Presenter(s):

Nicola Ann Plastow, Stellenbosch University, South Africa

Abstract

Introduction: Developing and maintaining functional ability is central to health aging. This functional ability includes the ability to participate in a wide range of meaningful daily activities including meeting basic needs, building and maintain relationships with others, and contributing to society. Health and social care professionals like occupational therapists can promote healthy aging, by addressing the factors that are likely to influence participation among older people.
Objectives: In two cross-sectional cohort studies in Cape Town, South Africa, we investigated the factors that influenced the participation of older people living in frail care (N=34) and in the community (N=55).
Methods: The dependent variable was the level of participation, measured using the Creative Participation Assessment (CPA). Creative participation is defined as actively engaging the body and mind in meaningful activities that challenge a person’s abilities, to achieve their potential. Independent variables included cognition (Allen Cognitive Levels Screen, ACLS), independence in self-care (Barthel Index) or level of disability (WHODAS 2.0), age, sex, home language, marital status, frequency of contact with their family, and health conditions. Statistical analysis using SPSS Version 28 software included correlations and linear regression analyses for each of the two cohorts.
Results: Participants’ ages ranged from 57 to 105 years. The community-living cohort were younger (Mage = 70.82, SD = 8.22) than the frail care cohort (M= 87.2, SD = 8.42). The level of participation evident across the two samples ranged from Tone (no or little awareness or response to the environment) to Contribution (Situation-centred action). In the frail care group, ACLS levels and scores on the Barthel Index significantly predicted levels of Creative Participation (p<.001). In the community-living sample, only age and ACLS level predicted levels of Creative Participation (p<.001).
Conclusions: Maintaining cognitive functioning for as long as possible appears to be critical for healthy aging. This means that health and social care professionals should create opportunities for cognitive stimulation, in a way that meets the needs and interests of older people in their communities. For older people in frail care, maintaining independence in self-care activities is likely to lead to greater levels of participation in other meaningful activities. This finding highlights the need to train care staff in rehabilitation strategies to achieve optimal independence in basic activities like washing, dressing, toileting and eating.

Bio(s):

Prof Nicola Plastow is an Associate Professor in the Department of Health and Rehabilitation Sciences at Stellenbosch University in South Africa. As an occupational therapist, her work focuses on equitable participation and health. She manages an occupational therapy service that promotes social participation and occupational justice for older people living in a historically disadvantaged neighborhood in Cape Town, South Africa.