The St Matthews day centre is located in Ballyfermot, Dublin 10. The centre opens from Monday to Friday, from 9 to 5 pm and the catchment is located within the Ballyfemot, Inchicore and Palmerstown. The centre runs different programs including activities for older people. Two members of staff work at the centre including volunteers who come to do activities with older people. As far as the St Mathew's Resource Centre catchment is concerned, as earlier mentioned it is located within the Ballyfermot and Chapelizoid partnership area which are located approximately 4 miles (6.4km) to the west of Dublin's city centre. According to TSA Consultancy (2009, p.3), the two areas' population is approximately 23 870 with Chapelizoid hiving an older age profile of 18% .of the over 60s (TSA Consultancy (2009, p.4). It is stated that, 'out of the 2875 people that avail different services, 644 are older people Ballyfermot and Chapelizoid (TSA Consultancy 2009, p.3). This clearly shows that there is significant number of older people who need social engagement so as to increase their quality of life.
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'People are living longer lives and this rapidly changing demographic demands a restoration of social infrastructure, services provided for older people & more importantly, a shift in our attitude towards age'(Lankin 2012). Connolly (2012) pointed out that older people are important sources of volunteering which means they play very important roles such as grandparents, carers and advisors just to name a few and some people do not intend to see it that way.
Aims and objectives:
The aim of this study is to investigate impacts of older people engagement in Community day care centre activities focusing on the case of the St Matthews Community Day Care Centre, in Ballyfermot, Dublin 10.
In line with above stated aim, the objectives of this study are to find out what activities are being carried out in the St Matthews Centre.
Another objective is to examine what National and International policies have been put forward to encourage old people social interactions.
Also the study sets out to examine how older people participate in these activities and what are the benefits of this participation to their quality of life?
Research Question
What are the Impacts of Older People's Engagements in the activities of the St Matthews Day Care centre?
Rationale reasons
This research study has been undertaken because of my interests in older people's welfare as a result of my working experience with senior citizens when I volunteered to work with them at the Blackthorn Day Care Centre in the summer of 2011. During these sessions I was able to witness firs hand the problems which senior citizens face when not socialising through activities and the differences that engaging in activities made in the lives of the older people who were attending this centre. I thus realised that this particular area of study is worth researching because when the older people are forced to give up particular roles for example work this should be replaced with creative activities that can increase their social connectedness and this knowledge will build on and add to the existing knowledge and policies on creative activities with older people.
Chapter 2
Literature Review
Introduction
Review will focus on literature around older people. The research will examine policy around social inclusion and participation of older people in different day centre organised activities. The research will also explore recently published literature on older people's participation and the benefits of participation. The aim of this research is to explore the nature of activities for older people provided by a Community Day Centre. The review will focus on literature around older people, activities and community day centres. It will examine policy around participation of older people in different activities and social inclusion. Recently published literature, perception of and research around older people will also be examined.
Older people were selected because in Ireland as in other countries many elderly person live in their own homes rather than institutions and policy developers has adapted the principal of enabling them to live in their own homes for as long as possible (Gallagher 2010, p.307). Older people were identified as the target group because Age and Opportunity (2012) concluded within its findings that quality of life increases for older people with greater social integration and by providing opportunities to get involved. According to the Age and Opportunity (2012) 'Loneliness has become a problem for a significant minority of older people, with 11% of over 65s having been found to have minimal social contacts and a limited social network'. Older people from 65 years and over were chosen because they are determined by leaving the labour market (Walker 1999 cited in MaCann James 2009, p.35). Review will focus on literature around older people, activities and community day centres. It will examine policy around participation of older people in different activities and social inclusion. Recently published literature, perception of and research around older people will also be examined.
(Ronald Aday's 2003 report cited in Miltiades et al n.d) on identifying important linkages between successful aging and day centre participation states that an important goal of senior centres is to provide a social environment conducive to the development of a social support system. He went on to say that 'such social support system will reduce loneliness and depression, and enhance life satisfaction' (Ronald Aday's 2003 report cited in Miltiades et al n.d.). 'People do not often ask themselves questions like: 'What kind of old do they want to be?', 'what facilities would they like to have access to as they get older?' and "how do they expect to be treated by the rest of society?" and so on (Larkin 2012). He stated that often people including him often ignore or avoid such kind of questions and assume they will see when they get there.
According to Miltides et al, (n.d.) it is projected that by year 2035 over fifty percent of Western Europe's population will be over the age of 65 years.
2.1. Definition of Concepts
Ageing: What is old?
According to Phillips et al (2006, p. 9) mostly the definition of age seems to differs across cultures.
For example; 'old age in Bosinia is not linked to chronological age or how someone looks or physical appearance: it is 'loss of power' for the people from Bosinia (Vincent, 2003, p. 15 cited in Phillips at al 2006, p. 9) and they will be referring to both physical and social strength'.
'Old age is determined by leaving the labour market at 65 thereby a person is entering old age' (Walker 1999 cited in MaCann James 2009, p.35). It is increasingly acknowledged that the older persons are a mixture of age group from the age of 65 and upwards which results in young elderly being fit, active and live independently (Gallagher 2010, p.307).
'For the psychologist Erick Erickson (1986), old age or 'later life' involves the stage of 'integrity versus despair' (MaCann James et al 2009, p. 36). This is where a person tries to experience a sense of wholeness and acceptance of their life and the choices they have made. She pointed out that people's definition of 'old age' tends to be closely related to their own age and is almost never below it (MaCann James e al 2009, p. 36). According to (Rowe and Khan 1987 cited in MaCann James et al 2009, p. 37) successful ageing is characterised by active involvement in life and living, high cognitive and physical functioning and being free of disability and disease.
2.2. Community Day Centre.
The main objectives of community day centres as set out in 'The Years Ahead' report (Department of health 1988 cited in Share and Lalor 2010, p. 312) were to provide services such as midday meals, a bath, physiotherapy, promote social contact among older people and prevent loneliness. Another aim was to relief family carers particularly those who have to go to work. The other important objective was to provide social stimulation in a safe environment.
'Because all communities are unique, older people in each community will have unique needs and their community centres should provide unique services to meet their needs' (Miltides et al, n.d. p. 17). In a research carried out by Miltides et al, (n.d. p.17) has shown that the definition for community centres has remained consistent since 1979, with the same concept still being vital on the development of programs and services. They offer a variety of programs to serve many needs of older people adults. These may include health programs, meals, recreation, socializing and financial assistance. Today community centres follow the beliefs of activity theory model of participation and this means that social and physical activities are expected to be rewarding among older adults (Miltiades et al n.d.). (O'Shea and Connolly 2003 cited in MaCann James et al 2009, p. 37) noted that 'The healthy Programme', can play a major role in this regard by acting as a important resource to support voluntary groups in achieving best practice in the operation of health ageing projects.
In Ireland there are different types of community day care services for the elderly. They are classified as: day care centre, day centre, social club and dementia -specific day care, according to a report by the National Council on Ageing and Older People on the development of day services (Haslet 2003 cited in Share and Lalor 2009, p. 31).
Day Care Centre
Day care centres provide a mixed model of care which means they provide a range of medical, therapeutic and social services, such as nursing, physiotherapy, bathing and chiropody (Gallagher 2009, p. 312). This is important particularly for older people who need continual care and minimum mobility (Gallagher 2009, p. 313). The people who work in these centres are mainly health care professionals who provide support on independent living and to give respite care. Most referrals are done by the public health nurse. For this reason this research will focus principally on community day centres whose activities are basically social services instead of involving the medical model of care.
Day Centres
(Gallagher cited in Share and Lalor, 2009, p.173) points out that these centres are mainly grant aided by HSE. They are managed locally by voluntary or parish groups. The main focus is on the provision of social and recreational activities as well as provision of meals. However, as Haslet ( Haslett 2003 cited in Share and Lalor 2009, p.173) points out while these centres' activities were initially for social services, due to inadequacy of the provision of day care centres with the mixed model of care within communities, the HSE has encouraged the incorporation of some of the day care centre activities into the day centres with the inclusion of services for ( For example the inclusion of services for physiotherapy, medical services and chiropody. Thus the Social/Day Centres are now providing increasing levels of services in the areas of personal care, paramedical treatment and even nursing'. Consequently Day Centres and Social Clubs have expanded due to the shortage of Day Care Centres. Haslett (2003cited in Share and Lalor 2009 p.175) observed that that day centres are hugely beneficial to many different categories of older people. She went on to say 'the social capital gain achieved through mutual support, co-operation, empathy and trust is huge and very real (Haslett 2003 cited in Share and Lalor 2009, p. 167). This means that the network of caring that the older person gets from other members of the parish committee, volunteers, drivers, managers, care staff etc is hugely beneficial to them in many ways in the long term.
Some old people's activities can be recreational and some are physical activities that the older people can undertake to increase their physical strength, flexibility and endurance for example walking, stretching cycling, and activities that may involve camping as a group (Chobharkar 2011). There are also social activities that involve just being in company of other people and they are normally done for pleasure (Dogra 2011).
Older people's minds can be kept sharp and alert by game activities because it involves social interaction, a very inexpensive form of entertainment and at the same time delaying or reducing the risk of age related dementia (Hurley 2013). She also pointed out that, that 'at any age playing games is healthy for the mind and body and because games can keep the brain active' (Hurley 2013). Studies have shown that playing games could help prevent Alzheimer's disease and dementia, so playing games could actually allow older person to live longer (Woolman 2013).
Other activities that are fostered in the centre are Arts and Crafts. Art and craft extends far beyond the creation of an object for many older people. Research has shown that many older people who live alone find making crafts an enjoyable activity and at the same time it helps them to be active as it involves using their hands, for example moulding clay. It also them helps to exercise their hands and fingers.
Benefits of activities
The relations between overall activity level and psychological well-being have been found to be significantly positive for example Markides and Martin 1979 cited in Warr et al 2004, p.173) and (Jahoda 1958 cited in Warr et al p.173) point out that, "an activity is often accompanied by the successful achievement of personal goals; goal setting and goal-achievement which are essential aspects of good mental health, self-validation and a sense of competence". Another example observed by, (Holahan 1988 cited in Warr et al p.173) "states that goals have an indirect effect on older people's psychological well-being through their behavioural expression in activity". This study shows that activities are almost all positive and they tend to yield the rewarding outcomes to which they are directed, with potentially positive contributions to psychological well-being of older people.
This research study is anchored on the activity theory of ageing, which was developed by the symbolic interactionists (Coon and Mitterer 2010, p. 141). The theory states that 'a decrease in social interaction that occurs with age is the result of a withdrawal of society from ageing people and most older people do not want this withdrawal'(Coon and Mitterer 2010, p. 141). Therefore, according to this theory, older people who are aging optimally stay active and resist shrinkage in their social world. They maintain activities of middle-age as long as possible and then find substitutes for work.
Activity theory is the idea that a high level of activity enhances personal satisfaction in old age and various activities help build social identity (Coon and Mitterer 2010, p. 141).
As (MaCann James 2009, p.37) explains, older people have identified two main features of aging in literature. These are, rest and relief formal working life, and the fact that governments can provide Research has shown that financial and other forms of state assistance to the old. She thus defined active ageing as 'a process of optimising opportunities for physical, mental and social wellbeing throughout life in order to extend health life expectancy, quality of life and productivity in older age'.
Loneliness.
'Loneliness is defined as 'the negatively perceived difference between the relationships one has and the relationships one would like to have' (Fokkema and Knipscheer 2007, p. 497). That is personal standards regarding relationships, 'it is not so much a matter of the number of relationships, or a lack thereof, but rather a lack of quality in the relationships people have' (Ibid.). However in this case the loneliness is based on social loneliness which is also related 'to deficient social integration, a lack of contact with people with whom one shares certain common traits, such as friends' (ibid) As far as loneliness is concerned Fokkema and Knipscheer (2007, p.503) observe that the use of internet by older people can "help in reducing loneliness by improving …[the lives of older people who participate in this activity]… by improving their social life and distracting them from their loneliness experience.
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Lonelines otherwise known as disengagement reduces satisfaction and meaning in older people's lives. The participation and involvement of the older people in the different activities give them the opportunity to interact with other people. The activities are provided by the different sectors to include the formal support networks such as the church, the local government unit, and the civil society organizations; and the informal support networks such as their family, relatives, friends and neighbours.
'Once retired from your full-time day job at the age of 55 or 60, you might think it would be great to lie around for the whole day watching TV or listening to your favourite songs. But one week from your retirement you will realize that it's not as much fun as you thought. Being a human you are a social animal, and you will crave to be doing something out there with friends or family instead of sitting around alone at home' Chobharkar (2011)
Balle, (2012) states that in most cases, getting an elderly person to be involved in some type of activity can help improve both quality of life and mental functioning. The increasing share of older people in the population is a fact and a challenge to social and health care services and creative activities (Coon and Mitterer 2010, p. 141). Longer life expectancy will produce a unprecedented increase in the percentage of the population older than 65 and the 'boom' is expected to start about now and peak by 2030 to 2050 (Taeuber 1993 cited in Coon and Mitterer 2010, p. 141).
Quality of Life increases with more social engagement
According to Age Opportunity (2012) loneliness has become an important problem for a significant minority of older people with 11% of over 65s having been found to have minimal social contacts and a limited social network. Studies have shown that quality of life increases with greater social integration and by providing opportunities to get involved the issue of loneliness among older people could be resolved.
Ageing population in Ireland.
In Ireland as in other countries many older persons live in their own homes rather than living in institutions. In 2012 the population of the 65 and over age group was 535,393, an increase of 14 percent from 467,926 in 2006(Central Statistical Office 2012). (Larkin 2012) points out that people do not often ask themselves questions like: 'What kind of old do they want to be?', 'what facilities would they like to have access to as they get older?' and "how do they expect to be treated by the rest of society?" and so on.
Often people ignore or avoid these questions and assume they will see when they get there. Dominic Campbell, Artistic Director of Bealtaine asserts that, by 2035 over 50% of the population of Western Europe will be over the age of 65" (Lankin, 2012). 'People are living longer lives and this rapidly changing demographic demands a remodelling of social infrastructure, the services we provide for older people and more importantly, a shift in our attitude towards age'(Lankin 2012). Connolly (2012) points to the fact that older people are an important source of volunteering which means they play vital roles such as grandparents, carers, mentors just to name a few and society tends not to see the significant value of these senior citizens. There is the need to to engage them to fulfil good quality of life and be valued.
Irish Policy/Legislation/Regulation Framework
As Connolly (2012) observes, policy makers view ageing as problematic because of the associated financial burden that the state has to undertake in order to keep these pensioners going Connolly (2012) further points out that, while these challenges exits new approaches are needed to address the realities because there are also significant benefits to be gained from older people (Connolly 2012).
The National Action Plan for Social Inclusion 2007 - 2016 published in February 2007 and states that "community care services are essential to enable older people to maintain their health and wellbeing, in order to live active, full independent lives, at home for as long as possible" (Barry 2010). This is relevant to the state because when older people are supported to participate in activities it gives them a feeling of control over their lives as well as that feeling of control contribute to mental and physical well-being. However, this policy framework provides criteria for eligibility and this hinders some retirees to engage in these activities.
A more recent national policy document entitled 'Towards 2016', the 10-year framework, sets out a vision for older people and is agreed by the social partners that set out a national plan for 2006-2015. One of the high-level goals it sets out is as follows: 'Every older person would be encouraged and supported to participate to the greatest extent possible in social and civic life' (Department of the Taoiseach, 2006, p. 60 cited in Age Opportunity 2012).
'The National Action Plan for Social Inclusion 2007 - 2016' published in February 2007 and states that "community care services are essential to enable older people to maintain their health and wellbeing, in order to live active, full independent lives, at home for as long as possible" (Barry 2010). Older people are supported to participate in activities as it gives them a feeling of control over their lives as well as that feeling of control contribute to mental and physical well-being. It clearly shows the principle of enabling older persons to live in their homes for as long as possible is central in Irish welfare policy. There are a number of services that provide meals on wheels, home help and other form of adult day care to facilitate this.
Positive intervention to engage older people's social activities
(Novak 2006, p. 20) pointed out that intergenerational programmes in schools are good because they reduce discrimination, negative attitude towards aging and social contact between the older and the young people (Novak 2006, p. 20).
Conclusion
This literature has explored the various activities that already exist in different day care centres that have contributed to the quality of life for the older people in general. After all the research and studies, policies and strategies by all experts the uniqueness of this study will have significant for planning for structured centre activities that is diverse.
Chapter 3
The Research Methodology
Research methods
Qualitative research methods allow opportunities for subjective meaning to be clarified rather than getting exact answers to specific questions (Creswell 2003, p. 21). Engel and Schutt (2005, p. 41) point out that qualitative methods can refer to several research designs, for instance participant observation that involves gathering data by developing a relationship with the people while they do their normal activities. Intense interviews are those that involve open-ended unstructured questions in which the interviewer seeks in-depth information on the interviewee's feelings, experiences and perception (Engel and Schutt 2005, p. 41).
Research design deals with how the researcher conceptualizes the entire research process. It is 'the logical sequence that connects the empirical data to a study's initial questions [leading] to its conclusions' (Yin 1994, p.28).
This involves the particular research approach to be used as well as the research processes (Gibson and Brown 2009, p.48). This study is a single descriptive qualitative case study. According to Yin 2009 cited in Kiriakidis (2011, p. 69) 'a case study is used to contribute to understand a group or an organisation'. In this sense the researcher will seek to answer some how and why questions in relation to one particular organisation. As (Baxter and Jack 2008 cited in Kiriakidis 2011, p 69) explain that 'this type of case study is used to describe an intervention or phenomenon and the real-life context in which it occurred. Using qualitative research methods allows one to explore attitudes, behaviour and experience through interviews or focus groups in an attempt to get in-depth information from participants (Dawson 2009, p. 14).
This model of this inquiry as indicated above is a single descriptive qualitative case study. A 'case' is 'a phenomenon of some sort occurring within a bounded context in this case it can be an individual, a professional role, group, an organization, a nation, a policy, a process, an incident or event of some sort' (Yin 2009 cited in Kriakidis 2011, p. 69). It is a unit of analysis which gives the researcher the opportunity to 'investigate and understand the case in depth, in its natural setting, recognizing its complexity and context' and allows for a holistic and detailed analysis of the case which other research methods ignore (Punch 1998, p.153). As Creswell (1998 p.153) explains, a qualitative case study is a 'bounded system', It is bounded by space and time (Creswell 1998, p.37).
The Context
In the context of this study which focuses on older people's engagements in community day care centre activities, the case study is St Matthews Community Day Care Centre which is situated in Ballyfermot in Dublin 10. The context is the engagement of old people in activities organised by the centre. The centre is a Family Resource Centre for the community of Ballyfermot. The researcher chose this centre because there is relatively little data available that can tell us how important these organised centre activities are to the health and well-being of the older adult or senior citizens growing population.
In relation to this research, a semi - structure interview method will be used allowing; (1)why they decide to attend the centre and (2) expectation of activities to act as guiding topic but with the discussion directed by the participants. Much research in relation to older people tends to focus more on the expert opinion of what is considered to be quality of life rather than gaining the views of an ordinary person (Bond and Corner, 2004, p. 42). Therefore interviews within qualitative method will allow for the contribution of older persons' opinion. The researcher will use a participatory research method.
Data Collection Tools
The data collection tools that will be used in this study will include: documents, use of technology, interviews and observations and the internet. Data collection from documents includes the use of both primary and secondary sources of information. The primary sources that have been used in this research include government reports on aging and community facilities for the old. The secondary sources include: books, especially on senior citizens academic research articles as well as internet sources. These sources of information are within the public domain and can be easily explored. But care has been taken to select appropriate content that deals with the study thesis because internet data often contains some content that is not of direct relevance to the specific research question or questions.
Technology: In addition to documentation, the researcher has used audio technology for voice recordings during interviews to gather the necessary information.
Other sources from which data has been collected for this study include interviews and observations. As Stake (2005, p.453) holds, 'the qualitative case researcher seeks to know what is happening in ordinary organisational settings. Although in the course of the inquiry process the researcher will attempt to reduce the gap between the researcher and the participants. It is obvious that researcher will remain the seeker of knowledge in the inquiry process and the participants the holders of the knowledge that the researcher is seeking to acquire.
Thus the interview and observation methods are also necessary for this study because the reality or knowledge which the researcher cannot see will be obtained by interviewing and observing the older people (participants) from the natural settings in which these social activities are occurring. The use of interviews in the course of this study will enable me to gain greater insight from the key actors or players in St Matthews Day Care Centre. That is the Old People and the Centre staff who are involved in developing the activities which these old people are engaged in. These interviews will enable me to have a closer picture of what is going on within the centre. The interviews it is hoped will be able to produce a picture of how the old people are participating? What are the types of activities they are engaged in? How do they feel about their engagements in these activities? In this light I have used semi - structure interview questions to method will be used allowing; what is their experience in attending the Day care centre? Why they decide to attend the centre? These interviews will thus allow for the contribution of older persons' opinions in relation to their engagements in the centre activities.
Information for the study will also be collected through observations. Observation is a method of collecting research information whereby the researcher immerses his or herself into 'the research 'setting' so that [he or she] can experience and observe first hand, a range of dimensions in and of that setting' (Mason, 2002, p.84). As Mason (2002 p.84) holds, observation has many features. 'It can be 'social interactions, behaviour, relationships or events; it can be spatial locational, or temporal and its frame can be experiential, emotional and bodily dimensions'. The use of observation will be necessary in this study because it will allow the researcher to witness first hand, how the old people in St Matthews interact in the various activities within the centre.
Other Data Collection and analysis tools
This research will also use other research methods like quantitative method to collect data where necessary. Such methods will be used to complement evidence collected from other qualitative methods. However, this research is principally a qualitative case study.
The analysis in this research will involve transcribing and discussing interview texts as well as connecting the contexts with explanations and interpretations that give a clear picture of what is happening in the St Matthews day Care centre in relation to the activities organised and the importance of these activities to the participants. This will involve naturalistic descriptions, interpretations, explanations, narratives and analysis of the information collected. It will involve a detailed description and explanation of the case which involves what (Stake 2005, p.450 cited Gibson and Brown 2009, p.8) call 'a thick description' which means providing details that outline the details of the context of people's actions and practices so that they become intelligible in their own terms'(Gertz, 1976 cited in Gibson and Brown, 2009, p.8).
Access
Access to participants was pursued by contacting and meeting the Manager of the Ballyfermot/Chapelizoid Partneship. She further referred me to the manager of St Mathew Family Resource Centre where they run activities for the elderly. The researcher chose to observe the participants by becoming part of the group organisation to
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