UNASSIGNED: The purpose of this study was to examine factors associated with engagement in meaningful activity among residents with dementia in assisted living. We hypothesized that greater functional independence, less pain, and lower behavioral and psychological symptom severity would be associated with higher engagement in meaningful activity after controlling for residents\' age, gender, comorbidities, and cognition. Understanding factors associated with engagement in meaningful activity can help to inform strategies for optimizing engagement among residents with dementia in assisted living.
UNASSIGNED: This descriptive study used baseline data from a randomized controlled trial, Meaningful Activity for Managing Behavioral Symptoms of Distress (MAC-4-BSD). Linear regression was used to examine factors associated with engagement in meaningful activity.
UNASSIGNED: A total of 71 residents from 5 assisted living settings were included in the sample. Most participants were female (n = 52, 73%), White (n = 62, 87%), and mean age was 85 years old (SD = 8.2). Controlling for age, gender, comorbidities, and cognition, pain was significantly associated with engagement in meaningful activity (b= -2.09, p < 0.05). There were no associations found between function and behavioral symptoms with engagement in meaningful activity.
UNASSIGNED: Findings from this study show that pain is a significant factor that is negatively associated with residents\' engagement in meaningful activity. Ongoing research is needed to help improve pain management for residents with dementia in assisted living and support their engagement in meaningful activity.

BACKGROUND: In addition to illness, inactivity is a risk factor for high mortality in nursing homes. Using innovative technology, such as virtual reality (VR), for meaningful group activities could provide new opportunities for solving this problem. VR interventions have already been approved as a promising method for enhancing the health of older adults.
OBJECTIVE: In this study, we examined whether VR-based group activities can have a positive impact on activity level and group interaction among older adults living in nursing homes.
METHODS: We conducted a longitudinal study and provided VR interventions as a group activity once a week for 4 consecutive weeks in nursing homes. Participants were recruited based on the experience of the nursing staff members and the natural decisions of the older adults. Within a virtual cottage, designed according to the needs of the target group, older adults were able to perform daily tasks that they were no longer able to do in real life, such as gardening and making pizza. Overall, 2 psychologists measured the psychosocial capacities, activities of daily life, and well-being before and after the interventions using standardized instruments.
RESULTS: The results focus on a total of 84 older adults from 14 nursing homes who completed at least 3 VR interventions. The results indicate that several psychosocial capacities among the older adults improved, including adherence to regulations (P<.001; η²=0.122), flexibility (P<.001; η²=0.109), and group integration (P<.001; η²=0.141). Problems related to competence also showed a slight decrease (P=.04; η²=0.039). In addition, the VR intervention promoted their proactivity (P<.001; η²=0.104) and mobility (P=.04; η²=0.039). During the VR group intervention, older adults\' well-being could be maintained at a high level. The results highlight the beneficial effects of VR intervention as a meaningful activity in nursing homes, showcasing the potential of VR applications in this setting.
CONCLUSIONS: This study provides a novel and naturalistic perspective, offering new insights into the use of VR in nursing homes. The VR intervention was well accepted and fulfilled the aim of enhancing capacity and well-being. It could be a meaningful group activity in nursing homes to improve social group interaction. To provide stronger evidence, randomized controlled trials are necessary.

For this study, we examined whether engaging in meaningful activities at home is associated with subjective well-being (SWB) in older adults with long-term care needs according to their preference for going out. We distributed a self-administered questionnaire to long-term care facilities in Japan and performed a linear mixed-effects model regression analysis of the responses. The dependent variable was SWB, and the independent variables were the number of meaningful home activities, preference for going out, and the interaction between them. In our survey (n = 217), we found that both number of meaningful home activities (B = 0.43; 95%CI: 0.17, 0.70) and its interaction with preference (B = -0.43; 95%CI: -0.79, -0.08) were associated with SWB. These results suggest the importance of engaging in meaningful activities at home for older adults who do not prefer going out. We should encourage older adults to participate in activities that match their preference.

This study aimed to clarify the association between changes in satisfaction with meaningful activities and the occurrence of depressive symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic.
A population-based prospective cohort study (Tarumizu Study).
A total of 231 community-dwelling older adults aged ≥65 years without depressive symptoms at baseline.
The participants completed baseline (June to December 2018, before the COVID-19 pandemic) and follow-up (September to December 2021, during the COVID-19 pandemic) assessments. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15) and defined by a GDS-15 score of ≥5. Participants selected meaningful activities from the 95 activities included in the Aid for Decision-Making in Occupation Choice, and their satisfaction levels were evaluated. Satisfaction with the most meaningful activities was assessed as to whether it was maintained/improved or decreased at follow-up.
In the follow-up survey, 31 (14.3%) participants reported the occurrence of depressive symptoms. Compared with before the COVID-19 pandemic, the rates of meaningful activities during the COVID-19 pandemic decreased for interpersonal interaction and social life and increased for leisure, sports, self-care, and domestic life. Logistic regression analysis revealed that changes in satisfaction with meaningful activity were associated with the occurrence of depressive symptoms after adjusting for demographic variables, baseline GDS scores, cognitive and physical status, and instrumental activities of daily living (odds ratio, 2.78; 95% confidence interval, 1.17-6.59, P = .020).
To avoid decreasing satisfaction with meaningful activities, supporting older adults may be protective against the occurrence of depressive symptoms. Our findings highlight the need for health care professionals to not only encourage older adults to participate in activities for their mental health but also consider whether the activities are meaningful or satisfying for them.

UNASSIGNED: Strategies for preventing and ending homelessness are frequently measured by their effectiveness on indices of tenancy sustainment. To shift this narrative, we conducted research to identify what is needed to \"thrive\" following homelessness from the perspectives of persons with lived experience in Ontario, Canada.
UNASSIGNED: Conducted in the context of a community-based participatory research study aimed at informing the development of intervention strategies, we interviewed 46 persons living with mental illness and/or substance use disorder [n = 25 (54.3%) unhoused; n = 21 (45.7%) housed following homelessness] using qualitative interviews. A subsample of 14 participants agreed to engage in photovoice interviews. We analysed these data abductively using thematic analysis informed by health equity and social justice.
UNASSIGNED: Participants described experiences of \"living in a state of lack\" following homelessness. This essence was expressed through four themes: 1) housing as part one of the journey to home; 2) finding and keeping \"my people\"; 3) meaningful activity as critical for thriving following homelessness; and 4) struggling to access mental health supports in the context of challenging circumstances.
UNASSIGNED: Individuals struggle to thrive following homelessness in the context of insufficient resources. There is a need to build on existing interventions to address outcomes beyond tenancy sustainment.

Around the world people with dementia face stigma and social exclusion. An interdisciplinary team from Seattle, Washington, and Vancouver, British Columbia led a collaborative project developing cross-border community partnerships to increase awareness and reduce stigma, promote social participation of people with dementia, and enhance their well-being. The work was organized around three themes - citizen engagement, social entrepreneurship, and creative expression - and involved regular meetings so researchers, community providers, and people with dementia and care partners could know each other better. Dementia Without Borders was organized as an end-of-project celebration, a public festival bringing together community members from both countries to share what the team had learned from each together. The event took place at the Peace Arch, an international park straddling the border between Washington and British Columbia. Over 140 people arrived on their respective sides, created banners, and walked together to the Peace Arch to meet and exchange gifts with those coming from the other country. A picnic shelter was used to display art created by people with dementia and outdoor tables allowed everyone to eat together and listen to poetry readings and musical performances. Feedback was overwhelmingly positive with many expressing a sense of hope and belonging. This project has leveraged the symbolic power of an international border to generate new ideas about fostering social inclusion and reducing stigma for people with dementia. It shows the importance of place and history, building relationships on trust and participation, and being flexible and responsive to opportunities for social innovation.

Most residential aged care facilities support residents to participate in activities and the importance of activities that are suited to individual preferences and abilities is widely acknowledged. Participating in activities, including those considered to be \'meaningful\' has the potential to improve residents\' quality of life. However, what makes activities meaningful for people living with dementia in residential aged care facilities is unclear. The aim of this study was to understand the key characteristics of \'meaningful activity\' in residential aged care facilities and the perceived value of residents participating in these activities. Using a qualitative study design, this study explored \'meaningful activities\' from the perspectives of people living with dementia in residential aged care facilities, their family members and staff. Across four residential aged care facilities, residents (n = 19) and family members (n = 17) participated in individual interviews while staff (n = 15) participated in focus group interviews. Interviews were recorded, transcribed and analysed using a qualitative content analysis approach. Participant responses suggest that the meaning of an activity is subjective, varying over time and between individuals. Key characteristics of an activity that makes it meaningful include being enjoyable, social and engaging, aligning with the persons\' interests, preferences, and abilities. To be considered meaningful, activities need to do more than occupy the person. The activity needs to be linked to a personally relevant goal and an aspect of the individuals\' identity. Participating in \'meaningful activities\' was perceived as valuable to encourage participation and socialising, provide a sense of normality for residents and improve their wellbeing. The findings of this study further our understanding of the concept of \'meaningful activity\' for people living with dementia in residential aged care facilities. Understanding the key attributes of \'meaningful activity\' can also provide practical guidance for those supporting people with dementia to participate in these types of activities.

This cross-sectional study investigates the associations among satisfaction with meaningful activities, and social frailty in community-dwelling Japanese older adults.
We analyzed data from 596 older adults (mean age 74.2 ± 6.4 years, female 63.6%) who participated in the Tarumizu Study 2019, a community-based health survey. Participants selected meaningful activities from 95 activities using the Aid for Decision-Making in Occupation Choice (ADOC) tool. Satisfaction was evaluated from 1 to 5, and those who were assigned a rating of 4 or 5 were operationally classified as the high satisfaction group (n = 487), with others occupying the low satisfaction group (n = 109). Both groups were evaluated based on the ADOC, social frailty (Makizako\'s five items), physical function, depressive symptoms, cognitive function, and higher-level competence.
Of the 596 participants, 18.7% showed prevalence of social frailty. The low satisfaction group had a significantly higher prevalence of social frailty (low satisfaction 28.4% vs. high satisfaction 16.4%, P = 0.004) and depressive symptoms (low satisfaction 30.3% vs. high satisfaction 17.9%, P<0.01), and poor higher-level competence (P = 0.026) than the high satisfaction group. Logistic regression analysis showed that social frailty (Odds Ratio 1.78, 95% Confidence Interval 1.068-2.990, P = 0.027) was significantly associated with satisfaction with meaningful activity after adjusting for covariates. We found no significant differences in categories of meaningful activities between the low and high satisfaction groups (P = 0.549).
This study suggested that social frailty was associated with satisfaction with meaningful activities, regardless of the degree or category of satisfaction.

We aimed to examine the feasibility and impact of a short-term occupation-based telerehabilitation intervention (Managing Participation with Breast Cancer (MaP-BC)) on daily participation, health-related quality-of-life, and breast-cancer-related symptoms and understand women\'s perspectives regarding strategies to manage daily participation and symptoms during COVID-19 pandemic. A mixed-methods study (single-arm pre-post with a qualitative component) included 14 women after their primary medical treatment for breast cancer. Women received six weeks of occupation-based intervention using a video-communication. Sessions focused on identifying functional goals and training strategies to manage daily participation. The primary outcome was perceived performance and satisfaction with meaningful activities by the Canadian Occupational Performance Measure (COPM). Secondary outcomes were participation in the Activity Card Sort (ACS), upper-extremity functioning of Disability Arm Shoulder Hand, self-reported symptom severity, executive-functioning, health-related quality of life, and a question regarding strategies used to manage daily participation. Women significantly improved their daily participation in meaningful activities in the COPM, most ACS activity domains, self-reported executive functioning, and health-related-quality-of-life. Qualitative findings revealed three main themes: (1) daily life under the threats of breast cancer and COVID-19, (2) women\'s own strategies to overcome challenges, and (3) contribution of the MaP-BC. Providing telerehabilitation during the COVID-19 pandemic is feasible and successful in improving women\'s daily participation after breast cancer.

To explore older care home residents\' experiences of maintaining a sense of purpose in life: a core component of psychological wellbeing.
Fifteen residents (9 female; 6 male), aged 60-95 years, from four care homes, were interviewed about their sense of purpose. Interview transcripts were analysed using inductive thematic analysis.
Theme 1 (\'Experiencing Loss\') comprises two sub-themes that describe the impact of age-related losses on residents\' sense of purpose (sub-theme 1) and the different responses that participants had to these losses (sub-theme 2). Theme 2 (\'The Protective Effects of Social Connections\') describes how social relationships could provide a sense of purpose, as well as the difficulties participants experienced in forming these relationships. Finally, theme 3 (\'The Roles of Activities\') describes the types of activities that could help residents to maintain a sense of purpose.
Care home residents experience losses and barriers that make it more difficult to maintain a sense of purpose. However, with appropriate support and opportunities, residents are able to engage in activities and relationships that provide a sense of purpose. To support residents\' mental health and wellbeing, care homes should offer varied opportunities for residents to engage in purposeful activities.