of individual motivation to facilitate social participation has been highlighted in earlier studies [10]. However, the findings also reflect how changing circumstances can reduce initiatives for social participation. The question arises as to whether maintaining social participation is mainly a personal responsibility and to what degree older adults can rely on society to support them. Therefore, future research needs to explore how various societal stakeholders may support older adults’ social participation. Previous research shows that boosting older adults’ motivation is important [10], for example, by guiding older adults to take part in activities that can match personal motivations [19]. This becomes especially important for those who experience loneliness and can thus lack motivation to take their own initiative for social participation, as this can become a threat to their health and well-being [9]. However, not all older adults experience loneliness in the same way or to the same degree. Therefore, interventions to support social participation need to consider various factors such as individual requirements, the economy, access to transport, place of residence and physical and mental health [45]. Thus, it also becomes critical to offer health-promoting initiatives for older adults, as a research [46] has indicated that group education programs can inspire older adults to make conscious choices to promote their health. However, little is known about whether health-promoting initiatives have an effect on the social aspects of older adults’ lives [47]. Hence, it is vital that future research focus on developing and evaluating occupational therapy interventions centred on facilitating motivation and the development of strategies to promote a social life for older adults. The need to develop occupational therapy interventions is also highlighted in a scoping review as current occupational therapy practice is criticized for seldom including interventions supporting social participation [23].

Methodological discussion

In this study, a qualitative approach provided insight into older adults’ experiences of the focus of inquiry. Aspects of trustworthiness in qualitative research, such as credibility, dependability and transferability, are intertwined [27,48]. The sampling of participants sought to provide a variety of experiences that could contribute to the study. However, the findings need to be considered in light of the fact that more women than men participated in the study and that all participants lived in an urban area, which can be seen as a limitation. Another limitation is that all participants were recruited from one municipal service that provides support for increasing social activities. Although the number of participants in the study was limited to nine persons, the interviews contributed with rich material.

The fact that the study took place during the COVID-19 pandemic could have had an impact on older adults’ willingness to participate. This was especially because the initial four interviews were conducted as video conversations requiring participants’ access, knowledge and the ability to use computers/tablets and the Internet. This may have resulted in the exclusion of potential participants who would otherwise have met the inclusion criteria. With the easing of the recommendations of social distancing from authorities concerning the COVID-19 pandemic, interviews were performed as personal meetings during the summer; that said, there may have also been older adults who still feared meeting in person due to the risk of contagion. The fact that four interviews took place as video conversations can be seen as a limitation in contrast to personal meetings. Nevertheless, the interviews, via video conversation, created possibilities for non-verbal communication and interaction, which is important in interview situations [25].

Trustworthiness throughout the analysis was established through ongoing discussions among all researchers, and the researchers took on different roles during the analysis process. Inspired by Lindgren et al. [48], the abstraction and interpretation during the analysis was an extensive process of thoroughly and systematically going back and forth in the material, revising and discussing codes, categories and the theme to enhance credibility. To facilitate transferability [27], the sampling and characteristics of participants, data collection and analysis were accounted for.

Conclusions

The results shed light on how older adults create opportunities for social participation by developing strategies and striving to adapt to changing situations. The results contribute to an enhanced understanding of how maintaining social participation is an active process that changes over time. The findings reflect a motivation to take initiative to cultivate social relations, preserve community bonds, and engage in social events and activities. However, the findings also indicate the challenges older adults face when striving to develop strategies and adapting to new circumstances. This became even more prevalent due to the COVID-19 pandemic and restrictions regarding social distancing.

Acknowledgements

The authors gratefully thank the participants for their contributions to the study. Also, Luleå University of technology for financing the PhD-student in the project.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This study received no funding.