Associate Professor Tim Windsor

College of Education, Psychology, and Social Work, Flinders University

What makes an activity meaningful? For me, one of the great pleasures of summer is listening to test cricket on the radio. Although there are many cricket fans in Australia, many others would just as soon watch paint dry. My wife is a keen gardener, and while I appreciate a nice garden, I find the actual doing of the gardening to be a bit of a chore (sorry Costa). It’s not that I find it unpleasant, I just prefer to be doing other things. 
We all know that different people find varying degrees of meaning in different activities. After all, one man or woman’s trash is someone else’s treasure, and their meat is also someone else’s poison, unless they are vegetarian and possibly British in which case it’s not their cup of tea. People’s preferences for activities arise from a complex blend of cultural and family influences, traditional gender roles, socioeconomic factors, exposure to different opportunities and influences, personality, and pure chance. The kid who grows up in Coogee is more likely to develop an interest in surfing than the one who grows up in Renmark. Later in life, the degree of pleasure and meaning that we derive from an activity is dependent on a long personal history of interests and experiences, our goals for the future, and our degree of openness to new experiences. [1] Best practice in aged care appropriately takes a person-centred focus, tailoring activities in ways that provide a fit with the needs and preferences of individual care recipients. [2]   
Given that different people are attracted to different activities, are there ways that we can (a) enhance the extent to which activities provide participants with a sense of meaning, and (b) design aspects of activities in aged care settings that will increase their wider appeal to residents? According to psychological viewpoints, the answer to both questions is ‘yes’. 
One prominent perspective that has gained extensive empirical support across a wide range of contexts from educational settings to work contexts to sporting endeavours is self-determination theory. [3] At its core is the notion that human motivation and well-being are sustained through the satisfaction of three basic psychological needs for autonomy, competence, and relatedness. [4] Applying this lens to activity programs could add a useful element to frameworks used to review best practice, enabling identification of areas where existing programs could be tweaked or revised, and providing principles that can be used to underpin the design of new activity-focused initiatives.

Autonomy

From a self-determination perspective, autonomy refers to having the capacity and opportunity to exercise choice over the things that we do. One of the greatest concerns people have about getting older is a loss of independence arising from increasing functional limitations, sensory losses and/or cognitive decline. This ties in directly with the notion of frustrated autonomy needs resulting from ageing. [5] Fortunately, many older adults can maintain autonomy despite ageing-related losses through flexible processes of goal adjustment. [6] This means being able to let go of goals that become unattainable and re-engage with new goals that provide a better fit with a person’s available resources. For example, when arthritic knees make playing golf too difficult, a formerly keen golfer might retire from golf and re-invest their time and energy into playing bridge.

In the aged care context, fostering autonomy through activities is about allowing care recipients choice in terms of which activities that they participate in, and opportunities to shape the course of those activities. For example, while the opportunity for people living in residential care to attend a music concert is likely to be a welcome event, autonomy needs might be better met for at least some residents through a music program that encourages singing participation and enables those involved to choose the songs that are sung together.

Competence 

The need for competence refers to the desire to experience a sense of mastery in the activities we do- to know we have a certain set of skills and to have the confidence that we will be able to apply them in reaching our goals. Activities most likely to support competence needs will either be (a) familiar activities that draw on a lifetime of skills, or (b) new activities that are set up in such a way that enable participants to acquire new skills and recognise their progress. For example, a well-run art program with a good teacher will give experienced artists access to the tools they need to express themselves in ways that tap into their lifetime of experience. But it will also have the scaffolding and guidance needed to help the novice artist grow, supporting their development of new skills, thereby contributing to the fulfilment of competence needs.  

Relatedness

Humans are fundamentally social creatures, and the need for relatedness recognises the extent which we need warm supportive relationships with others to feel good. Many activity-focused programs are inherently social, involving groups of residents, or older adults living in the community being brought together to engage in activities. Sometimes simply bringing people together is the goal, especially for those living alone in the community. Given that many activity programs are already social in nature, how might the notion of relatedness as a basic psychological need inform practice? While social engagement is vital it can also be a double-edged sword, with unpleasant social interactions representing a significant, and common source of stress. [7] Therefore, as we bring people together, we need to be conscious of ways to minimise communication difficulties or potential sources of conflict and establish strong, supportive, respectful, and inclusive group cultures that include staff, residents, volunteers and informal carers both within and outside of the context of organised activities. 
Across the sector, lifestyle coordinators, local councils and many others are currently doing great work in organising activities from a person-centred perspective that enrich the lives of older residents and community care recipients. My hope is that this blog piece can stimulate some new ways of thinking about activities that can lead to even better support for the psychological needs of those receiving care and the staff providing it.

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.